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April 20, 2022

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Healthy LIVING IN THIS ISSUE: • Schools, NOHN partner for mobile clinic • Pollen season getting longer • Coalition promotes community wellness • Podiatry gives general health a leg up

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volume 18, issue 1


SCHOOLS, NOHN PARTNER FOR MOBILE CLINIC By Drew Herman

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hen the unexpected COVID-19 pandemic disrupted normal life for schoolchildren, a well-timed asset for meeting their mental health needs was already on the road to Port Angeles. “It’s still fairly new,” North Olympic Healthcare Network CEO Dr. Michael Maxwell said. Thanks to a partnership between Port Angeles School District and NOHN, a new mobile clinic is bringing extra medical and behavioral services PHOTOS COURTESY OF NOHN to public school students. Design and The mobile health clinic visits Port Angeles schools in rotation. construction of the customized 38-foot Winnebago, a years-long process, was other clinics already in operation, the NOHN and PASD began already well advanced in 2020, although collaborating on the clinic in 2017, when Olympic team when to ADI Mobile pandemic delays meant the vehicle Health in Portland, Oregon, for specific the Federally Qualified Health Center arrived in October 2021, about nine design and construction. The cost before put it forward as a way to address months later than originally planned. fully equipping and staffing the vehicle demand for basic services in schoolStudents, parents and teachers came to about $350,000. A grant of age children. are still getting used to the resource, “The school district liked the idea, so $3.3 million from the United Health but Maxwell said reception of the convenient, new option for essential care we went ahead and designed this mobile Foundation helped make it possible. The unit’s interior is divided into unit,” Maxwell said. has been positive. four spaces: two counseling areas, a After attending a mobile clinic “You want to break down barriers to conference in Austin, Texas, and visiting getting the services you need,” he said.

medical/dental area, and a reception/ intake space. “When you’re on it, it feels surprisingly roomy,” Maxwell said. Regular personnel includes four people: a medical provider, a behavioral specialist, a support staffer and a driver/ security person. With the capacity to substantially augment the resources available from school nurses and counselors, the clinic visits eight school sites in rotation, two per day, five days per week. “Initially the focus was at the high school,” Maxwell said. The clinic proved so convenient and necessary, though, that children from the lower grades were being driven to the high school for visits, so the mobile clinic became more mobile. Maxwell said the capability of following and, if necessary, changing the school location schedule highlights the unit’s flexibility. Students can make appointments or walk in whenever the clinic is at their school. It also soon became clear that

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behavioral services were in more demand than the medicinal, with school counselors facing more varied and intense problems as the pandemic continued. “For the behavioral component, much of it is prescheduled,” Maxwell said. With the unit making weekly rounds, many children get access to more regular and flexible medical care than before. Available care includes counseling, immunizations, dental screenings and sports physicals. The mobile clinic works closely with the schools’ family navigator program (see Page 11) to spread word about the mobile unit and connect students who could benefit from a visit. Maxwell credits the program with making the mobile clinic

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Share your knowledge with your North Olympic Peninsula community! Health-related professionals are invited to contribute informative and educational articles for consideration in Healthy Living. Contact special sections editor Drew Herman at dherman@soundpublishing.com for more information. 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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more successful and the family navigator staff has also expanded. He expects even more families will make use of the clinic as it becomes a familiar sight at schools. Although mobile clinics are not as well equipped or profitable as conventional clinics, and don’t treat as high a volume of patients, Maxwell said the benefit for the community justifies the extra staffing and cost. “We will subsidize it because it’s meeting an important need,” he said. “It may be lower volume, but it’s higher impact.” For information about mobile clinic resources and appointments, and a schedule of its school locations, visit www. nohn-pa.org/mobile_health_ clinic.php.

| APRIL 2022 3


POLLEN SEASON GETTING LONGER AND MORE INTENSE WITH CLIMATE CHANGE

Here’s what allergy sufferers can expect in the future

By Yingxiao Zhang and Allison L Steiner The Conversation

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race yourselves, allergy sufferers — new research shows pollen season is going to get a lot longer and more intense with climate change. Our latest study finds that the U.S. will face up to a 200 percent increase in total pollen this century if the world continues producing carbon dioxide emissions from vehicles, power plants and other sources at a high rate. Pollen season in general will start up to 40 days earlier in the spring and last up to 19 days longer than today under that scenario. As atmospheric scientists, we study how the atmosphere and climate affect trees and plants. While most studies focus on pollen overall, we zoomed in

on more than a dozen different types of grasses and trees and how their pollen will affect regions across the U.S. in different ways. For example, species like oak and cypress will give the Northeast the biggest increase, but allergens will be on the rise just about everywhere, with consequences for human health and the economy. If your head is pounding at just the thought of it, we also have some good news, at least for knowing in advance when pollen waves are coming. We’re working on using the model from this study to develop more accurate local pollen forecasts. WHY POLLEN IS INCREASING Let’s start with the basics. Pollen

— the dust-like grains produced by grasses and plants — contains the male genetic material for a plant’s reproduction. How much pollen is produced depends on how the plant grows. Rising global temperatures will boost plant growth in many areas, and that, in turn, will affect pollen production. But temperature is only part of the equation. We found that the bigger driver of the future pollen increase will be rising carbon dioxide emissions. The higher temperature will extend the growing season, giving plants more time to emit pollen and reproduce. Carbon dioxide, meanwhile, fuels photosynthesis, so plants may

grow larger and produce more pollen. We found that carbon dioxide levels may have a much larger impact on pollen increases than temperature in the future. CHANGES VARY BY REGION We looked at 15 different pollen types, rather than treating all pollen the same as many past studies have. Typically, pollination starts with leafy deciduous trees in late winter and spring. Alder, birch and oak are the three top deciduous trees for causing allergies, though there are others, like mulberry. Then grasses come out in the summer,

ALLERGY continues on Page 10 >>

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THINK YOU HAVE ALLERGIES? IT MAY BE COVID It can be difficult at this time of year to determine what’s causing your symptoms. Early spring typically ushers in a lot of sniffling, sneezing and wheezing from seasonal allergies. You may assume these symptoms are due to the pollen in the air. But COVID-19 is still circulating and many symptoms of the virus are relatively mild and resemble seasonal allergies. That can make it hard to tell what your symptoms are coming from. Is it your usual seasonal allergy kicking into gear, or do you have COVID-19? Some symptoms of

allergies and COVID-19 are very similar. These include: • Runny nose • Nasal congestion • Sneezing • Sinus pressure • Cough • Fatigue. Symptoms of allergies that are not often seen in people with COVID-19 include: • Watery, itchy or red eyes • Itchy nose, roof of mouth or throat. Symptoms that are more likely due to COVID-19 than allergies include: • Loss of taste or smell • Shortness of breath or trouble breathing • Muscle or body aches • Headache • Sore throat • Fever or chills • Nausea or vomiting • Diarrhea. Keep in mind that you can

have seasonal allergies and COVID-19 at the same time. This adds to the difficulty of figuring out what’s causing your symptoms, because you may just assume symptoms are caused by your allergies. Symptoms can also be caused by the common cold or a flu virus. If you are not sure what’s causing your symptoms or you’ve been in contact

with someone who has COVID-19, it’s a good idea to get tested for COVID-19. If you can’t easily find a test, stay home and isolate yourself from others until you know for sure that you don’t have COVID-19. This makes it less likely you’ll spread the virus to others in case you have it. Olympic Medical Center

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| APRIL 2022 5


LOCAL COALITION PROMOTES WELLNESS IN OUR COMMUNITY By Olympic Peninsula Healthy Community Coalition

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ave you ever wondered how your neighbor, your favorite coffee shop or the community activities you enjoy and share, can have a significant impact upon your health and wellness? The health of your family? Your community? The Olympic Peninsula Healthy Community Coalition (OPHCC) is working to improve the daily lives of all community members. First through fostering individual activities and resources, and secondly, by creating a coalition of community service organizations, health professionals, educators, legislators, business owners and individuals. “What I am learning,” said Nicolina Miller, executive director of OPHCC, “is that wellness is within our reach. Together we can empower everyone to take ownership of their health.” EMPOWERING INDIVIDUALS To encourage individual health choices, OPHCC recently launched the Be Well initiative addressing the four pillars that create whole health:

mind, body, spirit and community. The ongoing project seeks to embolden individuals to take responsibility for their own well-being through small, simple steps. Using stories and graphics easily read and understood, strategies and tips will be shared via the OPHCC website and social media. These tips, used in conjunction with the Be Well Passport and other tangible, interactive motivational tools, will build an expanded menu of activities for all members of the community, beginning with a focus on “mind.” “When we talk about being healthy, it’s easy to go to the physical,” said Miller, emphasizing that people have a variety of unique components that make them who they are. “We will start with the mind,” said Miller, “encouraging people to be present and intentional.” For Miller, being present and intentional is about relearning our approach to those small decisions that impact our health, instead of automatically being led by our habits. Being intentional will allow space

to make a different choice, to choose fruit, and not to choose the cookie. According to Miller, it’s also about being nonjudgmental in our attempts to make changes, taking a breath, and showing “more grace to yourself.” “We can give ourselves permission to start wherever we are and know that we absolutely do not need to be perfect,” Miller said. It’s OK to say, “I don’t need to do it all, I just need to start doing. That’s the way to move forward into positive change.” Providing an example of the strategies to be offered, Miller shared these three tips: • Take a breath break. Close your eyes. Breathe in for a count of three. Breathe out for a count of three. Repeat. • Stop the mental spiral. Physically turn your body to look in a different direction, signaling a change in focus to your mind. • Make a decision with intention. Say it definitively out loud or to yourself, “I am doing this.” Then let it go. These simple and effective

PHOTEOS COURTESY OF OPHCC

Robbie Thompson rides the OPHCC Smoothie Bike.

Nicolina Miller and Aaron Brown (opposite page on bridge) on Peabody Creek Trail.

6 APRIL 2022 | HEALTHY LIVING

Peninsula Daily News / Sequim Gazette


UPCOMING PARTNER EVENTS: April 11, 18, 25 and May 2 Prevention Works Free Online Class Series! Up Your Parenting Game: Support Yourself & Your Family with Rachel Hardies – Session 2 Mondays 6:30-7:30 p.m. – Geared towards parents of kids ages 11-18, but all are welcome! Register: www.eventbrite.com/x/ up-your-parenting-gamesupport-yourself-your-familytickets-292856681217 May 7: OPHCC Smoothie Bike at the Irrigation Festival

met with creative solutions, allowing partners to be more impactful through the work they do. One partner may have the answer to another partner’s challenge. exercises can have a big impact on “One of our goals this year is settling your mind and calming your helping our partners be more effective body, strengthening your resolve and in achieving their own missions,” allowing for positive change. Miller said. Supporting community members Through monthly meetings, Miller to be well creates stronger families, hopes coalition partners will learn safer neighborhoods and healthier more about each other’s organizations communities. and the work they are doing. Partners “When we uplift individuals, we will be able to network, strengthening uplift community,” Miller said. And the community through connections, prospering communities in turn resource sharing and being more continue to support thriving members. “This is the cycle OPHCC is supporting.” aware of what is outside their own silo of activity. Community-developed and led CREATING HEALTHY COMMUNITIES strategies enhance the capacity of Healthy communities happen organizations to do their best work, in places where the members, both making changes that benefit all. individuals and organizations: Miller believes that through • promote affordable, healthful collaboration of all members of a food choices community — healthcare providers, • promote widely accessible service organizations working with physical activities children, elders, and individuals • promote prevention-focused with intellectual and developmental health strategies and resources • empower individuals to live their disabilities, tribes, business owners, farmers, artists, educators, mental healthiest lives regardless of their health providers, emergency age, their education or their economic personnel, law enforcement, resources. Miller hopes to grow the OPHCC to nonprofits, spiritual leaders — our be a hub where partners can exchange communities will become a “healthier place to live, learn, work and play,” knowledge and share resources, fulfilling the mission of OPHCC. creating a place where challenges are Peninsula Daily News / Sequim Gazette

With 50 members already bringing their expertise and connections from across the varying sectors of our community, Miller wants to bring even more voices to the table. “The coalition is open to new members,” said Miller. “We need to have all aspects of the community at the table, not only healthcare providers. We need farmers, local businesses and coffee shop owners. All these people are part of that living, breathing organism that we call community. All these people together contribute to making our community healthy.” The success of the OPHCC lies with its partners. “We want to provide tools and resources to our partners,” Miller said. “Partner feedback is key. To our partners, community is more than just a term.” According to Miller, everyone has knowledge, wisdom, and their role to play in creating a healthy community and in supporting our neighbors, friends and families. To learn more about the Olympic Peninsula Healthy Community Coalition visit healthyop.org. Find Be Well tips and more on the OPHCC Facebook page: @ olympicpeninsulahealthy communitycoalition.

May through October Sequim Farmers and Artisans Market, Kids and Seniors Days OPHCC, the Smoothie Bike, health screenings, and more! June 25 WAG Wiggle Walk 5K & 1K with vendors and fun at Carrie Blake Park All proceeds go to Welfare for Animals Guild – WAG. For more information and to become a participant, sponsor or vendor, please contact Olga Mosher at 360-630-3489. Online: Olympic Community of Health Coffee Break Video Series, addressing local health issues through community conversations and shared cups of coffee, www.olympicch.org/post/ochpresents-the-coffee-break-videoseries HEALTHY LIVING

| APRIL 2022 7


FOOT MONTH: PODIATRY CARE GROWS ON THE OLYMPIC PENINSULA Olympic Medical Center

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r. Adam Killpack joined the podiatry team at Olympic Medical Physicians in 2020, expanding expert podiatric care to both Port Angeles and Sequim orthopedic clinics. Killpack, a doctor of podiatric medicine, was always interested in the medical field. But it wasn’t until his wife started having issues with her foot and ankle that he discovered podiatry. “Podiatry was something I locked onto right away,” Killpack said. “I was impressed that (podiatry) tends to be more hands-on, and there are lots of little things you can do to get people feeling better quickly. That’s what I like about it.” Killpack said he finds something enjoyable in every aspect of podiatry, from preventive care and talking with patients about ways to keep their feet healthy, to the challenge

Dr. Adam Killpack

of surgery for trauma, reconstruction or salvaging limbs. “Both can make a significant impact on someone’s life. Anything I can do to keep someone walking pain-free is important to me,” he said. Killpack enjoys the breadth and depth of podiatry, which allows him to treat a wide variety of patients and conditions.

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“It’s foot and ankle, skin to bone, but it’s little kids to elderly, sick patients to high-level athletes, so I can really do a lot with it,” he said. “While it’s foot and ankle, it does span the whole breadth and I get a little flavor of everything.” Though podiatrists are best known for treating common foot ailments like bunions, ingrown toenails and ankle sprains, most modern podiatrists are also trained in fore- and rearfoot surgery, diabetic care, trauma, deformity correction and more. In fact, diabetes and other health conditions have made podiatry part of community health. Research shows that if people with certain serious conditions see a podiatrist for preventive care, it can keep them out of the hospital and significantly decrease the opportunity for loss of leg or limb. Killpack said that makes his job

special. “I enjoy seeing people regularly and keeping them healthy.” “We have a lot to offer on top of bunions and toe problems — though I love treating those,” he said. “The depth and breadth of what we do is not insignificant.” Podiatry offers preventive care for diabetic and high-risk patients, orthotics for flatfoot and foot deformities, trauma management for chronic injuries like joint instability and arthritis, and podiatrists also offer sports medicine. “We’re doing the whole gamut from reconstructive surgery to preventive care,” Killpack said. “Seeing patients get better and feel heard is what we all want. When a patient not only gets taken care of but feels taken care of, that is really rewarding.” A native of Arizona, Killpack received his undergraduate degree

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from Brigham Young University in Provo, Utah, before returning to Arizona to attend podiatry school at Midwestern University. Killpack went on to complete three years of podiatry residency at Swedish Medical Center in Seattle. After finishing residency, he moved to Sequim with his wife and young daughter to work on the Peninsula, “not only because of the beautiful area, but also because of the chance to be a part of the great community.” This community, including Olympic Medical Center, is what drew Killpack to practicing podiatry on the Olympic Peninsula. “This is an ideal area, and I couldn’t ask for a better place to work,” he said. “OMC is focused on providing healthcare to the community in an effective matter, with knowledgeable, helpful staff who are part of the community and invested in each patients’ well-being. “Everywhere we’ve lived has always been temporary because of schooling, so it’s nice to set down roots here and be a part of this community,” Killpack said. “We’re excited to be out here, and it already feels like home.”

HOW YOUR SHOES MAY BE HURTING YOUR FEET Why you should think about more than just style when choosing footwear Ever get home and kick off your shoes, only to find that your feet are red, swollen and achy? Maybe it’s because you’ve been on your feet all day. Or it could be your shoes that are causing the problem. Here are some signs that your shoes are causing more harm than good, even if they look cute with your skinny jeans. • Wrong size: Just because you wore a size 8 when you were 20, doesn’t mean you’re still a size 8 when you’re 45. Weight fluctuations and medical conditions may cause your feet to change size. When trying on shoes to find the proper fit, do it later in the day. Feet swell as the day goes on and shoes should be fitted when they are at their largest. When buying running shoes, go up at least half a size to compensate for foot swelling while exercising. • Worn out: Wearing shoes past their “expiration date” may cause foot pain from plantar fasciitis, tendonitis, stress fractures and shin splints. This is because the padding and support wear thin. Depending on your activity level and how they’re constructed, consider replacing shoes after six to 12 months of wear. • Going barefoot: Podiatrists are seeing an increase in foot issues due to people ditching their shoes as they work from home. Standing and walking barefoot on hard floors puts undue stress on your feet and ankles, causing inflammation and pain. Flip-flops aren’t much better because they don’t provide arch

TAKE A STEP TODAY FOR A BETTER TOMORROW

support or shock absorption. Instead, wear a supportive pair of slippers or slip-on shoes with memory foam inserts. • Wrong footwear: Do you wear flip-flops when you take the dog for a walk? High heels to grocery shop after work? Wearing the wrong footwear for the task may cause more damage to your feet than you realize. If you’re heading out the door for more than a few minutes, make sure you’re wearing shoes with good support. Need to wear those heels for an important meeting? Bring flats to change into afterwards. Your feet will thank you later. • Not enough arch support: If you have tingling or pain in your toes, heels, balls or arches of your feet, it means your shoes aren’t giving you enough arch support. Many stores sell over-thecounter arch supports. If these don’t help, a podiatrist can make recommendations for something that will. • Fashion failure: Unless you’re Carrie Bradshaw from “Sex in the City,” the fashion statement high heels make probably isn’t worth the pain they cause. High heels shift your weight forward to the balls of your feet, putting too much pressure on muscles and joints. If you still want to wear heels, look for ones with rounded toe boxes and a block heel or wedge that’s less than two inches high. To stay fashion forward, don’t discount the strappy sandal. There are many brands that offer cute but supportive styles (think Rachel McAdams in “The Notebook”). Baldwin Publishing

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when pollen comes out — what we call the phenology of the pollen. With that information, we can use followed by ragweed in late summer. meteorological factors like wind, In the Southeast, evergreen trees relative humidity and precipitation to like mountain cedar and juniper figure out how much pollen gets into (in the cypress family) start in the air, and atmospheric models can January. In Texas, cedar fever is the show how it moves and blows around, equivalent of hay fever. to create a real-time forecast. We found that in the Northeast, All of that information allows us pollen seasons for a lot of allergenic to look at where pollen might be in trees will increasingly overlap as space and time, so people dealing temperatures and carbon dioxide with allergies will know what’s emissions rise. For example, it used coming in their area. to be that oak trees would release We’re currently talking with pollen first, and then birch would pollinate. Now we see more overlap of a National Oceanic and Atmospheric Administration lab about ways to their pollen seasons. integrate that information into a tool In general, pollen season will change more in the north than in the for air quality forecasting. There are still some unknowns south, because of larger temperature when it comes to long-term pollen increases in northern areas. projections. For example, scientists Southeastern regions, including Florida, Georgia and South Carolina, don’t fully understand why plants produce more pollen in some years can expect large grass and weed than others. There’s not a good way pollen increases in the future. The Pacific Northwest is likely to see peak to include that in models. It’s also not pollen season a month earlier because fully clear how plants will respond if carbon dioxide levels go through the of the early pollen season of alder. roof. Ragweed and residential trees are also hard to capture. There are SILVER LINING: WE CAN IMPROVE very few ragweed surveys showing POLLEN FORECASTING where these plants are growing in Most pollen forecasts right now the U.S., but that can be improved. provide a very broad estimate. Part of the problem is that there aren’t POLLEN LEVELS ARE ALREADY many observing stations for pollen ON THE RISE counts. Most are run by allergy A study in 2021 found that clinics, and there are fewer than 100 the overall pollen season was already of these stations distributed across the country. Michigan, where we live, about 20 days longer in North America than it was in 1990 and doesn’t have any. pollen concentrations were up about It’s a very labor-intensive process to actually measure different types of 21 percent. Increasing pollen levels in the pollen. As a result, current forecasts future will have a much broader have a lot of uncertainties. These impact than a few sniffles and likely are based in part on what a headaches. Seasonal allergies station has observed in the past and affect about 30 percent of the the weather forecast. population, and they have economic Our model, if integrated into a forecasting framework, could provide impacts, from health costs to missed more targeted pollen forecasts across working days. the country. Allison L Steiner is a professor of We can estimate where the atmospheric science at the University trees are from satellite data and of Michigan and Yingxiao Zhang is a on-the-ground surveys. We also doctoral student in that department. know how temperature influences

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10 APRIL 2022 | HEALTHY LIVING

Peninsula Daily News / Sequim Gazette


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full-time team at Port Angeles School District specializes in putting students and their families together with services that can help address a range of obstacles to health and learning. Since 2019 Becca Larsen has served as the family navigator for PASD. She now has two assistants, and contacts with agencies around the region. The licensed clinical social worker is also the district’s Foster Care and McKinneyVento liaison. She estimated that each year about 100 children in the district are identified who can benefit from the family navigator help. “We do our best to connect families to resources outside of school,” Larsen said. Under the McKinney-Vento Homeless Assistance Act of 1987, every school district has a liaison for families. “It functions a little bit different in every school,” Larsen said. Her team works to find medical and mental health, housing assistance, food and other resources. “We can also provide transportation for families who might not get to the appointment without our help,” Larsen said. A big part of their job is identifying children whose families are homeless or in a difficult transition, she said, noting that a provision of McKinney Venmo means homeless students may continue to attend their school of origin and receive transportation so they can get there. “Housing is definitely a struggle for

families,” Larsen said. “We want to get kids in the (school) building.” The family navigators meet weekly with principals and administrators at each school to identify who and how they can help. “We get referrals from all over,” Larsen said. The coronavirus pandemic has added a source of disruption and stress that affects everyone, as children and parents struggle with anxiety and depression. “It spans over all economic statuses,” Larsen said. She said her favorite part of being a family navigator is building relationships with organizations Becca Larson PASD family navigator outside of the schools. She counts teamwork within PASD and cooperation with groups including Serenity House, Peninsula Behavioral Health and North Olympic Health Network as top assets. The partnership with NOHN helped add an asset to address family needs, with a mobile health unit. The 39-foot RV spends time at different schools each week, giving families easy access to medical and mental care. “Mental health is where we’re getting the most utilization at this point,” she said. Larsen is also grateful to school leadership for making the family navigator program work. “Because the district values and supports it, we’ve been able to accomplish a lot. “It’s not just about academic success,” she said. “It’s also about the social and emotional success, too. It all works together.”

“Because the district values and supports it, we’ve been able to accomplish a lot. It’s not just about academic success. It’s also about the social and emotional success, too. It all works together.”

Peninsula Daily News / Sequim Gazette

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12 APRIL 2022 | HEALTHY LIVING

Peninsula Daily News / Sequim Gazette


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