Oregon Healthy Living | November 2020

NOVEMBER 2020 | VOL. 13 — ISSUE 11 NOVEMBER 2020 | VOL. 13 — ISSUE 11

Facts 34 million Americans with diabetes want you to know

Muddled by Medicare?

Breaking down the options

Revised Thanksgiving recipes Skip the dairy, gluten or meat

Come out Swinging

conditioning for a better golf game

NOVEMBER 2020

on the COVER Golf Performance Specialist in Fitness at Southern Oregon Golf Academy Matt Preston leads students Braedon Grunwald of Medford, Brock Drury of Grants Pass, and Davis Hartwell of Klamath Falls in Saber stick swing exercises at Centennial Golf Club in Medford.

During the pandemic, golf has been one of the few athletic options that has checked off the safety guidelines for being performed outdoors and easy to maintain social distance. SOGA has both children and adult students who wish to learn and improve their golf game.

from the

EDITOR Since 2008, Oregon Healthy Living has inspired a healthier Rogue Valley community by providing quality wholelife wellness advice, insight and education for people who want to live life to the fullest. This issue is the final edition of 2020. Thank you for reading along with us over the last decade. Visit www.oregonhealthyliving.com to access some of our more recent archive articles. We wish you a happy and healthy holiday season.

Photography Illustration by Dustin Peters. crose@rosebudmedia.com

CONTENT HEALTH

FOOD

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Diabetes Quiz: Test your knowledge

vol. 13 – issue 11

FITNESS

FITNESS

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Explore Your Roots: Adaptable Thanksgiving recipes

COVER STORY

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Youth Athletic Training: Agility and endurance

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HEALTH

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Golf Workouts: Two Strangers Meet: Off the greens routines

EDITOR — Cheryl P. Rose SPECIALTY PUBLICATIONS SALES MANAGER Molly Little DESIGN & PRODUCTION Paul Bunch, Amy Tse, Dustin Peters

NATURAL

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Moving Parts in Overall Body Function: Medicare:

Could a piece of What combination Essential B candy save the day? works for you? vitamins

CONTRIBUTING WRITERS Aaron Cooper Micah Leigh Sarah Lemon Cheryl P. Rose Rebecca Scott Cindy Quick Wilson

CEO & PUBLISHER — Steven Saslow

HEALTH

PETS

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Itchy Ears:

Chronic canine infections

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CONTRIBUTING PHOTOGRAPHERS Denise Baratta, Dallion McGregor Oregon Healthy Living Magazine is published by the Rosebud Media Advertising Department 111 N. Fir St., Medford, OR 97501 | General information: 541.776.4422 | Submissions and feedback: crose@rosebudmedia.com

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HEALTHY Sherm’s Food 4 Less offers a wonderful variety of organic produce from avocados to spinach, corn and berries, melons to mushrooms and pears and asparagus, to name just a few! You’ll also find a plentiful selection of organic spices from Simply Organic, Wild Harvest Organic, and Organic Morton and Bassett to enhance the flavor of every dish you prepare!

2230 BIDDLE RD. • MEDFORD | Shermsmarkets.com

ULTIMATE FALL SALAD

INGREDIENTS: 1 small butternut squash

1 1/2 cups cooked farro

3 tablespoons extra virgin olive oil, divided

1/2 cup dried cranberries

1/2 teaspoon cinnamon 1/2 teaspoon kosher salt, divided 1/2 teaspoon freshly ground black pepper, divided 1 bunch chopped kale (about 6 cups) 3/4 cup chopped walnuts

2 cups chopped apples (about 2-3 apples) 4 ounces shredded Pecorino-Romano cheese 1/4 cup freshly squeezed orange juice 1 tablespoon Dijon mustard 2 tablespoon chopped shallot

DIRECTIONS: Peel, scoop out seeds, and cube butternut squash.* Toss in 2 tbsp extra virgin olive oil, cinnamon, 1/4 tsp salt, and 1/4 tsp ground pepper.

Spread on baking sheet and roast for 30 minutes at 400°F, or until squash is tender and golden brown.

In a medium skillet over medium heat, toast walnuts until golden brown and fragrant.

Combine kale, farro, apples, squash, walnuts, cheese, and cranberries in a bowl.

For the dressing, whisk 1 tbsp olive oil, orange juice, mustard, shallot, 1/4 tsp salt, and 1/4 tsp pepper in a bowl until fully combined.

Dress salad immediately, or keep dressing on the side and dress your salad as you go.

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HEALTH

Debunking

Diabetes Myths

Do you know fact from fiction?

STORY BY REBECCA SCOTT

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hen you have diabetes, your body does not make enough insulin or cannot use the insulin it makes efficiently. This causes too much sugar, or glucose, to stay in the bloodstream, which can lead to serious health problems. To test readers’ knowledge of this disease, we consulted two Southern Oregon medical experts. Take our quiz and determine if you know the real facts about diabetes.

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HEALTH 1. Both Type 1 and Type 2 diabetes are autoimmune conditions. a. True b. False nswer: b. Type 1 diabetes is an autoimmune condition, says Tina Jones, a registered dietiA cian and certified diabetes instructor at Asante Rogue Regional Medical Center in Medford.

With Type 1 diabetes, the immune system destroys insulin-making cells in the pancreas.

The body cannot make insulin anymore and a person requires insulin injections to live.

When you have Type 2 diabetes, either the body doesn’t make enough insulin, or the insulin doesn’t work properly, she says.

2. If you are diabetic, it’s because: a. You drink too much soda. b. You eat too many sugary snacks. c. None of the above. nswer: c. There’s not a direct correlation between eating a lot of sugar and developing A diabetes, explains Jones. Sugar can have an indirect influence because any diet high in calories may lead to weight gain, which increases your overall risk of getting diabetes.

3. Type 2 diabetes only affects overweight people. a. True b. False nswer: b. While it’s often associated with obesity, a person may have Type 2 diabetes and A be a normal weight, or even sometimes underweight, says Kim Waller, a certified physician assistant and certified diabetic educator at Siskiyou Community Health Center in Grants Pass.

4. Type 2 diabetes is: a. A mild condition. b. Potentially life threatening if ignored. c. No big deal. nswer: b. No form of diabetes is ‘mild,’ according to Waller. If not managed, diabetes A could lead to several serious medical problems, including heart disease, stroke, kidney damage, blindness and nerve damage.

5. If you have diabetes, you will always show symptoms. a. True b. False nswer: b. You can have diabetes and not show any symptoms, Waller explains. Especially A with Type 2 diabetes, the body is accustomed to functioning at higher blood sugar levels.

Over time, the body will adjust to that state of being until it cannot any longer, and symptoms begin, like increased urination, thirst and hunger.

6. Diabetics are: a. People who are overweight. b. Children under 12 years old. c. People who generally have several risk factors. nswer: c. A common myth is that being overweight means you will always develop Type A 2 diabetes, says Jones. It’s not a given because there are several risk factors involved, including family history, genetics, ethnic background and age. Being overweight compounds your risk of getting Type 2 diabetes, but it’s not the sole determining factor. continued on page 6

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HEALTH continued from page 5

7. If you are diabetic:

10. If you have Type 2 diabetes, you caused it to happen.

a. You can eat most foods in moderation as part of a healthy diet. b. You must avoid specific foods forever. c. You must follow a strict diet. nswer: a. Jones often encounters diabetics who believe they cannot eat A specific foods ever again; however, no foods are truly off limits. The key is the amount and how often you eat certain foods. A dietician will help you incorporate those foods into a healthy diet, she explains.

a. True

nswer: b. There is a stigma associated with diabetes that the person A caused it, says Jones. Many people are embarrassed because of this misinformation. Even if you are carrying extra weight, she says it is important to remember the impact of other risk factors that are out of your control, such as age, genetics and family history.

11. Symptoms of diabetes include:

8. Diabetics are more prone to getting sick. a. True

9. Diabetes can be _____with certain lifestyle changes. a. Put into remission

c. Cured

b. Reversed nswer: a. Diabetes cannot be reversed or cured, but it can go into a type A of remission with sustained lifestyle changes, explains Jones. If you are diagnosed with Type 2 diabetes and manage your weight and exercise regularly, it’s possible for your blood sugar to return to normal levels. But if you regain the weight or have a sedentary lifestyle, blood sugar levels will increase again, she says.

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a. Increased thirst

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d. Irritability

b. Frequent urination

b. False

nswer: b. You are not more likely to catch a cold or get sick if you have A diabetes, says Waller. If you do get sick, it can make your blood sugars more challenging to manage and could delay or increase the amount of time it takes your body to heal from an infection.

b. False

c. Fatigue

e. All of the above

nswer: e. All of those symptoms could be signs of diabetes, according to A Jones. You could also have unexplained weight loss, blurry vision or cuts that do not heal quickly.

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How many adults have diabetes or are prediabetic? a. 10 million

c. 2 million

b. 200,000

d. Over 50 million

nswer: d. According to the Centers for Disease Control and Prevention, A more than 88 million (1 in 3) adults have diabetes or are prediabetic, says Waller. â–

FOOD

Fresh

Flavors For

Fall Feasting Sharing new foods is a Thanksgiving tradition STORY BY SARAH LEMON

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ringing together diverse groups to share new foods is Thanksgiving’s origin story.

Centuries later, hosts can embrace that holiday spirit by welcoming vegetarians, vegans, gluten-free diners and others following special diets to the table. The spirit shouldn’t be one of compromise but rather enhancing the celebratory meal with hearty vegetables, legumes and whole grains, seasoned with immigrant influences and presented with some autumn pageantry.

Here are my picks for wholesome recipes using the cornucopia of fall produce to compose a complete meal for everyone, regardless of dietary requirements or preferences. These recipes also could be swapped for some of Thanksgiving’s traditional side dishes to improve the meal’s overall nutritional profile, not to mention heightening its visual appeal with vibrant colors.

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tested these recipes in my own kitchen, where Thanksgiving doesn’t have a set-in-stone menu, and there is always room for improvement, including making small (sometimes imperceptible) substitutions to accommodate everyone.

Find these in the archives of my blog, The Whole Dish, http://blogs.esouthernoregon.com/rogue-valley-food.

Food and dining columnist Sarah Lemon loves crafting special-occasion menus with seasonally and globally inspired themes while developing recipes for guests’ diverse diets.

Read her current posts and find more fall and winter favorites at mailtribune.com/lifestyle/the-whole-dish.

Photo by Dallion McGregor

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FALL HARVEST QUINOA AND LENTIL SALAD Forget “vegducken,” the zucchini-andeggplant-stuffed butternut squash that has been heralded as the plant-based answer to the typical holiday centerpiece. No one needs a contrived attempt at sating vegetarians with butternut squash when it’s easily married with quinoa, lentils, carrots, sweet potatoes, peppers and corn. Citrus juice and balsamic vinegar brighten the earthy flavors while alliums and herbs add freshness. Cutting everything into a uniform dice (about 1/4-inch) makes for the most pleasing texture and presentation. Serving it warm or at room temperature elevates this dish beyond salad status.

D I R E C T I O N S Rinse the quinoa several times and drain well. Rinse the lentils and pick them over for small stones.

Using 2 separate pots, bring 2 1/2 cups water to boil in each. Add quinoa to 1 pot and cook for 15 minutes or until all liquid is absorbed. Remove from heat and let stand for 10 minutes, fluff with a fork and let cool. Add lentils to other pot and cook until al dente, drain and cool.

In a large pot, quick-steam the squash and, if desired, the sweet potatoes, carrots and corn until just crisp-tender. Remove from pot and cool. In a small bowl combine the orange juice, lime juice and balsamic vinegar.

Just before serving, place cooled quinoa and lentils in a serving dish. Add juice mixture and toss to coat; fold in vegetables, the bell pepper, scallions, onion, garlic and mint. Season salad to taste with the salt and pepper just before serving.

I N G R E D I E N T S 1 1/2 cups quinoa 1 1/2 cups lentils 1/2 cup cooked butternut squash, peeled and diced 1/2 cup diced sweet potatoes 1/2 cup mixed, sliced orange and white carrots 1/2 cup fresh corn off cob (see tip)

6 tablespoons orange juice

2 tablespoons lime juice

1 tablespoon balsamic vinegar 1/2 cup diced red bell pepper 1/2 cup diced scallions

2 tablespoons diced red onion

1 garlic clove, peeled and minced

2 tablespoons chopped fresh mint Sea salt and cracked black pepper, to taste

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Defrost the kernels before using.

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S E R V I N G S 12 MF-00130079

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FOOD

CURRIED PUMPKIN SOUP

I N G R E D I E N T S

Silky, smooth squash soups have received a warm reception in recent years.

Adding a little curry powder not only enhances the vibrant color but adds a slightly spicy, earthy note that tempers the squash’s natural sweetness. It’s easy to make this recipe entirely plant-based by substituting oil for butter, vegetable stock for chicken stock and a dairy substitute such as unsweetened soy, nut, oat or coconut milk. Serving this soup in hollowed-out sugar or pie pumpkins makes an already delicious dish extra special.

D I R E C T I O N S

In a heavy soup pot over medium heat, melt the butter. Add the curry powder, onion and carrot. Cook, stirring, until vegetables are soft, for about 10 minutes. Add the stock and simmer, uncovered, for 10 minutes. Transfer to a blender or food processor and process until smooth.

Return mixture to soup pot and stir in the pumpkin, half-and-half, salt and white pepper. Heat over medium heat to a serving temperature. Scoop into soup bowls or pumpkin shells. Top with the sour cream and sunflower seeds.

T I P Cooked and mashed winter squash of many varieties, including butternut, can be used in place of the pumpkin puree. But many chefs swear by canned pumpkin puree (not pie filling) as a consistent, high-quality product in recipes like this one.

Integrated Wholistic and Natural

R E C I P E

2 tablespoons butter 2 teaspoons curry powder 1 large onion, peeled and chopped 1 large carrot, peeled and shredded 2 cups low-sodium chicken stock 2 cups half-and-half 1 (15-ounce) can unsweetened pumpkin puree (see tip) 1/2 teaspoon salt 1/4 teaspoon ground white pepper 1/4 cup sour cream, for serving Toasted pumpkin or sunflower seeds, for garnish

S E R V I N G S 6

continued on page 10

Photo courtesy of Tribune News Service

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FOOD

continued from page 9

R E C I P E COLLARD CASSOULET I N G R E D I E N T S

1 pound collard greens, stems and tough ribs removed Salt, as needed

5 garlic cloves, 1 peeled and crushed and 4 peeled and chopped 1/4 cup extra-virgin olive oil, divided

1 medium onion, peeled and chopped

1 small red bell pepper, cored and cut into 1/2-inch pieces

3 cups cooked white beans; 1/2 cup cooking liquid reserved 1/2 cup (plus more, if desired) diced or chopped cooked ham hock, sausage, chorizo or bacon 1/3 cup (plus more, if desired) freshly grated Parmigiano-Reggiano

1 tablespoon fresh rosemary leaves, finely chopped Pepper, to taste 1/2 cup (plus more, as needed) medium-coarse fresh breadcrumbs (see tip)

T I P Save the heels of store-bought sliced bread in a resealable plastic bag in the freezer until you have enough to grind in a food processor for breadcrumbs.

S E R V I N G S 4-6

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Photo courtesy of Tribune News Service

This Southern spin on French country cooking is one of my family favorites.

If you’ve never had collard greens, they’re similar to kale or chard, just sweeter and more velvety.

The original peasant dish was devised centuries ago to stretch a bit of meat with lots of beans. For plant-based eaters, it’s easy to eliminate this recipe’s ham, bacon or sausage, even the cheese to make it vegan or dairy-free.

Stirring in up to 1/4 cup miso paste can replace some of the meat’s savor.

You can consider choosing a gluten-free bread for the crumb topping or substitute some slivered almonds to finish the casserole with a bit of crunch.

D I R E C T I O N S In a large pot, cover the collards with salted water and boil over medium heat until tender, about 30 minutes. Drain well and chop into small pieces. Set aside.

Preheat oven to 475 F. Vigorously rub inside of a 10- or 12-inch gratin dish with the crushed garlic clove. Discard crushed garlic and set dish aside.

Heat 2 tablespoons of the oil in a large saute pan over medium-high heat. Add the onion and bell pepper and cook, stirring often, until tender, for about 8 minutes. Add the chopped garlic and cook, stirring, for 1 minute. Add collard greens, stir to coat and cook for 1 minute. Transfer to a large bowl.

Stir in the beans, meat, roughly half the Parmigiano-Reggiano, 1 tablespoon of the oil and the rosemary. Season with salt and pepper.

If mixture seems too dry, add enough reserved bean cooking liquid to moisten. (If you don’t have liquid, use water.) Spread mixture in prepared dish. Top with the breadcrumbs and remaining Parmigiano-Reggiano. Drizzle with remaining olive oil.

Cover dish with aluminum foil and bake in preheated oven until hot and bubbly, for 30 to 35 minutes. Remove foil and bake until top of gratin is golden and crusty, for another 10 minutes. Serve hot.

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FOOD

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ORANGE, FENNEL AND OLIVE SALAD WITH MARINATED FETA When multicourse meals call for prepping some dishes in advance, standard salad greens can fade before it’s time to join the party. Heartier pieces of produce not only hold up well for hours before the feast, but they make more of an impact alongside other bold, rich flavors. Fennel is a cold-season specialty that pairs beautifully with sweet citrus, accented with brine-cured olives and salty cheese. While marinating the feta is a nice touch, the cheese could just be crumbled on top. If you need to make this dish dairy-free, toasted pine nuts in place of the cheese would lend richness.

I N G R E D I E N T S

2 cups sliced fennel (halved lengthwise, cored and thinly sliced lengthwise with a sharp knife; see tip) 3/4 cup chopped feathery fennel fronds 1 3/4 cups pitted whole Italian oiledcured black olives (substitute Kalamata if desired)

8 navel oranges, divided

6 blood oranges or ruby red grapefruit 1/2 cup extra-virgin olive oil 1/4 cup red-wine vinegar

1 teaspoon honey 1/4 teaspoon coarse sea salt 1/4 teaspoon freshly ground pepper

D I R E C T I O N S In a large mixing bowl, place the sliced fennel, chopped fronds and olives.

Place 1 of the navel oranges on a cutting board; slice off both ends, then using a sharp knife, remove peel from flesh of fruit following contours, removing pith (white part) with skin. Using a paring knife, segment orange by removing flesh from membrane. Place in mixing bowl; repeat process with 6 more navels and all the blood oranges or grapefruit.

Juice 1 navel orange. In a small bowl, whisk orange juice with the olive oil, vinegar, honey, salt and pepper. Drizzle dressing over salad, tossing gently to combine. Salad can be made in advance and tossed before serving.

Serve at room temperature or chilled with marinated feta alongside.

MARINATED FETA: Cube 1 pound of feta cheese into 1/2-inch squares; place in a mixing bowl. Pour 1 cup extra-virgin olive oil over feta. Add 1/4 cup roughly chopped or torn, fresh basil. Season with 1/2 teaspoon black pepper; gently toss and set aside.

T I P Using a French mandoline makes easy work of slicing the fennel bulbs thinly and uniformly. Make sure to always use a guard to keep fingers away from the blade. â– Photo courtesy of Tribune News Service

S E R V I N G S 8-12

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FITNESS

Kick It Up a Notch

Increase intensity in training for return to sport

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STORY BY CHERYL P. ROSE

PHOTOGRAPHY BY DENISE BARATTA

osh Cline was 15 years old when he first began coaching as a volunteer for kids with special needs at his high school. Cline played multiple sports throughout his student years, culminating in playing for the Southern Oregon University football team that went to national championships. Cline is now the owner of Elite Training for Champions in Medford, but he also works with the wrestling team at South Medford High School. He has a passion for young athletes and wants to help them reach their goals. Last month, Cline suggested some basic strength and function moves to get inactive athletes back to building their strength. “We started light to get kids moving and grooving, but now we are going to make it more intense,� he says. Cline suggests middle and high school athletes begin to isolate muscle groups to build endurance. Here are some ideas:

STRENGTH

Two-step lunge With this exercise, you are building endurance and stability in the legs to maintain athletic position for long periods. Start in a forward lunge position, then fire off the front foot into a backward lunge in one smooth movement on the same leg.

Reps and sets: Youth athletes should strive for four sets of 12. (48 for each leg)

Kimberly Ceron, 15, demonstrates a two-step lunge. Ceron plays basketball and track for South Medford High School.

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FITNESS STRENGTH

Explosive pushup In this version of a pushup, you are working on reaction time and impact experience. Drop into a normal pushup position but then push off ground when lifting and catch yourself back in pushup position.

Reps and sets: Youth athletes should strive for four sets of 12.

South Medford High School football and wrestling athlete Hunter Hernandez, 15, demonstrates an explosive pushup.

FUNCTIONALITY

V-ups Also called pike crunches, this is another exercise that encourages reaction time by firing all the core muscles at once. Lay on the ground with legs and arms stretched to full length. Then engage core to fold up like a suitcase, so hands and feet meet in the middle. Cline warns to keep your neck stable.

Reps and sets: Youth athletes should strive for four sets of 15 reps.

South Medford High School soccer player Carmen Hutchins, 17, demonstrates the two-step V-up.

continued on page 14

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FITNESS continued from page 13

AGILITY

Double jab step This exercise helps your body learn to transition from forward to lateral movement quickly. Cline suggests taking a pair of shoes to mark your lines. Put one shoe about one stride in front of you and the other one stride to your side. While running in place, jab one leg forward, return, jab the same leg to the side and return. Repeat set on other side for other leg.

Reps and sets: Youth athletes should strive for four sets of 15 reps with each leg. ■

Josh Cline coaches Eyera Nogues, a baseball and basketball player from Ashland, in the double jab step.

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FITNESS

T ee Up Training Putting the work in now can improve your golf game for years to come STORY BY AARON COOPER

PHOTOGRAPHY BY DUSTIN PETERS

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olfers who’ve spent most of 2020 at home have likely put plans to improve their game this year on hold. Golf is time-consuming, and elevating your play requires attention to detail, mental and physical conditioning, and usually being on the course.

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FITNESS

But all is not lost. You can do much of the work to improve your game between rounds and even at home, according to Matt Preston, Golf Performance Specialist in Fitness at Southern Oregon Golf Academy (SOGA), which operates out of three locations: Centennial Golf Club and Rogue Valley Country Club in Medford, and Oak Knoll Golf Club in Ashland.

Year-round fitness for golfers “Several exercises that are important for golfers can be done away from the course,” says Preston, mentioning it is key to build core stability and flexibility and target strength training to improve one’s swing. “Golf requires club speed and ball speed, and that correlates with the body’s ability to generate power and rotation. In class, we focus on rotation and transferring power from the ground up through the hips and to the arms and shoulders.”

A certified athletic trainer who lives in Medford, Preston played baseball and golf in college at George Fox University in Newberg before earning a masters degree in kinesiology from Lamar University in Texas. His conditioning program, whether done in group classes at SOGA or at home, can “help golfers not only improve their game in the short run, but also help them play pain-free and avoid injuries throughout their lives.”

Preston’s group sessions, which include up to eight clients, begin with warmups and stretching before clients take swings with tools like the Saber weighted training shaft. “The Saber is a workout all by itself,” he says. “It weighs only a few ounces more than a regular continued on page 17

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Golf instructor Matt Preston leads Braedon Grunwald, 15, of Medford, (left), Brock Drury, 15, of Grants Pass and Davis Hartwell, 12, of Klamath Falls in exercises using golf training stick.

“Conditioning can help golfers improve their game in the short run and help them play painfree throughout their lives.”

Matt Preston Golf Performance Specialist in Fitness, Southern Oregon Golf Academy

FITNESS club but swinging it hard builds club speed and maximizes power.”

A typical session will include several reps of hard swinging combined with what Preston calls step-through swinging and swinging the opposite direction (swinging the shaft left-handed if you’re a right-handed player). Working out like this once or twice a week for 20-30 minutes is all it takes to increase club speed, he says.

Technical instruction complements physical conditioning While Preston focuses on physical training, Noah Horstman’s instruction hones proper technique. Horstman, PGA director of instruction and co-owner of SOGA, says the right technical instruction can help anybody’s game. “I’ve helped people as young as 3 and as old as 92,” he says. “We have player development programs and technology to help golfers make swing adjustments and help them reach their goals.”

The academy’s tech includes analyzing golfers’ form with launch monitors and simulators that enable Horstman to prescribe needed adjustments. And Horstman employs a K-Vest biomechanical analyzer to detect each golfer’s physical restrictions, allowing for changes that may prevent future injuries.

A former collegiate top 50 player, an injury sidelined Horstman’s professional golf ambition for himself. He enjoys teaching and coaching, and he still competes at a high level, including playing in an upcoming PGA regional qualifying event. For golfers who want to reach their full potential, it can take a team of specialists, continued on page 18

Ryan Kukula (right) demonstrates a K-Vest biomechanical analyzer, which helps golf coach Noah Horstman detect form and any physical restrictions.

Matt Preston leads Graham Buchanan, 14, through a workout with a weighted ball during a recent training clinic at Centennial Golf Course in Medford.

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FITNESS continued from page 17

Horstman believes.

“That can mean engaging a mental performance coach and a physical therapist, along with year-round conditioning,” he says.

No off season in golf You don’t have to be on the course to make big gains. “The winter months are crucial for focusing on your body and preparing for the coming season,” Preston says.

So even if you’re not playing much now, you can still work on improving your golf fitness for the future. And if you’re like most golfers, that future can be lengthy, as so many continue playing well into their senior years.

“Golf is a game for a lifetime,” says Horstman. “It’s got walking for exercise, and it’s a great social outlet. It’s all about challenging yourself on every shot. The weather can change, the greens can change, and every day brings a new challenge.”

Braedon Grunwald, runs an agility exercise under the watchful eye of Matt Preston.

“Golf is a game for a lifetime.”

Davis Hartwell completes jumps through an agility course at Centennial Golf Course in Medford.

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FITNESS

CONDITIONING FOR GOLF Matt Preston, golf fitness instructor at Southern Oregon Golf Academy (SOGA) in Medford, recommends these exercise routines for golfers to improve their conditioning: • Treadmill walking on an incline to build cardiovascular stamina.

(A round of golf can require 6-7.)

• Throwing and slamming medicine balls to improve stability and balance throughout the golf swing.

• Weightlifting that shifts power and force to the ground, such as kettlebell swings and a variety of forward, reverse and lateral lunges.

• Planks and pushups to strengthen, stabilize and prevent injuries to the core and back.

With both medicine balls and weights, Preston emphasizes moderation. “You can do a lot with a little weight,” he says. The key is to strengthen – not enlarge – muscles that aid rotation and stability. ■

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HEALTH

Carrying Candy

A chance meeting or something more?

STORY BY CHERYL P. ROSE

“I

don’t suppose you have any hard candy?”

In this reverse scenario of strangers and candy, I was caught flat.

It was a beautiful day, so the dog and I were out walking. Bored with walking in circles around the subdivision, I drove to the entrance of a nearby greenway. The pup, Zoey, was hopping excitedly as I stashed all but my keys and phone in the car. She pranced along in front of me as we approached the crosswalk. As we waited for the go sign, a tall man joined us, breathing hard. Once we crossed, he leaned heavily on the greenway sign.

That’s when he turned to me to ask about the candy.

When my children were younger, I carried “emergency” lollipops in my purse for bribes, distractions and comfort. But that day, when a stranger asked me for candy, the answer was no.

“Gosh, all I’ve got are my keys and phone,” I said. “Are you diabetic? Can I call someone for you?”

He nodded, confirming his diabetes, but said, “That’s OK” to the offer of a call. “My car is at the end of this section. I’ll make it,” he said. He walked quickly away on the forested path.

I didn’t like it. He didn’t look well. I reversed my steps to the car. Could there still be a vintage lollipop in my purse?

I dumped the contents out completely.

No lollipops, but there was the forgotten bag of M&Ms I bought on impulse the week before.

Zoey and I re-crossed the street and jogged after the gentleman. As we went around a curve, I spotted him well ahead of me.

“Sir! Sir! I found some!” I yelled, grabbing the attention of other walkers

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on the trail. He heard me, turned and paused until we reached him. “It’s not hard candy, but will it help?”

His hands shook as he tore open the package, spilling about a third of the candy-coated chocolates in trying to get them to his mouth. By then, other people had gathered and encouraged him to sit down. He was terribly embarrassed, but he let us fuss over him. I pocketed the dropped candy (dogs and chocolate do not mix) while we discussed what we could do for this fellow who was obviously not going to make it to his car or even back to the road.

A cyclist stopped, heard the news and offered to race ahead to find assistance.

Several walkers decided to stay with him until help came. Other walkers quickmarched off to get orange juice from the closest convenience store.

Warmed by the wonderful display of community spirit, Zoey and I continued our walk through the mixed pine forest, the scent of honeysuckle tickling our noses. My thoughts lingered on the lucky or fated chance that I had those M&Ms, and how kind strangers can be when we rally together. Not long after, a golf cart passed me. In the passenger seat was our new friend, who waved and called his thanks.

In all the excitement, I never even got his name. But friends, when I got home, I put a couple of pieces of hard candy back in my purse. You never know when they might be useful for making a friend, comforting a sorrow or even saving a life. ■

NOVEMBER 2020 | learn more online at OregonHealthyLiving.com

NATIONAL DIABETES DAY AND MONTH About 10% of Americans, or every 10th person you meet, is living with some form of diabetes. Type 2 is the most common form. In Type 2 diabetes, your body still breaks down the foods you eat into glucose. However, your body has trouble getting the glucose out of your bloodstream and into your cells. Right now, there is no cure for diabetes. However, people with Type 2 diabetes can do a lot to manage their health and live long, healthy lives. Activity and warm weather can affect blood sugar, so people with diabetes should carry glucose tablets, glucose gel or some other quick energy source (like hard candy) during exercise, especially in summer.

Turning

HEALTH

65?

Know your Medicare options

STORY BY CHERYL P. ROSE

F

or people 65 and older, the federal government provides a health insurance program known as Medicare. You can enroll in Medicare anytime between three months before your 65th birthday and seven months after. Unless you are already receiving Social Security, you will have to sign up during this window of enrollment for the best and most timely coverage and to avoid penalties for late sign-up.

Understanding the basic options When you enroll, there are different plans for Medicare: Medicare Part A: Everyone who enrolls receives this coverage for inpatient hospital stays, care in a skilled nursing facility, hospice care and some other critical medical care. There is an annual deductible that you pay first, then Medicare pays a portion and you pay a percentage without an annual out-ofpocket cap.

Medicare Part B: Most people

must choose whether they want to add Part B when enrolling. Part B expands coverage to certain medical services, outpatient care, medical equipment, ambulance and preventive services. In choosing Part B, you pay a monthly premium (based on your taxable income) and have an annual deductible. After you meet the deductible, you pay 20% of costs.

Medicare Part D: This is the prescription drug plan offered by the federal government. Prescriptions are NOT included in Parts A or B, so you must choose to add Part

D if you want this benefit. You will pay a monthly premium, annual deductible and copays. This can vary depending on what medications you use and where you get them.

Medigap: Even with Medicare, there can be a hefty financial burden for your share of costs for service if you have major or ongoing medical issues. Medigap insurance or medical supplement companies will help pay your out-of-pocket costs that Medicare doesn’t. Consumers should compare companies offering these insurance services for premium costs and coverage.

Medicare Advantage: These plans are provided by private companies who contract with Medicare to provide Part A and Part B services. They also often include prescription plans and offer more variety in customizing plans. As examples, dental services, vision, hearing and acupuncture are NOT covered by Parts A or B but may be part of a Medicare Advantage plan.

Also, there is often an out-of-pocket maximum cap which Parts A and B don’t have. The burden is on the consumer to compare plans and choose one based on fit for cost and services. continued on page 22

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21

HEALTH

continued from page 21

Original Medicare Combinations

Learn more for your circumstances Linda Clarkson, a health insurance broker with Futurity First in Medford has led free Medicare 101 workshops and webinars for several years. She says people who attend often are aware of the basic information but want to know how the options fit their individual lives.

Many people express concern about coverage for their prescription drugs as well as interest in how medical supplements can lower out-of-pocket expenses, she reports.

Adding services becomes a matter of comparing the many options available. “There are 27 different stand-alone prescription drug plans and half a dozen Medicare Advantage plans available in Jackson and Josephine counties,” Clarkson says.

There are also some specific rules for people who are still working and eligible for their companies’ benefits and for those who get benefits through the Veteran’s Administration or a union. Criss Garcia, manager of the Population Health Program with Asante in Medford, recommends people consult with a licensed health insurance broker as they approach 64 ½-years-old.

“These brokers represent multiple plans, and they are not tied to any particular one,” he says. “Their consultations are usually free, and they are motivated to have a lifetime relationship. They want to keep you happy and deliver you the best value, not a cookie-cutter solution.”

Well-care concept in Medicare Advantage plans Traditional Medicare pays providers in a fee-for-service model (paid per patient rather than by their health

22

outcome). Garcia explains that Medicare compensates providers at a fraction of the actual cost of providing care, which creates a financial loss. As a result, providers usually have to limit the number of Medicare patients they accept. It also means there is little leftover for preventive health measures, he adds.

Clarkson explains that Medicare Advantage flips this proposition by investing in preventive health to avoid costly care later. “These private companies work to try to keep your health as good as it can get, then keep you healthy. Their costs go down if their members are healthier. That is why they may offer a zero-dollar copay to see a primary care doctor, or they may offer you a gym membership.”

Garcia said that providers prefer Medicare Advantage because it allows them to manage the patient according to care needs and prevention, such as diabetes education. “At Asante, we partner with a couple of Medicare Advantage plans that we feel match our values.”

Medicare Advantage networks are designed as preferred provider organizations (PPO) or health maintenance organizations (HMO). Garcia said that unlike most of the state, Southern Oregon options are about 88% PPOs versus 12% HMOs. PPOs offer a network of selected providers to choose among.

“I think it’s worthwhile to attend a free program to learn the basics about what you get in Parts A and B,” Clarkson says, “and then learn how to compare options for additional coverage.” continued on page 23

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PART

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B

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PART

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HEALTH

Original Medicare vs. Medicare Advantage Medicare beneficiaries have a choice between Original Medicare or Medicare Advantage for their Medicare coverage.

The following chart highlights some of the similarities and differences between these two options.

Reprinted with permission from Asante

of how

tween nd plans.

best

Original Medicare

Medicare Advantage PPO

HMO

What do I pay monthly?

Part B premiums

Medicare Part B and Medicare Advantage premiums

Medicare Part B and Medicare Advantage premiums

Can I go to any doctor?

Yes, if they accept Medicare

Yes, if they accept Medicare

As long as doctor is in the HMO network

Where can I get, emergency care?

Anywhere in the country

Anywhere in the country

HMO plans require you to stay in network, except in an emergency

How do I get prescription drug coverage?

Purchase a Part D plan

Select a plan that includes drug coverage

Select a plan that includes drug coverage

Will I need a referral to see a specialist?

No

Generally, no

Generally, yes

Is there a limit to my out-of-pocket spending?

No

Yes, all plans have limits on out-of-pocket expenses

Yes, all plans have limits on out-of-pocket expenses

Will it pay for extras, such as routine dental, hearing or vision?

No, Medicare does not cover routine dental, hearing or vision

Most plans offer some additional benefits for routine care

Most plans offer some additional benefits for routine care

Do I need a Medicare Supplemental policy?

Yes, if additional coverage is desired

No, plan provides all coverage

No, plan provides all coverage

How do I enroll?

Enroll directly with the Social Security Administration

Call the MA plan of your choice during Medicare’s annual election period (Oct. 15 — Dec. 7)

Call the MA plan of your choice during Medicare’s annual election period (Oct. 15 — Dec. 7)

For additional information, please contact Medicare at Medicare.gov, SocialSecurity.gov or bycontact calling 800.633.4227 For additional information, please Medicare at Medicare.gov,

e s work.

SocialSecurity.gov or by calling (800) 772-1213

18HASO001

continued on page 24

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23

HEALTH continued from page 23

Savvy shopping during open enrollment Every year, Medicare’s open enrollment period is Oct. 15-Dec. 7. This means that once a year you can change your plan without penalty. It’s important to review your options during this time period, as Medicare health plans and prescription plans may change prices and coverage.

To be a smart consumer, compare plans to best fit your needs for the next year. Some things to consider: • Your health status and any upcoming health treatments, including medications • Total costs of premiums, deductibles and out-of-pocket expenses • What is and is not covered by the plans you consider • Your choices and availability of providers, hospitals and health networks • Quality of the providers, hospitals and health networks • Your needs for prescription medication, dental, vision, hearing and alternative health services ■

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MEDFORD • GRANTS PASS • ROSEBURG

ye Care

Mind Your Ps

HEALTH

Qs, Bs

and But Don’t Forget Your

Why B vitamins are essential

I

STORY BY MICAH LEIGH

f you have ever experienced fatigue, depression or anxiety, it may be caused by something as simple as a B vitamin deficiency. Collectively known as vitamin B complex, there are eight B vitamins that are essential to overall bodily function.

es

“We can’t survive without B vitamins,” says to Dr. Cory Tichauer of Bear Creek Naturopathic Clinic in Medford. “B vitamins help your body repair itself.”

Dr. Kristin Plunkett of Naturopathic Medical Clinic in Grants Pass agrees. “B vitamins are necessary for metabolism, energy, memory and nerve cell health,” she says.

What do B vitamins do?

All B vitamins have different jobs according to Tichauer. “Certain B vitamins target certain conditions,” he says. “For instance, B6 is used for diabetes, numbness and tingling, depression and anemia. B1 is used for alcoholism. B12 is used for immune function. B5 and B12 are good for adrenal fatigue, for people under lots continued on page 26

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25

HEALTH

continued from page 25

of stress, those who work the night shift. For muscle aches, try B2.”

B2 is also good for migraine relief, says Plunkett. “Research shows that B2, also known as riboflavin, can decrease migraines by 50%.

Migraine sufferers who take 400 milligrams of B2 once a day can see results within three months.”

B vitamins are involved in the prevention of infections, growth of red blood cells, good eyesight and healthy brain function. B vitamins are also important for muscle tone, healthy appetite and cardiovascular health. “B3, in particular, lowers cholesterol and triglycerides, and reduces plaque in arteries,” says Plunkett.

Who needs extra Bs? “Pregnant women, people over 60, vegetarians and those with other health conditions will need

extra supplementation,” Tichauer says. “For those struggling with severe fatigue, lassitude, brain fog, poor libido and generalized achiness, I would say that it is worth at least trying a B12 lozenge with a B complex for several weeks. Many clinics offer affordable walk-in B12 injections, which would be an even better option.”

Underlying health conditions, such as celiac disease, HIV, Crohn’s disease, kidney conditions, alcoholism, rheumatoid arthritis, and inflammatory bowel disease, can prevent your body from absorbing B vitamins, which can lead to deficiency.

“People who use proton pump inhibitors to block stomach acid should be particularly careful,” warns Tichauer. “Stomach acid is necessary to process B12. As we get older, our bodies produce less and continued on page 28

THE MAGIC EIGHT

“Research shows that B2, also known as riboflavin, can decrease migraines by 50%. Migraine sufferers who take 400 milligrams of B2 once a day can see results within three months.”

Dr. Kristin Plunkett Naturopathic Medical Clinic, Grants Pass

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B1 – thiamine B2 – riboflavin B3 – niacin B5 – pantothenic acid B6 – pyridoxine B7 – biotin B9 – folic acid B12 – cobalamin

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27

continued from page 26

HEALTH

less. Medications that reduce stomach acid can cause a deficiency.”

Plunkett reiterates the problem with acid blockers. “Stomach acid must be present to absorb B vitamins. A deficiency can cause pernicious anemia, which can create neuropathy. People who take these medications need injections or supplemental dosing of B6 and B12.”

Tichauer says the Food and Drug Administration sets daily requirements known as RDA (recommended daily allowance) for children and adults, but that these are the minimum needed to avoid deficiency.

“Given the polyvariant nature of B vitamins, all of them have some indirect impact on immunity, so I always recommend a good B-complex with methylated forms of the B vitamins,” he says. “The most recognized B vitamins for immunity are B12, B6, B5 and folate. These supplements can be used on your own, but caution should be exercised when taking vitamin B6 as one can create problems if using too much. I would suggest the average consumer not use more than 50 mg of B6 unless under the guidance of a qualified health care practitioner.”■

GETTING B VITAMINS IN YOUR DIET According to Dr. Kristin Plunkett of Naturopathic Medical Clinic in Grants Pass, the average American diet of processed food is deficient in all vitamins, so it’s best to eat healthy. B vitamins are naturally present in animal products such as milk, cheese, eggs, liver and kidneys. Chicken and red meat, along with fish, such as tuna, mackerel and salmon, are good choices. Shellfish, including oysters and clams, are also on the list.

Dark green leafy vegetables like spinach, broccoli and kale are loaded with B vitamins. Beans, potatoes, avocados, citrus, watermelon and bananas provide B vitamins along with nuts, seeds, soy products, wheat germ and nutritional yeast.

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PETS

Whining, scratching

and head shaking Canine chronic ear infections STORY BY CINDY QUICK WILSON

T

wice in the last few minutes, Duke has plopped on his haunches and started digging at his ears. It’s a sure sign something is going on, and if it isn’t a case of those fearsome little foxtails, he may well have an ear infection brewing.

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PETS Danger signs of infection It can be difficult for the casual observer to identify the beginning stages of an ear infection, admits Dr. James Hogg with Oregon Veterinary Services in Merlin. All too often, he says, veterinarians don’t get to see these dogs until there is a serious problem.

Ear problems are very common, Hogg says. “I see maybe five to seven cases daily of otitis, which is an inflammation of the ear. Some are acute cases like foxtails or foreign objects in the ear. Others are more chronic, often caused by allergies, with unhealthy tissue that wasn’t recognized early on. Soon you have a bad smell, swollen and red tissue, and a dog that is clearly uncomfortable.”

Both chronic and acute ear conditions can cause frequent head shaking, head tilts and scratching, explains Hogg. “Whenever you see an excessive production of ear wax, which can look black, brownish, yellow or white, it’s time to take your dog to the vet.”

Earache causes An ear infection, or otitis externa, is an indication that your dog’s body is dealing with an underlying problem, vets say. The most common causes are internal reactions to environmental or food allergies.

External causes include ear mites, foreign objects or water that gets trapped in the ear canal. These irritants can cause an overproduction of wax that allows naturally occurring yeast and bacteria to grow

out of control. In extreme cases, the ears become so swollen that they may close completely, Hogg says.

“That’s a problem that could result in hearing loss, in which case we might have to consider some surgical alternatives.”

Dr. Daphne Carlson with Riverside Park Veterinary Clinic in Grants Pass explains that dogs and cats have ear canals shaped like an L. “This means that anything that goes in the ear canal is very difficult to get out,” she says. “Bacteria and fungi live on the wax buildup within the ear, so anything that causes an overabundance of wax that cannot easily drain from the ear provides a perfect environment for excessive bacterial or yeast growth.”

Carlson says some breeds are genetically more prone to ear problems because of excessive ear hair growth (poodles and schnauzers), have heavy, pendulous ears, (cocker spaniels and hound breeds) or narrow ear canals (Shar-Pei).

These conformation factors make it more difficult for air circulation and inhibit normal wax movement up and out of the ear.

Diagnosing otitis “Our first step is to visually identify which part of the ear is affected and determine whether we can use an otoscope to look deeply into the ear canal under magnification,” Hogg says. “Some dogs need to be sedated for this procedure, which allows us to get a much better look and do a more thorough cleaning.” continued on page 31

HOW NOT TO TREAT YOUR DOG’S EAR INFECTIONS Dr. Daphne Carlson of Riverside Park Veterinary Clinic in Grants Pass warns, “We often see owners try to clean the ears with different household products or other home remedies. Sometimes these materials can cause abrasive damage to the ears or dry the skin so much that the ear continues to be itchy and irritated.

Putting anything in the ear without checking the eardrum first can cause serious damage.”

Always seek your veterinarian’s advice before attempting to clean or treat your dog’s ears.

• Do not use cotton swabs, as they are not designed to accommodate the L-shaped structure of a dog’s ear. They can irritate the ear opening and push dirt, wax and debris further into the ear canal.

• Use over-the-counter products meant specifically for dogs. Never use alcohol or peroxide, which can be highly irritating, or lanolin-based products, which may cause deafness. Mineral oil can trap dirt, bacteria and fungi in the ear.

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PETS Once the ear is open, they look for foreign bodies like foxtails, which are common in the Rogue Valley. But if the ear is tight and inflamed, he says, it is usually an indication of allergies. “We swab both ears and prepare a slide for the microscope, which can identify inflammatory cells, bacteria and/ or the presence of yeast. Those are relatively simple to treat by using antimicrobial medication for bacteria or antifungal for the yeast.”

Allergy treatment for dogs With canine allergies, Hogg says 80% are flea allergies that cause dermatitis. “Your dog may not even have fleas but may have been exposed to one flea bite, and it’s the protein of the flea saliva that can cause flea allergy dermatitis. That treatment can involve providing flea and tick prevention monthly. Or it may be food allergies or seasonal allergies caused by pollens and other airborne irritants. In most cases we can prevent those with an injectable treatment every four to eight weeks or pills to change the way the immune system reacts to a protein as it is introduced into the body.”

Clean ears are happy ears For some dogs, just having their ears cleaned is a great help, our experts say. Use a warm washcloth on the outer ear area and periodic hydrotherapy with an over-the-counter ear flush that is specifically meant for dogs. Do not use home remedies like alcohol or peroxide. After the flush, allow the dog to help remove the excess by shaking his head. A mild wax buildup can be removed in this way, they say, but any black, brown or yellow discharge and/or redness or swelling in the ear is a sign that a visit to the vet is in order. They also recommend keeping ears free from excessive hair growth, which can inhibit wax migration and healthy airflow inside the ear.

Carlson offers the following suggestions: “If your pet goes into any areas with foxtails, check them to make sure there aren’t any stuck in the fur, especially around the ears and feet.

After going to the river, wipe your pet’s ears with a soft cloth to remove excess water. Manage your pet’s allergies by working with your veterinarian and treat ear mite infections early to prevent a full-blown infection. Keep an eye on your pet’s ears and watch for any signs they may be feeling uncomfortable.” ■

“It can be difficult for the casual observer to identify the beginning stages of an ear infection.”

James Hogg, DVM Oregon Veterinary Services, Merlin

“Keep an eye on your pet’s ears and watch for any signs they may be feeling uncomfortable.”

Daphne Carlson, DVM Riverside Park Veterinary Clinic, Grants Pass

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