Special Sections - Healthy Living Summer 2018

HE ALTHY LIVING AN ADVERTISING SUPPLEMENT PRODUCED BY PENINSULA DAILY NEWS & SEQUIM GAZETTE

THE 5210 CHALLENGE COUNTY LEADERS TO INTEGRATE & SHARE LIFESTYLE CHANGES PAGE 9

PLUS:

CAMPFIRE SAFETY PAGE 3

BE BERRY CAREFUL! PAGE 5 STAY SUN SMART PAGE 17

SUMMER 2018

volume 14, issue 2

HEALTHY LIVING Volume 14, Issue 2

■

SUMMER 2018

Produced and published by the PENINSULA DAILY NEWS & SEQUIM GAZETTE Advertising Department Offices: 305 W. First St., Port Angeles, WA 98362 360-452-2345 ■ peninsuladailynews.com 147 W. Washington St., Sequim, WA 98382 360-683-3311 ■ sequimgazette.com

Terry R. Ward, regional publisher & vice president Steve Perry, general manager

Brenda Hanrahan and Laura Lofgren, special sections editors

Articles & submissions

Jefferson Healthcare is a proud recipient of the Healthgrades 2018 Patient Safety Excellence Award™, a designation recognizing superior performance.

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We’re always on the lookout for article ideas to include in our quarterly Healthy Living publication. If you have an idea for a story, please let us know.

Professionals in their field are invited to contribute informative and educational articles or columns for consideration in Healthy Living.

Send articles, columns and photos (jpgs at 200 dpi minimum) to special sections editor Laura Lofgren at llofgren@peninsuladailynews.com.

We cannot guarantee publication due to space and content considerations.

If your submission is accepted, we reserve the right to edit it.

Submitted articles are the opinions and beliefs of the contributing writer and in no way represent an endorsement by Healthy Living, Peninsula Daily News or Sequim Gazette.

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Safely build and enjoy a summer campfire right ignition under the right circumstances to start a catastrophic wildfire.

BY TRISH TISDALE

FOR CLALLAM 2 FIRE-RESCUE

Smokey Bear ingrained the message into our minds as kids: “Only you can prevent wildfires.”

For 70 years Smokey has been spreading that slogan, yet it is as true today as it was then.

In the United States, almost nine out of 10 wildfires are caused by people.

Washington’s 2017 fire season burned more than 300,000 acres.

The state’s worst wildfire season on record happened in 2015, with more than 1 million acres burning across the state from June to September.

Summer approaching means that camping season is here, and many are ready to pull their tents out of storage or get their RVs ready for outdoor adventures if they haven’t already.

But summer also brings hot, dry weather, and people need to be even more careful when it comes to building a campfire this time of year.

For the most part, human causes for

wildfires are from burning brush or arson, but the chances of a wildfire being started by a campfire are still high.

OLYMPIC PENINSULA AT RISK The Olympic Peninsula has an active

wildfire history and is especially at risk for a major wildfire.

Years of summer droughts have filled the forests with heavy decayed vegetation.

That vegetation combined with a dry climate means that all it would take is the

BURN REGULATIONS Of course, campfires are one of the great pleasures of camping.

We can still enjoy a campfire with friends and family; we just need to be smart about how we start, maintain,and extinguish our campfire.

First, always check to see if there are any campfire restrictions in effect before building a campfire.

Clallam and Jefferson counties have county-wide burn bans during the summer and early fall that apply to all outdoor burning except small recreational fires.

However, in extremely dry conditions, the counties might extend the ban to include recreational fires, including those in designated fire pits.

State parks and Olympic National park set their own rules for burn restrictions, and they might have burn restrictions in their campgrounds separate from the Jefferson and Clallam counties.

CAMPFIRES continued on Page 4 >>

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<< CAMPFIRES from Page 3

Check with your local fire district for burn regulations and burn restrictions in your area.

Check with individual campgrounds for any additional restrictions that might be in effect.

Even when a good rain follows a dry spell, the water may not have permeated the ground enough to saturate the vegetation, meaning that the chances of a wildfire are still high.

The best campfires use three types of wood: tinder (small twigs and dry leaves) and kindling (small sticks smaller than 1” around) to get the fire started, and fuel (larger pieces of wood) to maintain the fire.

CAMPFIRE SAFETY If fires are permitted, make sure you have plenty of water nearby.

Keep your fire small. A large fire just wastes wood, plus it takes a long time to burn down and cool off.

Don’t put leaves or other lightweight material on the fire. A sudden gust of BUILDING YOUR CAMPFIRE wind could quickly send those burning First and foremost, use an existing fire leaves flying and potentially ignite other ring when possible. Most campgrounds vegetation. have established fire rings.

An adult should supervise the campfire If you are constructing your own firepit at all times. area, select an open, level spot away from Never leave children unattended trees, logs, brush, dry grass and overhang- around a fire. ing branches.

The most important rule is to never Clear an area 10 feet in diameter. leave a campfire unattended!

Note that not all campsites allow you to Even a small breeze could quickly cause dig your own firepit; check your campsite’s the fire to spread. regulations.

Never allow your campfire to burn Clear all vegetation away from the fire down on its own; properly extinguish it. ring, including leaves and sticks.

Keep your campfire small and only EXTINGUISHING YOUR CAMPFIRE burn wood. Never cut whole trees or When extinguishing your campfire, use branches, dead or alive. the “drown, stir and feel” method.

Stack extra wood upwind and away from fire.

CAMPFIRES continued on Page 7 >>

CHILDREN & CAMPFIRES With so many fun camping activities centered around the campfire, children are especially drawn to the magical, mesmerizing allure of a campfire.

But campfires also are the leading cause of children’s camping injuries, so safety is of the utmost importance.

Education and supervision are two important things to remember when it comes to campfire safety.

Don’t let children play too close to the fire. And children should never be left unsupervised around a campfire.

While the “stop, drop and roll” technique is always worthwhile to teach, you also should teach children to understand the power of the campfire.

Talk about what you use the fire for, why it’s dangerous and how to safely interact with it. Let them know what tasks they can help with — gathering wood or helping to build the fire — but then explain when they must not get too close to the fire.

For curious, walking toddlers who will not be content being held in your

arms, always keep an eye on them.

This sounds obvious, but it is especially important to remember when it comes to kids walking around fires.

Another tip for curious kids is to create a barrier. This could be a ring of rocks set up around the firepit so they can easy see where the limit is.

“Don’t get too close to the fire” can be a vague statement and difficult for a child to measure the distance, while a visual line will be much clearer for them to understand.

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BE BERRY SAFE! SAFETY TIPS FOR PICKING WILD LOCAL BERRIES

e you can ay season is BY JEANETTE STEHR-GREEN

agement

c Monday, Wednesday what I told we are

WSU-CERTIFIED CLALLAM COUNTY MASTER GARDENER

Collecting sweet, juicy berries in the wild can be an BLACK CAP RASPBERRIES enjoyable activity for both kids and adults.

Keep a fun family outing from going sour (or even becoming a tragedy) by taking a few simple precautions.

Although the Pacific Northwest provides an abundance bush or vine on which it is growing, the shape of the leaf under the â&#x20AC;&#x153;Also coming in 2018â&#x20AC;? section. of wild berries, not all are edible and some are poisonous. and the leaf arrangement.

Sheidentify wantsand to say that we have a Sweatyou Lodge Wellness Path coming To familiarize with and the local berry bounty, here are Eat only those berries that you can know brief descriptions of 10 of the tastiest wild berries that are edible. soon Flowers are the best way to recognize most plants, but grow on the Olympic Peninsula.

Salmonberries (Rubus spectabilis) grow on tall flowers rarely are present at the time berries are ready shrubs commonly found along streams and on wet soils.

OF identificafor picking. At berry-picking time,BEST a positive The leaves have a toothed margin and are split into tion will include not only the berry itself, but likely the

three leaflets.

The raspberry-like fruits come in brilliant shades of yellow to red. The flavor varies with sun exposure but is usually described as mild with a hint of citrus.

Salmonberries do not keep well, so eat them right off the bush.

BERRIES continued on Page 6 >>

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<< BERRIES from Page 5

Thimbleberry is a thornless shrub that forms dense thickets. The plant sports large maple-shaped leaves that are somewhat fuzzy.

The raspberry-shaped berries progress from pink to ruby red as they ripen and form a pronounced thimblelike shape when harvested.

Thimbleberries have a delicate sweet flavor but can be bland depending on the growing site. Because thimbleberries are soft, often crumbling as they are picked, enjoy them as you harvest.

Trailing blackberry (Rubus ursinus), also known as the dewberry, is the only native blackberry on the Olympic Peninsula.

True to its name, trailing blackberries produce long prickly vines that trail over the ground and trip unwary hikers who go off trail.

Dewberries are tart, about half an inch long and progress from red to dark purple to black as they ripen.

Himalayan (Rubus discolor) and evergreen blackberries (Rubus laciniatus), both introduced species, are invasive, thicket-forming shrubs.

The sturdy, arching canes, with their stiff thorns can be “tentacle-like,” reaching out and grabbing those daring to pick from them.

The leaves have five leaflets that are rounded to oblong in shape (R. discolor) or have sharply cut, irregular margins (R. laciniatus).

The berries are large, black and delicious when ripe.

Blackcap raspberries (Rubus leucodermis) also have tall arching canes with serious prickles but are covered with a powdery white coating that gives rise to their

EDIBLE BERRY REFERENCES For more information about the identification of wild berries, consult the following references: • “Wild Berries of the Northwest: Alaska, Western Canada and the Northwestern United States,” by J. Duane Sept.

• “The Pacific Northwest Berry Book,” by Bob Krumm and James Krumm.

• “Wild Berries of the Pacific Northwest: On the bush ... on the table ... in the glass,” by J.E. Underhill.

• “Plants of the Pacific Northwest Coast: Washington, Oregon, British Columbia & Alaska,” by Jim Pojar and Andy MacKinnon.

• “A Summer Guide to Northwest Berries,” from the University of Washington. Available at tinyurl.com/UWberries. scientific name (“leucodermis” which means white skin).

The leaves have three to five leaflets with white undersides. The berries are about half an inch across and progress from red to purple to black as they ripen.

The fruit is rich, mildly sweet and not overly juicy.

Blueberries (Vaccinium sp.) can be either deciduous or evergreen shrubs and range in height from a few inches to 10 feet. The twigs have a characteristic zig-zag pattern and small glossy, dark green leaves.

The blue-black berries, about one-quarter inch across,

often have a whitish powdery coating.

Red huckleberry (Vaccinium parvifolium) is an upright deciduous shrub and relative of the blueberry. It is often found growing on or near rotting stumps along with salal. The leaves are small; young twigs are bright green. The berries, about a quarter of an inch in diameter, are bright red and round with a translucent skin (resembling salmon-eggs). Red huckleberries are tart but tasty and good in savory dishes.

Oregon grape (Mahonia sp.) is an evergreen stiffbranched shrub with shiny green, holly-like foliage.

In spring, Oregon grape sports large clusters of small golden flowers which give way to powdery blue fruits arranged in grape-like clusters.

Oregon grape berries are tart and the flavor is said to improve after frost.

Salal (Gaultheria shallon) is an evergreen shrub with dark green, lustrous leaves that are popular among florists.

The blue-black berries dangle in a row from reddish stalks, have a tough skin and taste like an almond-flavored blueberry.

Native Americans mixed salal and other berries with dried meat and fat to make pemmican.

Wild strawberries (Fragaria sp.) are an evergreen ground cover. They spread by runners to form low, compact mats.

The leaves, a medium green on top and light green beneath, have three leaflets and large teeth.

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BERRIES continued on Page 8 >>

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Peninsula Daily News/Sequim Gazette

Grocery store scavenger hunt tomer service desk at Forks Outfitters. During your next visit to the grocery store, use your game sheet to check out different store departments.

Along the trip, discuss what you’ve found while hunting for the next item on your list.

The participating Port Angeles Safeway is at 110 E. Third St.; Sunny Farms is at 261461 U.S. Highway 101; and Forks Outfitters is at 950 S. Forks Ave. Once you have finished the hunt, return your completed game sheet to your library and receive a free Love. Talk. Play. reusable shopping tote.

This fun, educational opportunity will continue for the remainder of 2018.

thing is wet.

Feel the coals, embers First, dump lots of water and any partially-burned on the campfire. Drown all woods.

Everything should be embers. There should be no cool to the touch. more “hissing” sounds.

If it’s too hot to touch, it Some people suggest using dirt to smother a fire, is too hot to leave.

Finally, check the entire but this could take hours campsite for possible before the fire completely sparks or embers. cools.

Trish Tisdale is a volunAlso, digging up dirt impacts the land and vege- teer EMT with Clallam 2 Fire-Rescue in Port Angeles. tation around your campShe has been an EMT since site.

2003 and has also served Next, stir the campfire as a firefighter, rescue diver with a shovel. and wildland firefighter.

Make sure that every<< CAMPFIRES from Page 4

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Want a fun way to teach your kids about healthy foods and get them excited to try new things?

North Olympic Library System is partnering with the Olympic-Kitsap Peninsula’s Early Learning Coalition, the Safeway in downtown Port Angeles, Sunny Farms in Sequim and Forks Outfitters in Forks to create a grocery store scavenger hunt that turns an ordinary shopping trip into an interactive learning experience for parents, caregivers and young children.

Pick up a scavenger hunt game sheet at the Port Angeles Library, Sequim Library, Forks Library, the Farm Store at Sunny Farms or the cus-

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Keep your eyes peeled for wildlife.

Bears like berries, too, so make lots of racket while picking to let them know you If you’re just learning how to identify are there. wild berries, don’t rely on these descripBears will instinctively move away if tions; carry a field guide with color photothey sense humans approaching. graphs to help you confirm the identity.

Watch out for wasps, hornets and yellow References are available at local librarjackets that will be attracted to the fruity ies and bookstores (as well as online) to smell. help you make the identification.

Talk with your health care provider about carrying epinephrine if you have OTHER SAFETY TIPS had serious, life-threatening reactions to Wear protective clothing when picking since many berry bushes (or the surround- insect stings in the past.

Take a walk on the wild side, but be ing vegetation) have thorns and prickles.

Protective clothing includes the following: berry safe!

Do not pick on private property without • Long jeans or thick pants • Sturdy, closed-toes sneakers or hiking permission.

Although berry collection generally is boots permitted on most public lands for per• Lightweight long-sleeved shirt sonal consumption, quantity restrictions • Hat might apply.

Because it is difficult to wash berries, Jeanette Stehr-Green has been a WSUavoid picking them along roadsides and in certified Clallam County Master Gardener areas that have been sprayed recently since 2003. with herbicides.

She writes gardening articles for the Dead and stunted vegetation that is leafing out unevenly, especially along roadsides Peninsula Daily News and Sequim Gazette or under power lines, is a good indication of and participates in a monthly call-in gardening program on KONP. a recent herbicide application.

She enjoys teaching others about garEven when collecting in a pristine area, dening and is a berry enthusiast who it is a good idea to rinse wild berries with enjoys not only growing berries in her garpotable (drinkable) water before eating den but collecting them in the wild. them. << BERRIES from Page 6

WILD BERRY CALENDAR The different wild berries do not all ripen at one time, but emerge in a colorful and tasty array from late spring to fall (or even the first frost).

• Salmonberries are among the earliest berries, ripening in May in warm, sunny exposures and continuing to late July at higher elevations.

• Thimbleberries ripen soon thereafter, running from late June into August.

• Blackberries, blackcap raspberries, blueberries, huckleberries and Oregon grape are available in the heart of summer (July and August).

• Salal berries are among the latest of the local wild berries, ripening from August through September.

• Wild strawberries are everbearing and ripen from late spring through fall.

Begin looking for berries at lower elevations in late spring. As the season progresses and the weather warms, climb to higher elevations to find later ripening berries.

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Are you up to the

CHALLENGE? Clallam County community leaders test themselves with monthlong 5210 program This July, community leaders from across Clallam County will embark on a monthlong challenge to live more healthful lives.

Along the way, they will share their struggles and successes as they build new habits and change old ones.

These 12 leaders are challenged to adopt the “Live 5210” principles by Olympic Peninsula Healthy Community Coalition (OPHCC), a county-wide nonprofit working to decrease chronic disease in our region.

During July, participants will strive to incorporate four healthy habits into each day:

• Eat 5 servings of fruit and vegetables • Reduce their recreational screen time to 2 hours or less • Engage in 1 hour of physical activity • Drink 0 sugar-sweetened beverages

These four lifestyle behaviors have been found by researchers to be the most powerful steps anyone can take to prevent chronic diseases, such as cancer, heart disease, arthritis and diabetes.

So why not join in on the challenge?

It’s a great time for you, your family and even your co-workers to join with these leaders and follow along with the 5210 Challenge.

The summer weather is great for being active and outdoors, and fresh produce is abundant across the Olympic Peninsula.

In addition, tips and tricks will be shared throughout the month with leaders and community members on best ways to make these changes not only for this month, but also as a part of lasting change.

Find 5210 tips and challenge updates, plus printable tracking sheets, at facebook.com/olympicpeninsulahealthy communitycoalition.

For more information, visit healthyOP. org.

TURN THE PAGE TO SEE WHO HAS ACCEPTED THE CHALLENGE! AND KEEP THIS PULL-OUT TO HELP TRACK YOUR CHALLENGE PROGRESS! Peninsula Daily News/Sequim Gazette

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ERIC LEWIS

Chief Executive Officer, Olympic Medical Center

E G N E L CHAL

D E T P E ACC

MOST DIFFICULT The most difficult part for me will be getting enough vegetables. I need to continue to focus on this area.

EASIEST I have been trying to make 5210 daily habits for me since the beginning of 2018. I have great habits of avoiding sugar-sweetened beverages and screen time at home. My Fitbit keeps me on track for activity.

SUPPORT TEAM My coworkers are focused on health lifestyles, so this gives me support and encouragement.

COMMUNITY OBSTACLES Sugar-sweetened drinks are everywhere and contain a lot of calories. This will take a cultural change to achieve this part. I find black coffee delicious so this is easier for me to achieve each day.

MARK OZIAS

Clallam County Commissioner, OPHCC Board Director Twelve Clallam County community leaders have taken on the “Clallam County 5210 Leadership Challenge.”

They were asked a few profile questions:

MOST DIFFICULT I expect the one hour of physical activity to be the most difficult for me, as I have been attempting to accomplish one hour of activity three days per week and so far cannot do this consistently.

EASIEST I never drink sugar-sweetened beverages, so this will be the easiest for me. most difficult for you: eating five fruits and vegetables a day, getting two hours or less of recreational screen time, getting one hour of physical activity, or drinking zero sugar- SUPPORT TEAM My wife will certainly support my efforts, but I know that my coworkers sweetened beverages? will as well.

EASIEST Which of the four do you think will be the easiest for you to achieve, or are COMMUNITY OBSTACLES In my opinion, the most difficult obstacle we face is a lack of there any you’re already doing? sufficient funding for the community health-related programming we need to be doing.

For example, every survey and data point suggest that combating chronic disease (as we SUPPORT TEAM Who in your life do you think might support you in the challenge? are doing via 5-2-1-0) absolutely needs to be a top priority, but our county health departCOMMUNITY OBSTACLES From your leadership lens, what do you see as the most ment addresses these issues only tangentially and significant funders like the Olympic difficult obstacle we face in Clallam County to achieving good health?

Community of Health usually find themselves fighting to carve out even modest Here’s how each leader answered: amounts of funding for these efforts due to their long-term nature.

MOST DIFFICULT Which of the four parts of the challenge do you anticipate being the

REBEKAH MILLER

NICOLE BREWER

MOST DIFFICULT To get ready for the 5210 Challenge, I’ve been

MOST DIFFICULT I believe the most challenging will be a combi-

Development Director, Peninsula Behavioral Health & OPHCC Board Secretary

Executive Director, Parenting Matters Foundation and The First Teacher Program, & Board Director, Prevention Works!

nation of one hour of physical activity and zero sugar-sweetened beverages.

I have my routine workouts now four times a week, but I don’t consciously make the effort to get a full hour of physical activity the remaining days.

Also, I really like my creamer in my coffee. I might just have to do a switch to tea for the EASIEST Sally and Henry, our 4-month-old golden retriever and 4-year-old Labrador, will duration. have no problem ensuring that we’re active for an hour each day.

EASIEST The easiest for me to achieve will be the five fruits and vegetables a day, as it’s SUPPORT TEAM All 100+ workmates at Peninsula Behavioral Health know about the the bonus of living on a family farm where we grow produce for our farm stand and our challenge, and some of them are going to take the challenge with me. My fiancé may not family. July also is an ideal month for fresh fruits and vegetables for our area. know it yet, but he’ll be taking the challenge, too, and we can spur on each other.

SUPPORT TEAM I know my family, colleagues and friends will support me through this COMMUNITY OBSTACLES Perhaps the most difficult obstacle to achieving good health in challenge and push me through the hard times. the county is acknowledging that there’s really not just one obstacle. If our residents have to choose between having a roof over their heads or a hot meal, or between paying COMMUNITY OBSTACLES I believe as a county, our biggest challenge in our community for for a life-saving prescription or gasoline for their car to get them to work, it’s no wonder achieving good health is our societal norms: sweet, high-sodium or high-caloric treats at gatherings versus healthier options; our ever-increasing technological age where many they need the community’s support.

What comes first? A home? Food? Job? Sobriety? Mental health treatment? Medical are focused on their screens the majority of the time; limited encouragement of physical treatment? Dental treatment? Not all of us have to make these choices. But for someone activity; and sugar-sweetened beverages around every corner. We need a cultural shift or who is constantly navigating them, it can be exhausting, intimidating and demoralizing. policy change toward healthier practices. tracking my recreational screen time, and it’s no wonder that I’m on level 3,407 on Candy Crush; I spend way too much time on my phone, and I’ve got to find an alternative relaxation practice. It wasn’t an intentional overlap, but I also set July 1 as my day to quit smoking.

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Peninsula Daily News/Sequim Gazette

TOM SANFORD

JIM STOFFER

MOST DIFFICULT I think the biggest challenge will be recreational screen time. I enjoy relaxing in the evenings with a few shows and smartphone scrolling. It will be good for me to limit my screen time, and July is the perfect time to just spend that time outside instead.

MOST DIFFICULT Getting five fruits and vegetables. Due to my

Executive Director, North Olympic Land Trust

Board Director, Sequim School District travel with the Washington State School Director Association (WSSDA), I am on the road a lot. I will need to menu plan and ensure I make good choices along my journey.

EASIEST I usually drink water or tea, so cutting out sugary drinks should be pretty easy for me.

EASIEST I currently fast walk 45-60 minutes each day. I will add bike riding and other physical activities. I rarely drink sodas or teas. I will have to forgo lattes. I will start a donation jar for my latte costs and SUPPORT TEAM At North Olympic Land Trust, my coworkers are already brainstorming sweeten give to our food bank. ways to stay active together and participate fully. My wife and daughter will help me stay on track, especially during our family vacation.

SUPPORT TEAM My wife, Diana, and I challenge my friend and fellow School Board Director Brandino Gibson to the 5210 Challenge.

COMMUNITY OBSTACLES Access to healthy food. Here in Clallam County, we grow some of the most beautiful, healthy produce in the state but struggle to get it into the hands COMMUNITY OBSTACLES More activities for our youth. The city, YMCA, Boys & Girls Club of locals who need it most. and Sequim School District are working together to increase opportunities, but we need the whole community.

THOM HIGHTOWER

Board Commissioner, Olympic Medical Center MOST DIFFICULT My plan is to reduce recreational screen time

to less than two hours. This will be a challenge being that I am retired. I would like to get out to hike more and read more.

EASIEST Since I am already plant based, the fruits and vegetables will be pretty easy. I can sometimes get in five servings of fruits by the end of breakfast.

CINDY KELLY

Board Director, Port Angeles School District MOST DIFFICULT Two hours or less of recreational screen time.

EASIEST Getting one hour of physical activity.

SUPPORT TEAM My family will be very supportive. I challenge

all my fellow school board directors across the Olympic Peninsula to be part of this journey with me.

SUPPORT TEAM My wife, who also is plant based. Plus, of course, my walking buddy, Allie.

COMMUNITY OBSTACLES Our families have a lot of daily demands on their time and This is a team sport. energy from their jobs while juggling their household obligations, along with their chilCOMMUNITY OBSTACLES I think the biggest obstacle people face about achieving good health dren’s school and after school events and activities. Many of our families are struggling is believing that they possess control of most aspects of their life that can help them become with having adequate financial resources. more healthy. We spend our lives building habits that are unhealthy. To change, we must first learn the science about how certain habits harm us and then, subsequently, we must learn what science shows us about what other lifestyle choices build and support health. The chalSequim Free Clinic Board, Sequim Food Bank Board lenge then becomes replacing old, unhealthy habits with new healthier habits, one at a time.

PATTY LEBOWITZ

ANDRA SMITH

Executive Director, Sequim Food Bank, & OPHCC Board Treasurer MOST DIFFICULT For me, it will probably be getting in five fruits and veggies a day. When life gets hectic — and it is usually that way — I grab what is most convenient to eat and not necessarily the most nutritious.

& OPHCC Board Director

MOST DIFFICULT The most difficult part of the challenge will be

two hours or less of recreational screen time. My husband and I choose not to have commercial television, cable or Netflix.

Instead, we read local newspapers and some national news online. For me it can be challenging not to get sucked into computer games, blogs and eBay.

EASIEST The easiest for me will be zero sugar sweetened bever- EASIEST Eating five or more fruits and vegetables a day. This will not be a problem at all

ages. I cut those out years ago ... with the exception of wine.

as this is already something I have incorporated into my daily life.

SUPPORT TEAM During the challenge I’ll have the support of my husband, daughter and SUPPORT TEAM My family. They are very supportive. friends.

COMMUNITY OBSTACLES That is a hard one. I don’t think there is one obstacle that is most difficult. I think it is a combination; access to affordable fresh produce, cost of eating COMMUNITY OBSTACLES I believe the scarcity of full time jobs with employer-provided more nutritious foods, nutrition education and individual/family/community support. All health insurance is a large obstacle to good health. After rent, food, utilities and transportation expenses, it is common for individuals and families to be left without money of these are equally important and are obstacles for good health. for health care expenses. That’s why I am passionate about supporting the Sequim Free Clinic, because I know I play a role in breaking down the financial barrier many in our community face when seeking out good health.

MARY BUDKE

Executive Director, Olympic Peninsula Boys & Girls Clubs of the Olympic Peninsula

MOST DIFFICULT Frankly, on any given day, all five of them present a challenge. The most difficult, though, will be zero sugarsweetened beverages. I like a morning latte with brown sugar.

EASIEST The easiest will probably be two hours or less of recreational screen time.

SUPPORT TEAM Spouse, co-workers and 400+ children.

COMMUNITY OBSTACLES Consistency in practicing healthy eating and exercising.

PENINSULA DAILY NEWS/SEQUIM GAZETTE

JESSICA HERNANDEZ

Executive Director, Port Angeles Food Bank MOST DIFFICULT Getting one hour of physical activity.

EASIEST Eating five fruits/veggies a day.

SUPPORT TEAM My kids, husband and coworkers.

COMMUNITY OBSTACLES Access to healthy foods for all people regardless of socioeconomic status.

HEALTHY LIVING

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Join our Healthy Leaders in taking the 5210 Challenge!

Eat at least 5 servings of fruits and vegetables per day!

Shoot for less than 2 hours of recreational screen time!

Try for at least 1 hour of physical activity per day!

Aim for 0 sweetened beverages per day!

Healthy habits start at home and take time to develop. This handy tracker will help you adopt healthier habits and record your success! Check each box for the habit(s) you accomplish each day. 5210 is fun for everyone. Challenge your family and your friends.

5 5 5 5 5 5 5 5 5 5 5 5 5 5

Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Monday Tuesday Wednesday Thursday Friday Saturday

2 2 2 2 2 2 2 2 2 2 2 2 2 2

+

1 1 1 1 1 1 1 1 1 1 1 1 1 1

+

0 0 0 0 0 0 0 0 0 0 0 0 0 0

+

Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Monday Tuesday Wednesday Thursday Friday Saturday

=

5 5 5 5 5 5 5 5 5 5 5 5 5 5

2 2 2 2 2 2 2 2 2 2 2 2 2 2

Total

1 1 1 1 1 1 1 1 1 1 1 1 1 1

0 0 0 0 0 0 0 0 0 0 0 0 0 0

How did you do?

30-59 checkmarks = good start, keep trying, new habits take time to learn.

Focus on one new habit at a time.

60-84 checkmarks = terrific, youâ&#x20AC;&#x2122;re doing great. Now add one more healthy habit to each day.

85-112 = outstanding 5210 super star!

Share your success with others and show them how well 5210 works for you.

Need another challenge sheet? Get one at www.olympicmedical.org/challenge

Olympic Medical Center encourages healthy lifestyle habits.

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HEALTHY LIVING

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Peninsula Daily News/Sequim Gazette

HEPATITIS C:

SAFE, EFFECTIVE TREATMENT IS AVAILABLE

BY JEANETTE STEHR-GREEN, MD & GERALD B. STEPHANZ JR., MD, FACP

Hepatitis C is an infectious disease caused by a bloodborne virus that attacks the liver.

The Hepatitis C virus (HCV) differs from other infectious diseases in several ways: • Most people infected with the virus do not get sick when they initially are infected.

• Once infected with HCV, most people do not clear the infection from their bodies and remain infected for life (called “chronic infection”).

• People with chronic hepatitis C can live for decades without symptoms, but their livers are being damaged.

• The damage can build up over time and result in

SUBMITTED PHOTO Volunteers in Medicine of the Olympics (VIMO) free clinic in Port Angeles has a designated Hepatitis C Treatment Team. It includes, from left to right, Don Ho, patient navigator; Michael Salyer, clinic manager; Jeanette Stehr-Green, medical epidemiologist; Joe Cress, clinical psychologist; Lori Jacobs, patient navigator; and Gerald Stephanz, clinic medical director. liver scarring (cirrhosis), liver cancer and even death.

HCV is spread through contact with the blood of an infected person.

Before a sensitive test became available to screen the

blood supply in 1992, HCV was spread through blood transfusions and organ transplants.

HEPATITIS C continued on Page 14 >>

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Today, HCV is spread primarily by sharing needles (and other paraphernalia) used to inject drugs.

Other means of spread do occur, such as from an infected mother to her baby during pregnancy and through sexual contact with a person infected with HCV, but these routes of transmission are much less common.

IMPACT OF HEPATITIS C According to the Centers for Disease Control and Prevention (CDC), an estimated 3.5 million people in the United States, or about 1 percent of the population, have chronic HCV infection.

HCV prevalence is highest among persons born from 1945 to 1965 (baby boomers).

Hepatitis C is a leading cause of liver cancer and the No. 1 reason for liver transplants in the United States.

Based on national data, HCV kills more Americans than any other infectious disease reported to the CDC, including human immunodeficiency virus (HIV).

In 2016, HCV caused or contributed to more than 18,000 deaths in the United States alone.

IMPROVEMENTS IN HCV TREATMENT Chronic hepatitis C is treatable.

Treatment helps to reduce progression of liver damage and may prevent liver cancer. It also prevents the spread of the infection to others.

Initially chronic HCV infection was treated with an injectable drug called interferon-alfa.

This drug worked by boosting the body’s immune system to fight the infection. But less than a quarter of

SCREENING FOR HEPATITIS C The Centers for Disease Control and Prevention (CDC) recommends hepatitis C testing at least once for persons with the characteristics listed below.

• Born from 1945-1965 (baby boomers).

• Ever injected illegal drugs, including those who injected once or a few times many years ago.

• Received clotting factor concentrates produced before 1987.

• Received a transfusion of blood, blood components or an organ transplant before July 1992 (before screening was implemented).

• On long-term hemodialysis.

• Infected with HIV .

• Have signs or symptoms of liver disease (for example: abnormal liver enzyme tests) • Born to hepatitis C virus-positive mothers.

If an individual continues behaviors that put them at risk for hepatitis C infection (such as injecting drugs), testing should be repeated at least annually. patients were cured even after 48 weeks of treatment.

Reformulation of the interferon and addition of another drug (ribavirin) doubled the response rate but the regimen still required months and months of treatment and many patients developed serious side effects.

Luckily, in the past 10 years, HCV treatment has improved dramatically; more than a dozen drugs aimed at the HCV itself have emerged.

These orally administered medications, referred to as direct-acting antivirals (DAAs), act by blocking steps in the virus’ life cycle.

When used in certain combinations, cure rates are as high as 98 percent after eight to 12 weeks of treatment and the side effects are much diminished.

HEALTH PLANS RESTRICT REIMBURSEMENT Although current HCV medications are effective with minimal side effects, a full course of DAAs can cost from $28,000 to $80,000, depending on the DAA and duration of treatment.

These high costs have led to restrictive reimbursement policies by health plans and payers in which only the sickest patients (those with most advanced liver disease) are approved for treatment.

Of concern, the delay in treatment could allow further progression of liver damage due to the infection and an increased risk of HCV complications during the wait.

Following a 2016 class-action lawsuit, Washington State Medicaid was ordered by a federal judge to cover treatment of chronic HCV infection without regard to degree of liver damage.

Health Care Authority (HCA) which oversees Medicaid in Washington; however, will not pay for hepatitis C treatment unless a liver, GI or infectious disease specialist, or a provider who specializes in the treatment of HIV, is involved in the case.

HEPATITIS C continued on Page 15 >>

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<< HEPATITIS C from Page 14

As a result, many low-income patients, especially those living in more rural or under-served communities, have had difficulty accessing this life-saving treatment.

participated in UW-ECHO since 2008.

The North Olympic Healthcare Network, also in Port Angeles, officially joined the program in 2017 and treats patients who are co-infected with the HIV. In addition to the local clinics participating in UW-ECHO, GI specialists at Olympic Medical Physicians Specialty Clinic in Sequim also can provide care to

hepatitis C patients, especially those with more advanced liver scarring.

BOTTOM LINE Let this story have a good ending. HCV infection can be cured and treatment is available locally. If you think you or a friend or loved one might be infected with HCV, get screened.

HEPATITIS C continued on Page 16 >>

WHAT…is MELT®?!

INTERESTED IN LEARNING HOW TO LIVE A MORE ACTIVE, PAIN-FREE, HEALTHY LIFE? MELT® Method a self-treatment, soft tissue technique using small balls and a soft foam roller may be the answer.

The nervous system cannot relax and heal properly when it is receiving signals of pain.

MELT® is used to treat an array of issues, such as stiffness, achiness, tension, digestive issues, arthritis, and neck and low-back pain.

Achieving and maintaining healthy fascia is the missing link between fitness and medicine.

Strait Exercise & Wellness Center has on-going classes and workshops for many different conditions.

Call us 360-417-0703 or drop by for more information.

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A LOCAL SOLUTION Fortunately, another option exists.

The HCA will approve treatment for patients whose doctors are not specialists but are participating in Project ECHO. Project ECHO (which stands for Extension for Community Healthcare Outcomes) is a health care model that was launched by the University of New Mexico Health Sciences Center in 2003.

ECHO expands access to expensive hepatitis C medications by linking expert specialists at academic centers with primary care providers in local communities.

Unlike telemedicine which links patients to providers, ECHO trains primary care providers to deliver specialty care services.

It also provides ongoing consultation and oversight of those providers.

Because of lack of access to specialty care in Clallam County, Volunteers in Medicine of the Olympics (VIMO) free clinic in Port Angeles joined the ECHO network based at the University of Wash-

ington (UW) in 2015.

Involvement in ECHO requires weekly participation in teleconference meetings and the presentation of cases to the UWECHO faculty.

VIMO free clinic also designated a Hepatitis C Treatment Team to make sure patients receive needed follow-up and complete treatment successfully.

Since joining UW-ECHO, VIMO free clinic has treated 36 Clallam County residents with chronic HCV infection.

The patients have come from all walks of life, ranging in age from 21 to 67 years; about half have been women.

Some of the patients have been homeless or dealing with significant life challenges, but many could just be your next door neighbor or friend.

Although the number of patients treated by the free clinic is encouraging, responses from patients who have been treated and learn they no longer carry this infection demonstrate that the effort can be a life-changing event.

For instance, one patient has returned to school and hopes to pursue a career in counseling.

Currently, VIMO free clinic is not the only ECHO participant on the North Olympic Peninsula.

Calawah Medical Clinic in Forks has

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<< HEPATITIS C from Page 15

It is the only way to know if you are infected. (See sidebar on Page 14.)

Early treatment can prevent permanent damage to your liver and is a crucial step to ensuring your longterm health and preventing the spread of infection to others.

Dr. Jeanette Stehr-Green is a medical epidemiologist and was interim Clallam County Health Officer in 2015. She served on the Clallam County Board of Health from 20032016 and has volunteered at Volunteers in Medicine of the Olympics (VIMO) free clinic in Port Angeles since 2008.

Dr. Gerald Stephanz is a board-certified nephrologist and internist. He is the medical director of VIMO and is chair of the Clallam County Board of Health.

WHAT SHOULD YOU TO DO IF YOU HAVE HEPATITIS C VIRUS INFECTION? If you find you have been exposed to the hepatitis C virus, work with your health care provider to confirm the infection and take steps to protect your liver from further damage.

• Get evaluated to decide if treatment is a good option for you and which medication is best.

• Get vaccinated against hepatitis A and B, if you are not already vaccinated, because these can also damage your liver.

• Abstain from drinking alcohol or using other drugs, including marijuana, which can further damage your liver.

• Check with your health care provider before taking any new prescription pills, over-the-counter drugs (such as non-aspirin pain relievers), or supplements, as these can potentially damage the liver.

Hepatitis C evaluation and treatment is available through the following local health care providers: Volunteers in Medicine of the Olympics Free Clinic 819 E. Georgiana St. Port Angeles, WA 98362 360-457-4431 Calawah Medical Clinic 460 W. E St. Forks, WA 98331 360-374-2500

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GET SUN SMART SHIELD YOURSELF FROM HARMFUL RAYS YEAR ROUND

BY JAMIE WENDORF

OWNER, SEA SIREN SKIN CARE

As warmer weather approaches, those of us who are lucky enough to live in the beautiful Pacific Northwest will be spending more time outdoors.

What that outdoor time also means is an increased risk for sun damage to skin.

Skin cancers are on the rise in the United States.

The American Cancer Society estimates there will be more than 70,000 new cases of malignant melanoma, the most serious form of skin cancer, and more than 2 million new cases of basal and squamous cell skin cancers in 2018.

The numbers make it clear: It is important to understand the importance of sun protection and how sunscreen, when applied properly, can prevent skin cancer.

ULTRAVIOLET RAYS Ultraviolet, or UV, radiation is contained in the light that reaches Earth from the sun.

There are UVA, UVB and UVC rays in the ultraviolet spectrum.

UVA and UVB rays penetrate the atmosphere and provide warmth, while UVC rays are blocked by the atmosphere.

SUN SAFETY continued on Page 18 >>

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of 30, you could remain outside 30 times longer than if unprotected.

Another way to look at it is in terms UVB rays cause the initial redness of percentages. of a sunburn by damaging the outer An SPF 30 keeps out 97 percent of epidermal layer of skin.

UVB rays and an SPF of 50 will proThe superficial redness and pain tect you from 98 percent of UVB rays. caused by UVB rays subsides Nothing offers 100 percent protecWEAR AND REAPPLY OFTEN quickly, but the underlying damage Serious sun exposure management tion, and there is no statistical signifiremains and accumulates, potenrequires more than just applying sun- cance to using an SPF over 50. tially resulting in basal and squaThe SPF number is useful, but in screen protection at the beach or mous cell cancers. reality, it is just an estimate. before that 10-mile hike.

UVA rays were once thought SPF doesn’t take into consideration It is an everyday commitment. essentially harmless, but it is now whether or not you have been swimWhen outdoors, seek the shade, known that UVA rays cause pigmenwear protective clothing, a largeming, sweating or the level of the UV tation changes associated with sunbrimmed hat and sunglasses. index that day. tan and, worse, the negative effects Use extra caution near water, snow Products with higher SPF ratings generally associated with long-term and sand, as they reflect the damaging can be misleading and give a false sun exposure. sense of security.

UVA exposure leads to skin dryness, rays of the sun, increasing your chance of sunburn.

It is much easier to just stick to the uneven pigmentation, inflammation, Check the UV forecast for your area rule to reapply sun protection every wrinkles and sagging skin. in the newspaper, on the radio or on two hours.

The rays penetrate deep into the websites such as EPA.gov or When enjoying water sports, such as dermis, resulting in loss of the elastic water skiing, surfing or swimming, quality of its supportive collagen, caus- accuweather.com before going out for reapply after toweling off. the day. ing premature aging.

Apply sunscreen generously to your Avoid using tanning beds.

Extended UVA exposure has been face, back of neck, tops of ears and all The easiest and most convenient linked to the development of basal and squamous cell cancers, as well as pre- way to protect oneself, according to the areas that are not protected by clothAmerican Academy of Dermatology, is ing. The American Cancer Society reccancerous lesions. to apply a water-resistant, broad-spec- ommends following the guideline of Tissue damage from UVA rays is trum sunscreen with a sun protection applying 1 ounce of product, which is cumulative and, unfortunately, the about a palm-full, or enough to fill a effects do not appear until years after factor (SPF) of at least 30 and up to shot glass. an SPF of 50. exposure.

Every sunscreen has a “Sun ProtecAccording to ScienceDaily.com, 10 to CHOOSE A SUNSCREEN tion Factor” number.

12 times more UVA than UVB rays It’s important to choose a sunscreen The SPF number theoretically correach the Earth’s surface at sea level. that you like.

Unlike the shorter wavelength UVB relates to how long a person can stay in the sun without burning. rays, UVA rays easily penetrate clear For example, while wearing an SPF barriers such as home and auto SUN SAFETY continued on Page 19 >> window glass and cloud cover.

UVA rays contain the same energy level regardless of time of day or season, presenting the same damaging effects at 9 a.m. in December as they do at 4 p.m. in July.

<< SUN SMART from Page 17

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The easier it is to apply and the more comfortably it wears, the more likely you’ll be to actually use it daily and reapply it frequently.

There are two formula types of sun protection: physical and chemical.

Physical sunscreens contain active mineral ingredients such as titanium dioxide and zinc oxide, which are both naturally broad spectrum, protecting you from both UVA and UVB rays.

Micronized minerals are smooth to apply and work immediately after application, sitting on the surface of the skin, scattering and reflecting the sun’s rays.

Chemical sunscreens tend to be more common and penetrate the surface of the skin to absorb the sun’s rays like a sponge.

They need to be applied at least 20 minutes before sun exposure and can potentially be more irritating to the skin, since multiple ingredients are combined to get the broad spectrum coverage.

You don’t need to be afraid to enjoy the outdoors; you just need to be sun smart.

Stock up on your preferred sunscreen.

Prepare by wearing comfortable protective clothing and applying sunscreen to any exposed skin.

Reapply often when really active or getting wet.

Sun protection is one of the easiest and most important steps you can take to avoid sunburn, reduce premature aging and protect your skin from the risk of skin cancer.

Jamie Wendorf is the owner of Sea Siren Skin Care in Sequim. She graduated from aesthetics school in California in 1993, studied with an Austrian aesthetician for two years and is still studying the art of perfecting clients’ skin.

Wendorf is married with two young adult children and a greyhound. She also is an avid gardener and loves to cook and paint.

Threat posed by parvo virus been contaminated with feces. If this fecal matter comes from dogs that have parvo, the virus can spread.

Like their owners, dogs are not But parvo also can spread through immune to illness. With a little help from their veterinarians, dogs might indirect contact. Because the resilient parvo virus can survive on clothing, recover from a host of health problems rather quickly. But other prob- including shoes, human skin and lems pose greater threats, and some equipment, as well as in the environcan even prove fatal. ment, puppies or young dogs can conOne health problem dog owners tract it through these sources as well. hope to avoid at all costs is parvo.

Resistant to common household According to the American Kennel cleaners and disinfectants, the parvo Club, dogs infected with parvo can go virus can survive for years if it’s profrom happy and healthy to fatally ill in tected from direct sunlight. a matter of days, which only highlights Are certain dogs at greater the need for dog owners to learn about risk of contracting parvo than parvo and how to prevent it. others?

What is parvo?

The AKC notes that, while the Parvo is a highly contagious virus reasons are unknown, German shepthat affects the gastrointestinal herds, rottweilers, Doberman pintracts of puppies and young dogs. schers, English springer spaniels If the gastrointestinal illness that and American Staffordshire terriers results from a parvo infection is not are at greater risk of contracting the treated, it can be deadly. parvo virus than other breeds.

How do dogs contract parvo?

But the dogs whose risk of conParvo can spread through direct tracting parvo are the greatest are contact with infected dogs or those between six weeks and six through feces and spreads easily months of age, as well as dogs that through the canine population, have not been vaccinated or whose according to the AKC. vaccinations are incomplete.

Direct contact with poop through The link between vaccinations the nose and mouth can occur when and parvo can be found in the anticurious puppies or young dogs sniff or bodies puppies receive from their lick surfaces or other dogs that have mothers before they are born.

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Dog owners must vaccinate their dogs to protect them from parvo as these antibodies fade after puppies are born.

What are the symptoms?

The AKC notes that the most common symptoms of parvo include: • Severe and bloody diarrhea • Lethargy • Anorexia • Fever • Vomiting • Weight loss • Weakness • Depression • Dehydration Can parvo be prevented?

No dog is 100 percent safe from the parvo virus; however, vaccinations can be highly effective, and the AKC recommends all puppies begin receiving vaccinations for the parvo virus when they are between six and eight weeks old.

These vaccinations are typically administered in a series of three, and the second round might occur between 10 and 12 weeks, with the third coming between 14 and 16 weeks.

Within a year of receiving the final initial round of vaccinations, a booster shot will be administered and then re-administered every three years after that.

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