Home and Garden - Kitsap Living - Winter 2017 by Sound Publishing

KITSAP

HOME, HEALTH AND WELLNESS IN KITSAP - WINTER 2017

Human Touch The benefits of massage

Dining Out Making healthy menu choices

Fresh Fitness Popular forms of exercise in 2017

Eating Well

How to stay healthy when dieting

A SUPPLEMENT OF THE BAINBRIDGE REVIEW , BREMERTON PATRIOT, CENTR AL KITSAP REPORTER, NORTH KITSAP HER ALD AND PORT ORCHARD INDEPENDENT

KITSAP LIVING WINTER EDITION

JANUARY 27, 2017

OTICON OPN - Hearing Breakthrough in Diﬃcult Situations

Traveling with a large group of teenagers can put quite a strain on us, especially those of us with a hearing issue, which I do. I am Dr. Megan Nightingale of Peninsula Hearing, Inc. with oﬃces in Poulsbo and Port Townsend. Allow me to tell you a story about a trip I took with my husband, our son and 29 other teenagers this past summer.

Being a chaperone meant that we were responsible for many students. Being as short as I am, I could not see the teens we were responsible for; I had to rely on hearing their voices in a crowd and I could easlily do that with the OPN’s on. Without them (I forgot to put them in one day), voices were just a blur in a crowd and I felt ashamed when I could not answer questions from the other people on tour with us. f

We found ourselves in large groups listening to tour guides and riding on busses with our tour guide speaking through the onboard sound system, and as we all know, young people tend to talk fast and are not particularly patient. So, I needed to know I could keep up with the conversations. The hearing devices I had were very good in most situations, but I still had a hard time hearing in background noise, like most people with hearing diﬃculties.

One situation put us in a restaurant with 400 students from around the U.S. We were in a large room with long tables around a stage. It was very loud, most especially when the entertainers were on stage! You can see the video on our Facebook page or on our website to hear what it was like. www.facebook.com/Peninsulahearinginc http://www.peninsulahearing.com/opn

Just before we left, my professional team and I had the opportunity to learn about a new hearing device that was just coming out and had been years in the making. To say that this device, the “Oticon Opn is technogically beyond any other device available today is an understatement”, they told us; but those are just words. How they perform out in the real world is what matters. So, I set myself up with a pair of OPN’s and put them to the test. There were two major diﬀerences I noticed about these new OPN devices I want to sha with you; I could keep up with the teens on share our tour and I could have easy conversations with relative strangers in background noise!*

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KITSAP LIVING WINTER EDITION

JANUARY 27, 2017

Eating right

Make sure you stay healthy when you are dieting NUTRITIONISTS PROVIDE THESE GUIDELINES: IMPROPER NOURISHMENT: Your body needs a certain amount of calories – the basic energy unit of the body – to function. Almost all foods have at least some calories, but not all foods have the proper nutrients your body needs. Sugary snacks, for instance, are often high in calories, but they are “empty calories,” meaning they have none, or very little, of the important nutrients, such as vitamins and minerals, that you need. Not getting enough nutrients can result in malnutrition. Mild symptoms of malnutrition include dizziness, fatigue and weight loss. In severe cases, symptoms such as hair loss, fainting and lack of menstruation can occur.

By LESLIE KELLY

lkelly@soundpublishing.com

It’s a big temptation, after eating yourself through the holidays, to want to crash diet. But nutritionists, including Anita Bermann of Bainbridge Island, say that will only lead to more problems. Bermann, who owns Ideal Feast Nutrition, tells her clients that fad dieting — juicing, liquid diets and cleansing — can bring on health issues such as anorexia, bulimia, osteoporosis, pancreas problems, heart issues and diabetes. “Radical diets are not sustainable,” she said. “They don’t last. You become weak and fatigued and you go off that diet. Then you begin to feel like a failure.” Instead, she suggests that if you was to lose weight, read the labels on the food you are eating. “Processed food can negatively affect you,” Bermann said. “Look for fresh vegetables, fruits and lean protein.” She also warned against diets that totally eliminate things like fruit or bread. “On diets where you have no carbs or sugars, you ultimately will begin to crave those things,” she said. “What you need to do is limit those things and make good choices.” For example, she said, look for whole grain breads. They are healthier and will make you feel fuller faster. And speaking of that, she teaches something called “intuitive eating.” “When we are babies we eat when we are hungry,” she said. “That’s the natural way to eat. Regional publisher: Terry R. Ward General manager/advertising: Donna Etchey Display Advertising: Sharon Allen , Marleen Martinez, Bill McDonald, Ariel Naumann, Stephanie Lavin Managing editor : Richard Walker Special publications editor /writer: Leslie Kelly Staff Writers : Terryl Asla, Michelle Beahm, Sophie Bonomi, Mark Briant, Luciano Marano, Sara Miller, Nick Twietmeyer Creative services manager: Bryon Kempf Artists: Vanessa Calverley, Mark Gillespie, John Rodriguez, Kelsey Thomas

As adults, we often eat because the clock says it’s time to eat. We need to be in touch with our own hunger and fullness signals.” The focus should be learning how to tell when you are truly hungry and knowing when you are full, she said. “Our bodies are meant to be fueled every few hours,” Bermann said. “So eating small meals throughout the day can be a way to keep hunger at bay.” When crash dieting happens, the dieter often times doesn’t get enough vitamins and begins to feel sluggish. “And they become susceptible to disease and infection because their immune systems is weak,” she said. In order to diet safely, she suggests doing some research first. “If you can’t afford to see a nutritionist, look online. Figure out what a balanced diet is – for you – and how much food intake is safe.” She suggests the Academy of Nutrition website at www.eatright.org. In the first few days of your diet, think about when you truly are hungry and when you are full.

According to the Centers for Disease Control and Prevention, 35.7 percent of adults and 17 percent of children are obese. Obesity puts stress on every part of your body and increases your risk of developing major health problems, including heart disease, Type 2 diabetes, high blood pressure, stroke, liver disease, infertility and sleep apnea. TYPE 2 DIABETES: Obesity is one cause of Type 2 diabetes, but another is unstable blood sugar levels. When you consume a lot of refined grains and sugar-rich foods, your glucose levels spike and drop repeatedly. Over time, these dramatic changes in your blood sugar levels can lead to insulin resistance, which is characterized by a decreased sensitivity to insulin. If this condition is not corrected, it can advance to Type 2 diabetes. HEART DISEASE: Unhealthy foods are often high in sodium, fat, cholesterol and sugar. Eating these unhealthy foods on a regular basis can increase your blood pressure as well as your cholesterol and triglyceride levels. Over time, high blood pressure and high lipid levels can put a great deal of stress on your heart, increasing your risk for heart attack, stroke and coronary artery disease. Source: Bermann at www.idealfeastnutrition. com, Harvard School of Public Health, Centers for Disease Control

DISEASE: If you body doesn’t get enough of the proper nutrients, particularly antioxidants, your immune system will feel the effects. A weakened immune system makes you susceptible to ailments, such as the flu or common cold. Lack of proper nutrients can also affect your major organs, leading to or contributing to a variety of ailments. For example, one common problem that results from a diet high in sugar and processed carbohydrates – a complex form of sugar – is that your pancreas can become overworked. The pancreas produces a hormone called insulin, which helps break down sugars in the body. If you body doesn’t utilize insulin properly, a diet high in sugars causes insulin production to increase exponentially, which can lead to the pancreas eventually shutting down or limiting insulin production – a condition known as Type 2 diabetes. When untreated, Type 2 diabetes often leads to other problems, including fatigue, increased hunger and thirst, blurred vision and erectile dysfunction. NUTRITIONAL DEFICIENCY: Most vitamins and minerals are found in whole foods, such as fruits, vegetables and lean meats. Neglecting to include these foods in your diet can lead to nutritional deficiencies.

“Listen to your body,” she said. As for breakfast being the most important meal of the day, she subscribes to regular meals throughout the day as the most important. “But if you skip breakfast, you are allowing your body to go without food and fuel for too long,” she added.

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KITSAP LIVING WINTER EDITION

JANUARY 27, 2017

Deliberate dining Eating out doesn’t have to be a diet-breaker

By LESLIE KELLY

ORDER A SALAD before eating anything else on the menu. This will fill you up some, so you won’t eat as much of the main course.

lkelly@soundpublishing.com

Suzanne Martinsmith has a sure way to find a healthy place to take her family when they eat out.

CHECK THE ONLINE MENU before you leave home. Make the decision then about what you are going to order based on what is healthy.

“Look for places that are home-owned, not part of a chain,” she said. “Those places are more likely to make their own food from scratch and that means fewer – or no – preservatives.”

SKIP FANCY DRINKS TOP A BAKED POTATO WITH VEGGIES from the salad bar. Avoid the butter and sour cream.

Martinsmith, who owns the Home Made Cafe in Port Orchard, thinks the preservatives and the fructose used in pre-made foods is a big cause of unhealthy eating, at home and out.

ORDER FISH. Just not fried fish. Seafood should be ordered steamed, baked, broiled sautéed, blackened or grilled to keep the calorie count lower.

At the cafe she owns with the life partner, Paul Robinson, everything they serve is made by hand, sans a few kinds of breads, and they cater to those with special food needs.

DRINK PLENTY OF WATER throughout the meal. It will slow your eating down and let the message get to your brain that you’re full before your plate is empty.

That brings us to another thing about eating out the healthy way.

SKIP THE DESSERT. Or have a sorbet. Stay away from the triple chocolate cake.

“Don’t be afraid to ask for your choices to be made the way you want it,” Martinsmith said. “In locally-owned restaurants, they expect that. That’s why they don’t make your food up ahead of time. They wait until the order comes in.”

When eating out, try these healthier options:

When eating breakfast at a sit-down restaurant, and when watching the calories, eat omelets. “Especially the veggie ones,” she said. “They have lots of vitamins and protein.” As for lunch, she suggests soups and salads, or maybe their “Debbie’s Tuna Salad,” which is served on a bed of lettuce. “Keep it light with a balsamic dressing,” she

said.

restraint.

Many restaurants serve bottled dressings, not homemade, and they all have preservatives and bad sugars, she added.

“Here, we serve big portions,” she said. “So ask for half of it to go and take it home. How much you eat is up to you,” she said. “It’s time to stop blaming the restaurant for that.”

Another suggestion from Weight Watchers is to always ask for the dressing on the side. Dip your fork in it and then eat. Martinsmith doesn’t really have a list of “nevers” when eating out. She said you can even eat fried food, but ask for it to be cooked in healthy oil, such as olive oil. As for other things, she said the key is have

Other suggestions from nutritionists are: ASK FOR TRIPLE THE VEGETABLES, to replace the starchy carbs. ORDER FROM THE HEALTHY, LIGHT, LOW FAT ENTREES ON THE MENU. Check the calorie count, which by law, should be available at every restaurant.

TACO TIME, a local chain that buys ingredients locally and cooks without preservatives, Martinsmith said. GREENS ON YOUR WAY, with locations in Poulsbo and Silverdale. Here you can drive up and take a salad with you. Options include Caesar, Chef’s, or Cobb. Order online ahead of time and save time. ANOTHER OPTION, Jake’s Pickup on Bainbridge Island. Try the organic greens with smoked turkey or salmon. There’s also Mom’s Tuna Salad and eggs for breakfast cooked-to-order.

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JANUARY 27, 2017

Get moving with the kids Don’t let them become ‘couch potatoes’

By LESLIE KELLY

lkelly@soundpublishing.com

OK. So it is cold outside. That doesn’t mean you and your children have to stay inside. There are plenty of winter-time outdoor activities for kids. And there are some great ways to keep active inside, too. TAKE A HIKE. According to state and county websites these are some of the best outdoor winter hikes for kids: Clear Creek Trail in Silverdale. There’s a paved trail and an interpretation center to learn about the nature and history of the area. There are places to picnic and plenty of parking off Bucklin Hill Road. To map out your visit go to www.clearcreektrail.org. Classes and volunteer opportunities are also available. Grand Forest Trail on Bainbridge Island. It’s a easy day hike for kids at approximately two miles. Grand Forest Park Trail is a 2.8 mile heavily trafficked loop trail that features a lake and is good for all skill levels. The trail offers a number of activity options and is accessible year-round. Dogs are also able to use this trail but must be kept on leash. Point No Point, near Hansville. This hike is about a mile and a half long and includes the opportunity to see the Point No Point Lighthouse, and a “sugar and sand” beach (rocks and sand.) There’s a beach walk where kids can collect shells, driftwood and rocks. Or try Foulweather Bluff, a one-mile beach hike, with a beach that’s covered in driftwood. The hike to the beach is through a Douglas Fir and cedar forest, and it’s located two miles northwest of Hansville on the Kitsap Peninsula. For more on any of these and other trails, check out www.visitkitsap. com, which will take you to local, county and state parks throughout the county. GO ROLLERSKATING. At Bremerton Skateland, there are family skating times at 6:30 p.m. on Thursdays, and open skating at 10:30 a.m. and 7 p.m. Saturdays, and 1 p.m. and 7 p.m. Sundays. Skating is a great activity and according to wellness.com, a person weighing 100 pounds, will burn 252 calories an hour with active roller skating. To learn more, go to www.Bremertonskateland.com, or call 360-479-roll. Skateland is located at 1740 N.E. Fuson Road, Bremerton, phone 360479-7655. NOTHING’S BETTER THAN AN INDOOR PLAYGROUND. And at Ahoy Kitsap, that’s just what you’ll find. There’s open play from 10 a.m. to 5 p.m. Monday, Tuesday and Saturday, and from noon to 5 p.m. on Sunday. The indoor playground that resembles a pirate’s ship, is open Wednesday, Thursday and Friday until 7 p.m.

playallstar.com. All Star offers an arcade for kids full of fun games to play and a great lunch counter/diner for a snack or meal before or after bowling. The alley is at 10710 Silverdale Way NW, Silverdale, phone 360692-5760. Hi-Joy Bowl has open bowling every day of the week, including Sunday through Thursday from 8 a.m. to midnight, and on Friday and Saturday from 8 a.m. to 1 p.m. Rates are $3.50 per game per player, or $4.50 on Saturday and Sunday. There is a kid’s club with youth bowling at 9:30 a.m. Saturday. For more information go to www.hijoy.com. This 32-lane bowling alley is the most iconic bowling lane in the county at 1011 Bethel Ave., Port Orchard, phone 360-876-8111.

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This is the county’s destination indoor children’s playground at 5934 Highway 303 NE in Bremerton. Cost to play is from $6 to $10, based on the age of the child. Call 360-479-7529 or go to www.ahoykitsap.com for more. LET’S GO BOWLING. Who doesn’t like the opportunity to show off your bowling alley skills? In Kitsap County, bowling is available at All Star Lanes in Silverdale and Hi Joy Bowl in Port Orchard. At All Star, there’s a Sunday family bowl from 9 a.m. to 2 p.m.and it’s only $50 for five people to play for an hour and a half. The bowling alley, at 10710 Silverdale Way, also has online reservations for other open play times. Check out www.

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And, by the way, bowling for an hour will burn 150 calories for a youth weighing 100 pounds. TAKE IT TO THE ICE. Kitsap County has its own indoor ice skating rink in Bremerton. Bremerton Ice Arena, at 1950 Homer Jones Drive, offers public skating on Saturday from 10 a.m. to noon, and Sunday from noon to 5 p.m. Other public skating times are available during weekday afternoons. Check the online calendar at www.bremertonicecenter. com. Cost to skate is $6.50 per adult and $4.50 per youth 5 years old and younger. Call 360-479-7465 for more information. Skate rental is $2.50 and the center also offers skating lessons.

departments in the county have classes for kids. Everything from writing your life story to learning to knit can be achieved through a park department class. Most are reasonably priced and will give the kids something to do on the winter weekends. An example is Bainbridge Island Metro Parks and Recreation District which offers painting and pottery for youth. Or go geocaching through an activity at the Kitsap County Parks Department. Classes are offered on weekdays after school and on Saturdays.

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Human touch

Massage can be good for physical and mental wellness By LESLIE KELLY

that uses localized finger pressure in a rhythmic sequence on acupuncture meridians.

lkelly@soundpublishing.com

Each point is held for two to eight seconds to improve the flow of energy and help the body regain balance. People are normally pleasantly surprised when they try shiatsu for the first time. It is relaxing yet the pressure is firm, and there is usually no soreness afterward.

Massage therapist Michelle Clemens likes to compare the human body to a car. It’s an easy way to explain how “routine maintenance” needs to be performed. “We forget that our body is really a machine,” Clemens said. “It’s just like with a car. We need regular oil changes.”

THAI MASSAGE: Like shiatsu, Thai massage aligns the energies of the body using gentle pressure on specific points. Thai massage also includes compressions and stretches.

The “oil change” she refers to is massage. Something that was once thought of as a relaxation method is now much more commonplace and is viewed by medical professionals as necessary to keep the body healthy.

You don’t just lie there – the therapist moves and stretches you into a sequence of postures. It’s like yoga without doing any work. Thai massage is more energizing than other forms of massage. It also reduces stress and improves flexibility and range of motion.

In fact, according to Netwellness.com, massage can be used as a way to increase circulation, enhance the immune system, promote nervous system function, reduce blood pressure, relieve muscle tension and pain, and improve mood, intellectual reasoning and job performance.

PREGNANCY MASSAGE: Also called prenatal massage, pregnancy massage is becoming increasingly popular with expectant mothers. Massage therapists who are certified in pregnancy massage know the proper way to position and support the woman’s body during the massage, and how to modify techniques.

While most of the clients Clemens sees are referred to her by a physician or chiropractor for therapeutic massage, more and more, people are using massage as a way to maintain good health. “When a doctor refers someone, it’s usually because of a specific problem, like a muscle strain or sprain, or post surgery for a torn rotator cuff, or even for headaches,” she said. “We start with a clear diagnosis and work on the soft tissue.” But some clients come for routine maintenance, as a way to get rid of the tightness, stress and tension that is brought on by every day work. “I think we sometimes under value the benefits of massage,” she said. “So often today, we sit at a desk all day and the tension and stress builds up in our body. The more stress in our body the worse it performs.” Massage, however, can counteract that by allowing muscle tissue to loosen and hence, restoring better blood flow to all parts of the body, she said. Specifically, people with circulatory problems can benefit from massage, which lengthens muscles so that they are not contracted. Too, the fascia, a thin sheath of fibrous tissue enclosing a muscle or other organ, is helped. “Fascia is intertwined into every muscle tissue in the body,” Clemens said. “It’s a huge part of our structure. It’s wrapped around all of our organs and it plays a big factor in our overall health.” Massage keeps the fascia hydrated and keeps fluid reaching all of the muscles, she said. “When both are tight, it limits our ability to move properly.” And she added that drinking fluids after a massage can help rid the body of the toxins that have broken loose during a massage. Another benefit of massage is that it can help our thinking processes. “Massage regulates the nervous system,” she said. “Mood can be improved because massage helps release the good endorphins. And when you feel better, you can work more productively.” When the myofascia surrounding muscle tissue and organs is tight, the body will not function at optimum health. It can be a cause

of paiun and dysfunction. “The digestive system can be affected,” she said. “And if you are tight and tense, you don’t breath properly. So routine massage can help with these body functions, too.” Often times people will experience problems with their sciatic nerve which results in numbness down the leg. This happens when tight muscles put pressure on the nerve.” “That happens when the muscles near the spine invade the sciatic nerve,” she said. “Working on loosing the muscles near that nerve to clear that up relieves the numbness and pain.” Another benefit of routine massage, is to strengthen the body to prevent injury, Clemens said. “We want to be able to prevent injuries in those people who are athletic,” she said. “By strengthening muscles and keep them elastic, it means less chance of injury.” She also suggests that anyone considering massage look for someone who is licensed by the state and if possible, get referrals from previous clients. Consult the state’s website at http://www.doh. wa.gov/LicensesPermitsandCertificates/ ProfessionsNewReneworUpdate/ MassageTherapist to find if a therapist’s credentials are current. Look for therapists who also are members of the American Massage Therapy Association. For more go to www.amtamassage.org.

more scented plant oils called essential oils to address specific needs. The massage therapist can select oils that are relaxing, energizing, stress-reducing, balancing, etc. One of the most common essential oils used in aromatherapy massage is lavender. Aromatherapy massage is particularly suited to stress-related conditions or conditions with an emotional component. HOT STONE MASSAGE: Heated, smooth stones are placed on certain points on the body to warm and loosen tight muscles and balance energy centers in the body. The massage therapist may also hold stones and apply gentle pressure with them. The warmth is comforting. Hot stone massage is good for people who have muscle tension but prefer lighter massage. DEEP TISSUE MASSAGE: Deep tissue massage targets the deeper layers of muscle and connective tissue. The massage therapist uses slower strokes or friction techniques across the grain of the muscle. Deep tissue massage is used for chronically tight or painful muscles, repetitive strain, postural problems, or recovery from injury. People often feel sore for one to two days after deep tissue massage. SHIATSU: This is a form of Japanese bodywork

MASSAGE THERAPY

HERE IS A QUICK GUIDE TO SOME OF THE MOST POPULAR TYPES OF MASSAGE THERAPY. SWEDISH MASSAGE THERAPY: This is the most common type of massage therapy in the United States. It is also known as Swedish massage or simply massage therapy. Massage therapists use long smooth strokes, kneading, and circular movements on superficial layers of muscle using massage lotion or oil. Swedish massage therapy can be very gentle and relaxing. If you’ve never had a massage before, this is a good one to try first. AROMATHERAPY MASSAGE: Aromatherapy massage is massage therapy with adding one or

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Pregnancy massage is used to reduce stress, decrease swelling, relieve aches and pains, and reduce anxiety and depression. The massage is customized to a woman’s individual needs. REFLEXOLOGY: Although reflexology is sometimes called foot massage, it is more than simple foot massage. Reflexology involves applying pressure to certain points on the foot that correspond to organs and systems in the body. Reflexology is very relaxing, especially for people who stand on their feet all day or just have tired, achy feet. SPORTS MASSAGE: Sports massage is specifically designed for people who are involved in physical activity. But you don’t have to be a professional athlete to have one – it’s also used by people who are active and work out often. The focus isn’t on relaxation but on preventing and treating injury and enhancing athletic performance. Strokes are generally faster than Swedish massage. Facilitated stretching is a common technique. It helps to loosen muscles and increase flexibility. BACK MASSAGE: Some massage clinics and spas offer 30-minute back massages. If a back massage is not expressly advertised, you can also book a 30- or 40-minute massage and ask that the massage therapist to focus on your back. Source: www.verywell.com

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MANAGE YOUR PAIN & REGAIN CONTROL

Janet and Steve performing aerobic exercise to improve her pain management.

Janet Moriarty, Poulsbo

Chronic pain had created limitations in Janet’s day-to-day life while in her 30s, at which time she was deemed physically disabled. Janet has since dealt with rheumatoid arthritis for over 25 years, and she has four severely degenerated discs in her spine. Early on, Janet was also diagnosed with fibromyalgia which causes widespread nerve pain, as well as severe osteoperosis (accelerated bone deterioration) in her femurs. Janet knew that she needed to somehow get past the pain and exercise her body in order to avoid losing more bone mass. For many years, Janet was in so much pain that she could barely function, and found her quality of life had greatly diminished. Doctors prescribed narcotics to help manage the pain, but they prevented her from living the life she wanted, so she weaned herself off them. “I preferred to suffer through the pain in hopes of returning to an active lifestyle over dealing with the adverse side effects of medications,” she said. Now in her 50s, Janet was so desperate for a solution that she thought assisted living was the only option left for her. Still, driven by just a grain of hope, she continued searching for an alternative.

Dr. Andrew McNeil, DO - Peninsula Pain Clinic

Dr. Andrew McNeil, a Doctor of Osteopathic Medicine at Peninsula Pain Clinic (PPC), has helped many patients manage their chronic pain using multimodal therapy and a multi-disciplinary approach. He firmly believes that the best results occur when the patient is truly focused on improving his/ her condition by making healthy lifestyle choices, managing the underlying pathologies (such as diabetes or rheumatologic conditions) dealing with mental health concerns and being aware of basic preventive care. Dr. McNeil believes in the benefit of physical therapy to assist his patients in their course to recovery. He states that regular exercise designed and guided by a trained professional will help optimize a patient’s pain control through improved body mechanics. He feels that conservative therapy is often the best initial approach to pain and can often successfully treat and optimize pain relief. However, when this is not enough, Dr. McNeil is fellowship-trained in pain medicine and can offer other alternatives to help manage the pain. He believes in a graded approach and will evaluate each patient’s needs individually. He, and the other two physicians at PPC, Dr. Jon Hillyer and Dr. Terry Pexton, can utilize interventional therapy when needed (to include epidural steroids, joint injections, radiofrequency lesioning, spinal cord stimulation, vertebral augmentation, and intrathecal pumps as a few examples). Medication management can be used when necessary, although the overarching goal

is to use the lowest effective dose and optimize other modalities whenever possible. Dr. McNeil states that often with the complex nature of pain there is more than one pain generator. He likens chronic pain to an onion; “pain has multiple layers and often there is not a single pain generator or layer that we must deal with but multiple.” He states that it is critical, therefore, to fully participate in physical therapy when possible. He feels that not only is he sending his patients to physical therapy to assist with the primary pain generator but also to prevent them from developing or worsening other pain generators. Here’s an example he uses: if you have a hurt knee, you may change your body mechanics both consciously and subconsciously to protect that knee because of the pain. Subsequently, you begin to use your back muscles in a way they were not intended to be used; i.e. you put stress on other parts of your body because you are protecting yourself from the pain. For example, you step out of a car differently, step off a curb differently, get out of bed to go to the bathroom in the middle of the night and without thinking about it your body mechanics are thrown off perhaps leading to worsened low back pain - all from a hurt knee. This is where physical therapy can really play a preventive role - helping the patient with improved body mechanics not only helps with the primary pain generator but helps prevent other pain generators from developing in the future. Dr. McNeil advises that “just about anyone dealing with chronic pain can benefit from some form of physical therapy.” He maintains that physical therapy regimens target and treat the underlying problem(s). He feels that regardless of where you fall on the care spectrum, the foundation of care should always start with and include conservative therapy which revolves around good mental health care, preventive care, management of underlying health comorbidities, and a good regular low impact exercise/stretching routine taught and routinely monitored by a professionallytrained physical therapy team. “Overall the goal of physical therapy, in most patients, should be to get them back home with a good home exercise/ stretching routine. However, I strongly believe that regular refresher courses are vital to ensure that you keep doing those exercises/stretches correctly.” Ultimately, he said, patients must have a strong desire to recover and fully commit their effort to a care plan for it to work effectively.

Steve Goldrick, PT, DPT, OCS, TPS - Kitsap Physical Therapy

As a last-ditch effort, Janet visited Kitsap Physical Therapy (KPT) and was referred to Steve Goldrick, a certified Therapeutic Pain Specialist (TPS). She was soon relieved to learn of a realistic solution to manage her chronic pain and regain control of her

life without using narcotics. Steve said chronic pain is characterized by “any pain lasting longer than six months without a new mechanism of injury, which can exist in any area of the body.” He said a huge piece of persistent pain management is educating the patient about why they hurt, and what areas of the body are responsible for these symptoms. “Steve explained how pain works so I could fundamentally understand the program,” Janet said. She was delighted that Steve allowed her to feel in control of her wellness. In order to get patients back to the life they want, Steve becomes a partner in the journey and builds on functionality rather than limitation – what they can do despite being sore or in pain. “The goal is to resume daily living activities achieved through a pacing approach” which Steve described as a process of adding new activities periodically, and gradually increasing the intensity or length of time depending on each patient’s unique care program. “All pain involves the nervous system” Steve said, “which can mistakenly defend against movements or activities that are not actual health threats.” Steve noted that the nervous system is the body’s defense mechanism against injury, and sometimes it can become hypersensitive when it is constantly working to protect one area of the body. “That’s why we perform specific exercises to desensitize the overworked nervous system so the patient is able to do more and more.” Steve’s top priority was getting Janet to the point where she could manage her pain independently. He set her up with a customized exercise routine which they built on incrementally to reach the current program she now maintains on her own. Janet began experiencing results within the first couple of visits, which she found very reassuring! Janet has been doing her program for three months now. Within the first six weeks she felt completely in control of her pain levels, her fatigue had subsided and her endurance continues to increase each day. Steve testified that the body’s natural pain killers, endorphins and encephalins, and are proven to be 25 times more potent than narcotic painkillers. “Don’t let anyone ever tell you that your pain isn’t real or is something you just ‘have to deal with’. Your pain is 100% real, but a major key to treating persistent pain is for you as the patient to understand in great detail why you hurt and then focus on restoring function in a gradual manner.” KPT has Therapeutic Pain Specialists at two locations in Kitsap County who are trained in educating patients about how pain management works and what affects it. To learn more or to schedule an appointment, visit www.kitsappt.com.

International Spine and Pain Institute (ISPI) 2016

KITSAP LIVING WINTER EDITION

JANUARY 27, 2017

Exercising in 2017: It’s not just walking on the treadmill anymore

By LESLIE KELLY

lkelly@soundpublishing.com

With every new year come the resolutions about exercising. By now, you’re a month into 2017, and maybe the old aerobics class or 20 minutes walking on the treadmill have already become a bore. There’s plenty of other ways to work up a sweat. Here’s a sample of what’s out there and gaining in popularity. BARRE Using a blend of ballet, Pilates, yoga, light weights, and body weight exercises, barre workouts sculpt lean muscles, increase strength, and improve flexibility in an uplifting atmosphere. Lotte Berk, a German dancer living in London, came up with the idea to combine dance conditioning with rehabilitative therapy. Lydia Bach, an American student of Berk’s, brought the workout back to the states in 1970s. Barre has morphed from a class for nimble dancer-types to become the workout of choice for fitness fiends everywhere. It starts with a mat-based warm-up full of planks and push-ups, then a series of arm exercises, and continues at the bar with a lower-body section to work the thighs and glutes. participants finish with a series of core-focused moves at the bar or a short session on the mat. Locally, try Barrecor at 360 Tormey Lane NE #194, Bainbridge Island, phone 206-451-4207. Emiliana Prado and Daniel DeBellis opened their Barrecor studio two years ago and ever since, have seen numbers of participants increase. Men and women from ages 15 to 80 take barre sessions. They offer up to 28 classes a week.

Instructor Emiliana Prado checks the form of a student at her Barrecor studio on Bainbridge Island.

“Our member like the results they get,” Prado said. “For a very reasonable price they get the fun and friendship of a group class, while getting personal attention from the instructor.”

KICKBOXING AND BOXING

Barre is taught so that persons of various levels can take the same class and adjust according to their fitness level and any injury they may be recovering from. POP PILATES If you like Pilates but feel your workout has become less interesting, Pop Pilates group fitness classes might be the right step to recharge your 2017 exercise routine. Developed by YouTube fitness guru Cassey Ho, Pop Pilates blends Pilates, dance, and music for a powerful and effective full-body workout. Using only your body weight, Pop Pilates sculpts and strengthens your muscles. Pilates is a physical fitness system developed in the early 20th century by Joseph Pilates. Pop Pilates is the combination of total body Pilates exercises with the attitude of choreographed dance and the energy of music. Students will be challenged to flow from one exercise to the next, developing a rock solid core, leaving no muscle untouched. Every exercise can be modified to fit personal needs. Locally, try Westcoast Fitness in Port Orchard at 4740 Ramsey Road SE, phone 360-874-2818. Andrea Zabel has been teaching Pop Pilates there since last June. She has three classes a week and has seen them grow in popularity. “We’re the only place that has it around here,” Zabel said. “People think of it as a stretching and breathing class and some shy away from it because they want something where they’ll work up a sweat. But once they try it and find that they are sweating with the whole body workout and the cardio, they love it. And the music — Top 40 songs — makes them want to move.”

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Her classes range in size from eight to 10 participants, both men and women of all ages.

While boxing isn’t exactly a new fitness trend, it’s seeing a surge in popularity thanks to Instagram videos of stars in old-school rings boxing their way to a toned body. With a mix of cardio, strength training, upper cuts, and right hooks (just to name a few), boxing provides a fullbody workout, relieves stress, and gives a feeling of empowerment. If regular ring boxing is something you want to try, check out Bainbridge Boxing at 9463 NE Business Park Lane, Bainbridge Island. Whether you want to compete, learn self-defense, or just get in shape, coaches put you through the paces of a professional boxer’s workout like you’re training for a shot at the title. The club offers open gym time, plus a complete schedule of boxing classes – more than 20 per week – all included in your membership. Kickboxing can be found locally at a number of places including ilovekickboxing.com, 10516 Silverdale Way, Suite 300, phone 360-633-3632. According to the website, “it’s is a bag-hitting, adrenaline-flowing workout that anyone can do. It’s a place where passionate instructors really do care about you and your goals – and will do whatever it takes to help you achieve them.” POLE DANCING OR AERIAL YOGA: Jump into a silky sling and consider giving gravity-defying aerial yoga a try. This can best be described as “yogi meets acrobat meets gymnast.” For those who think hanging from the ceiling seems a little too gimmicky, aerial yoga provides some serious health benefits: There’s next to zero impact on your joints; the cardio involved is similar to brisk walking; and it’s one heck of a core workout. Plus, many classes will end in a zenlike savasana while you’re enveloped in soft fabric, making it a true mind-body experience.

Expansions Yoga at 9479 Bayshore Drive, Suite 101, Silverdale, phone 360-990-9642, has a variety of yoga classes to try, including and over 50 class, Bro-yoga and Vinyasa, a heated yoga. But for an aerial yoga class, you’ll have to travel to Seattle. However, you can find a place to learn to pole dance in Port Orchard at the Dolphin Dance Studio at 1341 Bay St., phone 206-2013635. Start with warm-ups and stretching and then go to the pole to learn holds and pull-ups. Choreographed routines follow. Or try Envy Fit in Bremerton at 243 Fourth Street, phone 360930-2107 which also teaches pole dancing. INDOOR CYCLING One of the most promising workout trends is Peloton indoor cycling. Peloton offers a studioquality, indoor cycling experience without having to leave your home. Once you’ve made the $2,000 investment to own the exercise bike in your home, Peloton offers wide array of classes to choose from

and makes indoor cycling convenient and fun. One special feature of this cycling and technology combo is its ability to connect you with other riders from all over the world for every class, so you’re never alone when you cycle. During the class you’ll hear the instructor’s instructions as well as see various camera shots live of the instructor and others in the class. When you’re watching the screen, you’re seeing actual humans in a live class in New York City, not just some recorded thing somewhere without others. But if that’s out of your price range, try a spin class at any of the local gyms. Basic cycle classes and advanced are typically available, like at Poulsbo Athletic Club, 19611 7th Ave., NE, Poulsbo, phone 360-779-3285, where an instructor guides a 30-45- minute fitness class which uses stationary cycles in a group setting. Classes are easily adapted to a variety of fitness levels since each participant is in control of their bike.

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Puppy love

Pets can improve your physical and mental health By LESLIE KELLY

being.

lkelly@soundpublishing.com

Another aspect of having a pet in the family is that it will help only children from becoming too shy or too self-centered. Research shows that when a child has no brothers or sisters, pets help children develop a greater empathy, higher selfesteem, and increased participation in social and physical activities.

Having an animal companion can improve your health. Poulsbo veterinarian Lisa Newnham sees it every day. “It’s quite remarkable,” she said. “I’ve seen it time and time again. Having a pet can really improve your life.” According to the National Center for Health Research, research has shown that people who have a pet have healthier hearts, stay home sick less often, make fewer visits to the doctor, get more exercise and are less depressed. Pets may also have a significant impact on allergies, asthma, social support and social interactions with other people, said Dana Casciotti and Diana Zuckerman, who have both worked in researching the value of pets for human health. A recent study by the center showed that blood pressure is reduced in times of stress for those who have an animal companion, as opposed to those who don’t. “Companion animals improve heart health by lowering blood pressure and regulating the heart rate,” the study said. Other ways health is improved with a pet include that children who have a pet have less anxiety. The study showed that the social support a pet provides can make a person feel more relaxed and can decrease stress. Having a pet can reduce the feelings of loneliness or isolation, not only because the pet becomes a friend, but for example, with a dog, the owner will walk the dog and meet

Newnham said it’s obvious that when someone has a dog, they get more exercise, in that they have to walk the dog. “When an overContributed photo weight person gets Veterinarian Lisa Newnham knows pets can improve health. a dog, they have to walk it and suddenly other people while out and about. they are outside getting exercise and enjoying life The study also showed that elderly individuals more,” she said. with a dog or a cat were better able to perform cerShe also has experienced situations when pets tain daily living physical activities such as climbing stairs, bending, taking medication preparing have helped those who are depressed. meals and dressing. Researchers said that having “The connection they make with their pet, the an animal, and being in that care-taker role, may empathy they feel, the feeling of having to be there give older individuals a sense of responsibility for someone else — that gives them a reason to get and purpose that contributes to their overall well- up every day,” she said.

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She has a few clients who actually have a professionally trained pet to help them with health conditions such as post traumatic stress disorder. “We can use pets for emotional support,” she said. “I’ve seen this in people with PTSD.” One client even has a rabbit as an emotional support animal, she noted. She also has seen a client rehabilitate himself faster in a hospital setting because he knew he needed to get home to be with his border collie. Another example of ways that pets can support children emotionally are the programs where children go into animal shelters and read to the animals. “Animals don’t judge,” Newnham said. “You can be and say things with a pet that you might not with a person,” she said. Pets provide that safe place for owners to be themselves. “They give love unconditionally,” she said. “And that’s so important to our physical and mental health. And when a bond is made with a pet, that gives us a reason to be — to care for that dog or cat.” Dr. Newnham has been practicing in the Kingston and Poulsbo area for the past 20 years. You can reach her at 360-779-6534. Learn more about pets and their impact on health at www.center4research.org.

KITSAP LIVING WINTER EDITION

JANUARY 27, 2017

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