Inhealth 12/01/2013 by The Inlander

INHealth

HEALTHY LIVING IN THE INLAND NORTHWEST • FREE

ly l a e R r a g u S Is t Bad? 15 Tha DEC. 2013-JAN. 2014

SPECIAL SUPPLEMENT TO THE INLANDER

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BEATING GRAVITY BOOMERS Reducing risk for falls PAGE 38

ERASE THAT FROWN HEALTHY BEAUTY Botox and depression PAGE 25

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A special thank you to our business sponsors, guests, restaurants, wineries, breweries and volunteers for making the 32nd Annual Epicurean Delight the most fun black-tie gala in the Inland Northwest! Proceeds from this event benefit the Inland Northwest Blood Center and its life saving mission.

Culinary Award Winners

• Outstanding Hors d’oeuvres: Burgundy’s at The Spokane Club - Pan Fried Crab Cakes • Outstanding First Course: The Flying Goat - Rabbit Confit • Outstanding Entrée: EPIC at Northern Quest Resort & Casino - Apple Wood Smoked Columbia River Steelhead • Outstanding Dessert: Simply Gourmet - Green Bluff Apple Tarte Tatin • People’s Choice Best Restaurant: Burgundy’s at The Spokane Club - Pan Fried Crab Cakes

Culinary Judging Panel Bob Aldred – The Davenport Hotel & Tower; Carla Altepeter – Numerica Credit Union; Adrienne Anderson – Merritt Brothers Lumber Company; Dr. Tim Bax – Spokane EN&T; Mike Bookey – The Pacific Northwest Inlander; Mayor David Condon – City of Spokane; Shawn Crawford – Ramey Construction; Dan Demchuk – Moss Adams, LLP; Dr. Bill Dittman – INBC Board Chair and Providence Sacred Heart Medical Center; Barbara Grant – KREM2; Paul Harrington – Spokane Produce; Anna Haugen – Kalispel Tribe and Northern Quest Resort Casino; Pat Holt – Blood Systems, Inc.; Alex Jackson – Providence Sacred Heart Medical Center & Children’s Hospital and Providence Holy Family Hospital; David Jones – Fidelity Associates Insurance & Financial Services; Jennifer Lehn – Numerica Credit Union; Bob McDaniel – Kootenai Health; Sherree Niepomnik – Premera Blue Cross; Rick Olsen – URM Food Service; Mike Renes – Washington Dental; Steve Storey – Sterling Bank; Dave Walker – Washington Trust Bank; Mel Watson – Camp BMW; Keith Western – AmericanWest Bank Grand Presenting Partner Numerica Credit Union Event Partners American West Bank, Blood Systems, Inc., Camp BMW, Davenport Hotel and Tower, Fidelity Associates Insurance & Financial Services, Gritman Medical Center, InCyte Pathology, Kalispel Tribe/Northen Quest Resort & Casino, Kootenai Health, Moloney + O’Neill Benefits, Moss Adams LLP, Physicians Insurance A Mutual Company, Premera Blue Cross, Providence Holy Family Hospital & Providence Sacred Heart Medical Center & Children’s Hospital, Ramey Construction Co., Randall & Hurley, Spokane Ear, Nose, and Throat Clinic, P.S., Spokane Produce, Inc., Sterling Bank, Surgical Specialists of Spokane, Terumo BCT, Inc., URM Food Service, Washington Dental Service, Washington Trust Bank

Table Sponsors Jeff & Melinda Bryant, Cancer Care Northwest, Jan-Pro Northwest, Pathology Associates Medical Laboratories (PAML), Rockwood Health System, The Cellar at 317, Visit Spokane

Table Hosts Asuris Northwest Health, Dr. Don Chilson, Columbia State Bank, Dr. Travis Dierks, Dr. William & Mrs. Eileen Dittman, Jr., Dr. Sean Hurley, Inland Northwest Health Services, Dr. Sidney & Mrs. Debbie Kasuga, Jean & Bill Merrill, Marcia & Harry Mielke, Thomas Quigley, Rosauers Supermarkets, Michael Senske, Sterling Bank, Washington Trust Bank – Private Banking, Washington Trust Bank – Retail Services, Washington Trust Bank – Wealth Management & Advisory Services, Richard Westerman, Nancy & Chuck Wilbert, Dr. A. Morgan & Mrs. Olga Wright

In-Kind Supporters Advanced Dermatology & Skin Surgery, Ajuva Medical Aesthetics, ALSCO American Linen, Arbor Crest Wine Cellars, Banyan’s on the Ridge, Teri & Rob Barros, Be Loved Salon, Brickhouse Massage & Coffee Bar, Scott & Stefanie Bruno, Chateau Ste. Michelle, Tricia & Joe Cheevers, Clover Restaurant, Coeur d’Alene Cellars, Columbia Crest, Kit DeAndre, Deer Park Golf Club, Domanico Cellars, Double Tree by Hilton, Dry Fly Distilling, Eastern Washington University Athletics, Eau de Vie, EMVY Cellars, Finders Keepers I & II, Melanie Fisher, Fitzgerald Ice, Garrison Creek Cellars, Girly Girl Wines, Gonzaga University IMG, Michelle Grabicki, Georgette & Thomas Grainger, Hay J’s Bistro, Home Depot, Huckleberry’s Natural Market, Idaho Vandals Sports Properties, Iron Horse Brewery, Jan-Pro Northwest, Jensen Distribution Services, Scott & Vicki Jones, Ben Joyce, Gretchen Kramer, Lamar Companies, Latah Creek Wine Cellars, LCD Exposition Services, Gary Lindeblad, Sherry & Richard Lewis, LithoArt Printers, Lowe’s Home Improvement, Manito Tap House, Marcus Whitman Hotel, Maryhill Winery, Pam McLaughlin, Wade McNeilly, Meadow Wood Golf Course, MOR Furniture for Less, Mustard Seed, No-Li Brew Co., Numerica Credit Union, Okanogan Estate & Vineyards, Orlison Brewing Co., Palouse Ridge Golf Club, Pend d’Oreille Winery, Planet Beach Contempo Spa, Pounder’s Jewelry, Ramblin’ Road Craft Brewery, Angela & Jason Ramey, River City Brewing, Robert Karl Cellars, Rocky Coulee Brewing Co., Silver Lake Winery, Spokane House of Hose, Spokane Symphony, Standard Digital Print Co. Inc., Steam Plant Brewing Co., Steam Plant Grill, Chuck & Lu Stocker, Sun Dance Golf Course, The Melting Pot, Three Rivers Winery, Total Wine & More, Townshend Cellar, Twelve String Brewing Co., Twilight Cider Works, VINO! A Wine Shop, Vintage Hill Cellars, Walla Walla Vintners, Walmart, Watermill Winery, WestCoast Entertainment, White Heron Cellars, Whitestone, Whitworth University Athletics, Nancy & Chuck Wilbert, Woodcraft, Young’s Market Company, Ziggy’s

Media Partners KREM2-TV, Tom Sherry – Chief Meteorologist and Kevin Tompkins – Commercial Production Supervisor; The Pacific Northwest Inlander and InHealthNW

Friends of INBC AmeriBen, Melanie Fisher, Bill and Judi Williams Restaurants Ambrosia Bistro, Beacon Hill Events, Beverly’s, Black Tie Catering, Boyd Coffee Co., Burgundy’s at the Spokane Club, The Cellar, Central Food, Coeur d’ Alene Casino, Resort, & Hotel, Cravens Coffee, Cruiser’s Catering, Deaconess Hospital Catering, Downriver Grill, Epic at Northern Quest Resort & Casino, Fai’s Noodle House, The Flying Goat, Glover Mansion/Red Rock Catering, Herbal Essence Cafe, Italia Trattoria, Just American Desserts, Masselow’s, Max at Mirabeau, Rock City Grill, Saranac Public House, Simply Gourmet, Spencers for Steak’s & Chops, Spokandy Chocolatier, Sweet Dreams Bakery, The Spokane Melting Pot, Taste of India

Wineries & Breweries Arbor Crest Wine Cellars, Chateau Ste. Michelle Winery, Columbia Crest Winery, Domanico Cellars, EMVY Cellars, Girly Girl Wines, Maryhill Winery, Okanogan Estate & Vineyards, Pend d’ Oreille Winery, Robert Karl Cellars, Silver Lake Winery, Townshend Cellar, Twilight Cider Works, Vintage Hill Cellars, Walla Walla Vintners, Watermill Winery, White Heron Cellars, Whitestone Winery, Iron Horse Brewery, No-Li Brewhouse, Orlison Brewing Co., Ramblin’ Road Craft Brewery, River City Brewing, Rocky Coulee Brewing Co., Steam Plant Grill, 12 String Brewing Co. Mark your calendar for the 33rd Annual Epicurean Delight! Friday, November 14, 2014! For more information and event photos visit www.EpicureanDelight.org. contributing to Epicurean Delight prior to the press deadline, 11/11/13.

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Health SPOKANE • EASTERN WASHINGTON • NORTH IDAHO 1227 W. Summit Parkway, Spokane, Wash. 99201 PHONE: 509-325-0634

EDITOR Anne McGregor

annem@inhealthnw.com

MANAGING EDITOR Jacob H. Fries ART DIRECTOR Chris Bovey CALENDAR EDITOR Chey Scott PHOTOGRAPHER Young Kwak

Thank you to our patients, customers, partners and providers for working together to improve our communities health. With a commitment to quality patient care and innovative technologies, INHS employees are providing collaborative health care services to benefit the entire region.

CONTRIBUTORS Jordy Byrd, Lisa Fairbanks-Rossi, Heidi Groover, E.J. Iannelli, Laura Johnson, Jacob Jones, Deanna Pan, Stephen Schlange, Carrie Scozzaro, Katelyn Smith, Matt Thompson, Daniel Walters, John White PRODUCTION MANAGER Wayne Hunt ADVERTISING SALES MANAGER Kristi Gotzian DIRECTOR OF MARKETING Kristina Elverum ADVERTISING SALES Autumn Adrian, Jamie Albertini, Bonnie Amstutz, Bruce Deming, Gail Golden, Carolyn Padgham-Walker, Janet Pier, Emily Walden SALES COORDINATION Raevyn West, Rebecca Rison, Gilbert Sandoval, Angela Rendall DESIGN AND PRODUCTION Tom Stover, Derrick King, Alissia Blackwood Mead, Jessie Spaccia DISTRIBUTION MANAGER Trevor Rendall BUSINESS MANAGER Dee Ann Cook

St. Luke’s Rehabilitation Institute • Information Resource Management (IRM) Northwest MedStar • Northwest TeleHealth • Community Wellness Center of Occupational Health & Education (COHE) Health Training • Center of Philanthropy

Support our services in the community by making a gift. Visit www.inhs.org/foundation

ACCOUNTS RECEIVABLE Kristin Wagner PUBLISHER Ted S. McGregor Jr. GENERAL MANAGER Jeremy McGregor

INHealth is published every other month and is available free at more than 500 locations throughout the Inland Northwest. One copy free per reader. Subscriptions are available and cost $2.50 per issue. Call x213. Reaching Us: Editorial: x261; Circulation: x226; Advertising: x223. COPYRIGHT All contents copyrighted © Inland Publications, Inc. 2013. INHealth is locally owned and has been published every other month by Inland Publications, Inc. since 2004.

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Anne McGregor is the editor of InHealth. Email her at annem@inhealthnw.com.

ccording to a recent Pew Research project, 77 percent of people look to the Internet for health information. Locally, however, it can be difficult to find reliable health news specific to our corner of the world. So I’m happy to report that all of the content ever published in InHealth is just a click away — everything from robotic surgery to local chefs’ healthy recipes to ways to age gracefully. Simply go to Inlander.com and look for the InHealth button. There, the current issue awaits — look at it story-by-story, section-by-section, or for the first time as a complete digital edition (which looks great on a tablet, by the way). And while you’re there, you can access all the exciting journalism and listings the Inlander publishes, too. All of our archives are easily searchable now. Say you’re interested in everything we’ve ever written about exercise or alternative medicine — you can search by section. Maybe you have a favorite writer: You can find them all by keywords. Of course, we didn’t leave out your mobile devices. Just browse to Inlander.com on your tablet or phone and it will automatically show you the mobile version — you can even create a button for it on your phone. Scroll down and you’ll find InHealth content, anytime or anywhere you want to read it. The one thing we don’t have is a paywall. It’s all free for you to access and share. So go ahead — pin it, tweet it or post it on Facebook. To your health!

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CHECK-IN STAY CONNECTED Send letters and story ideas to InHealth Editor Anne McGregor at annem@inhealthnw.com. Join the conversation on the InHealth Facebook page and at Inlander.com/inhealth

ON OUR FACEBOOK

What’s the best way to combat the winter blues around here? LYNN GIBSON ELLIS: Lots of opportunities to get together with loved ones, vitamin D, the hot tub and a sun lamp. PATTI GIBSON NEPEAN: Just being able to “stay in touch” with the outdoors makes all the difference to me, so I make a point every day to take a good, brisk walk no matter the weather. COLLIN DOUGLAS: Playing indoor sports, working out, skiing. You gotta ski if you live up here or there isn’t much to look forward to all winter. TARA L. PARKS: Vitamin D3 2000. I work graveyard, and in the winter I never see the sun. All of us take an extra vitamin D to combat depression. AMY DOWNER: Hot cocoa and Kahlua. VINCE LEMUS: Trivia night at Jones Radiator. STEPHANIE RUTH SCOTT: Take vitamin D, get a good hobby to do indoors, and then GO SNOWBOARDING. Come on people. We live in a great recreation state. I don’t want to hear any craptalk about the dark and the rain. Get a raincoat. RANDALL KYLE: What are winter blues? This is the best and most active time of year for me. Wax your sticks and ride. It’s the best full body workout anyone can have. SARAH EVANS: Get outside while it’s daylight, even if it means a 10-minute walk over lunch break. NASHYRA TUININGA: Vegas. 

THEIR OWN WORDS

Dorothy MacEachern Armed mainly with detailed questionnaires, epidemiologist Dorothy MacEachern tracks down the sources of food-borne disease for the Spokane Regional Health District. I’ve been hearing a lot about salmonella. It seems to be everywhere! I think there are probably a few things that are going on. One is that there’s better laboratory tracking. That allows us, from the whole nation, to connect cases together that we wouldn’t have been able to do readily before. We also have a few states that have really taken the lead to do intensive investigations — and one of those states is Oregon. The other is Minnesota. Also, we have a much more centralized food system than we’ve ever had before. If there’s a problem, it could go everywhere. So when you’re sick, how do you know if it’s food poisoning? You don’t. You don’t really know unless you get tested. There are lots of different bugs that can make you sick; they each have their own constellation of symptoms. They might affect you in six hours. Or it might be 10 weeks if you have something like a listeria infection. Given your line of work, are you able to enjoy a potluck? I don’t really worry about it. There are certain things I wouldn’t eat. Some of them are personal preference. I don’t eat hamburgers unless I know the cow. I don’t eat raw milk. I think that’s a potentially dangerous product at all times. What’s one piece of advice you’d like to give? We really like people to know that you shouldn’t be washing your chicken at home. You’re potentially contaminating everything in that environment, where all those little fine-mist particles are going out. You wash down your sink, but it is really on your counter, too. So just take your chicken out of the bag, put it in the oven, wash your hands. You’re done. — INTERVIEW BY ANNE McGREGOR

YOUNG KWAK PHOTO

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CHECK-IN HEALTH NEWS

A Toothy Matter

ou’ve probably heard this before: Your mouth is the gateway to the rest of your body. Mounting evidence shows that poor oral hygiene is often linked with chronic and severe health conditions, like coronary heart disease, stroke, aspiration pneumonia and pancreatic cancer. A person with periodontal disease is nearly twice as likely to develop Type 2 diabetes. “Most people don’t realize what happens in the mouth affects the rest of the body,” says Dr. Jim Sledge, from the University of Washington’s School of Dentistry at the Riverpoint Campus in Spokane. “If you don’t have a healthy mouth, the rest of your body is going to suffer,” Experts agree: Good oral health is a vital part of overall health. So why isn’t adult dental care covered under the Affordable Care Act? Although dental disease is almost entirely preventable with healthy habits — like brushing, flossing and regular teeth cleanings to keep smaller problems from developing into larger ones — many Americans, especially low-income adults, lack access to preventive dental care.

As a result, emergency room visits for dental conditions are increasing across the country, and at a high price. A study by the Washington State Hospital Association found that 54,000 dentalrelated emergency room visits over an 18-month period cost the state more than $36 million. The good news is the Washington Health Benefit Exchange is considering adding adult and family dental coverage during open enrollment in 2015. In a survey of 1,200 Washington residents by the Washington Dental Service Foundation, four out of five adults agreed that

LIFE COACHING

Holiday Obligations?

Cat Carrel is a certified life coach in Spokane.

or many of us, the holiday season represents faith, love, giving, joy and family. For others, it may represent stress, guilt and codependence. Coping with the family dynamics of the holidays can be difficult, but if we remember a couple of common-sense choices, it can be made a little easier. First, we don’t have to do anything that makes us uncomfortable or that doesn’t support us. If we find ourselves saying, “I have to do this,” we can ask, “Or WHAT?”

Washington state should provide access to quality dental care for adults who can’t afford it. Yet the survey found nearly a third of Washingtonians lack dental coverage, and nearly a quarter haven’t seen a dentist for a routine checkup in the past year. “Somehow the mouth has gotten separated from the rest of the body and seems to have less importance for most people,” Sledge says. “The long and short of it is, if your mouth isn’t healthy, you really aren’t healthy.” — DEANNA PAN

Just changing our viewpoint from “I have to... ” to “I want to because... ” will shift the energy from fear to love. Next time you say “I have to... ” switch it up and see if the energy shifts. If it doesn’t, then don’t do it. Second, we are allowed to create a family of people who support and love us. If those people are your family of upbringing, so much the better; for some of us, creating a family of close friends is far more affirming and loving than the family members who raised us. Remember, we are the only ones who can create a supportive and loving space for ourselves during the holidays. — CAT CARREL

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A 3,500-Year-Old Tradition

ultivated as long ago as the Bronze Age, Camelina sativa, the flowering plant from which the oil is derived, fell out of favor in the modern American agricultural economy, mainly because it couldn’t be made into margarine. But camelina is making a comeback, thanks to its unique properties and adventurous farmers like the Greenwalt Family in Ritzville, Wash. “The composition of the oil is such that you’re looking at 35 percent Omega-3s [compared] to about 3 to 5 percent in olive oil,” says Curt Greenwalt, who along with his wife Lynn first started growing the plant five years ago at the urging of his son. “The biggest benefit is the amount of vitamin E. There’s about 12 times the amount in camelina as there is in olive oil, and six times as in canola. “When you cook with it, that vitamin E also acts as an antioxidant and helps protect the oil from producing free radicals,” says Greenwalt. That means the oil better withstands high temperature, which is why his son was initially researching it

for potential use as a biofuel. “It doesn’t sound good to eat, I know,” he laughs, “but the health benefits for human use are much better.” The high vitamin E content makes it equally ideal for topical use. Some of Greenwalt’s customers have used it to treat dry skin. So it might not be long before camelina finds its way into cosmetic products. But many return to camelina because of its nutritional value — and let’s not forget taste. Camelina is a member of the brassica family, so it shares flavor characteristics with broccoli. There are also hints of butter and asparagus. That makes it perfect for frying veggies as well as potatoes, fish and chicken. The Greenwalts currently grow, press and bottle on their 32-acre, state-inspected facility. The oil sells for $14 per 17-oz. bottle — “We’ve

ASK DR. MATT

Showing Off the Baby

hen is it safe to take the most beautiful newborn ever out of the house? This is one of those questions for which no one answer will suffice. There are numerous variables to consider: the age of the child; the time of year; the presence of risk factors specific to the given infant such as prematurity, cardiac or respiratory problems, vaccine status of the infant, etc. Overall, the goal is to reduce the likelihood of exposure to infectious illness. Keeping babies in a bubble doesn’t really work too well (although John Travolta gave it a good try in the ’70s). On the other hand, it is not enough to simply watch out for sneezing, sniffling or queasy-appearing people. Keep

Matt Thompson is a pediatrician at Spokane’s Kids Clinic.

YOUNG KWAK PHOTO

priced it so we’re in the middle of the extra virgin olive oil range,” he explains — and is available from grocery retailers like the Main Market Co-op, Huckleberry’s and Rocket Market. More info is at www.camelinagold.com — E.J. IANNELLI

in mind that many pathogens live for hours to days on surfaces like keyboards, yoga mats, pool cues, wands, etc. Additionally, with viral season upon us there are more germs to share when your baby is passed around the office, play group, fantasy football club, or coven. So if you must venture out, good hand hygiene goes a long way to reducing transmission of illness. We must be mindful to not be vehicles of pestilence, unwittingly delivering germs to our own, or someone else’s, precious progeny. Take a moment to sanitize your own hands before picking up the pacifier and popping it into your baby’s mouth, especially if you just cheesed a hot dog and pulled a fresh Slurpee at your neighborhood Seven-One-One. You have to live life — just try to reduce the likelihood of your infant getting sick, particularly before they have had a chance to receive their initial series of vaccines. — DR. MATT THOMPSON

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CHECK-IN

SUPERFOOD

Power of Pink ATTRIBUTES: A relative newcomer in the botanical world, grapefruit is the result of a cross between oranges and pomelos. This citrus fruit, first named in 1814, grows in clusters like grapes and is at its peak in the Inland Northwest’s cold, snowy months, offering a juicy burst of sunshine in every bite. SUPER POWERS: Absolutely loaded with vitamins C and A, pink grapefruit also boasts beauty- and

immune-enhancing antioxidants. And it contains little-known limonoids, compounds that seem to help make it easier for the body to rid itself of toxins, and that may help prevent some types of cancer. WEAKNESSES: Grapefruit can interfere with absorption of a big list of medications. Make sure yours aren’t on the list before you consume grapefruit juice or whole fruit.

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Bone of Contention The controversy over Fosamax (alendronate) causing problems with bone breakdown in the jaw is concerning me. Should I be worried about this?

John R. White is a pharmacy professor at WSU-Spokane.

ll drugs come with risks and benefits. The drug alendronate has been prescribed for more than 10 years to hundreds of thousands of patients with osteoporosis, and its use has resulted in the prevention of serious problems — such as hip fractures — in many. However, this drug has been linked (at least by association) to a rare jaw problem called osteonecrosis of the jaw. The problem typically occurs

HOW TO USE IT: Be sure to wash the outside of grapefruit before slicing, sectioning and enjoying as is. Or for more style points, grapefruit brûlée makes an impressive and healthy dessert: Halve a grapefruit, sprinkle with coarse sugar and a tiny bit of sea salt. Use a kitchen torch or broiler to melt and brown the topping. — ANNE McGREGOR

after a patient has undergone some traumatic event to the jaw, such as a tooth extraction. After such an event, the bone fails to heal and bone tissue actually dies. This is a rare event, but the risk may be increased in patients taking alendronate if they have an invasive dental procedure, cancer, require chemotherapy or corticosteroids, or have significant dental disease or anemia. It is not clear that alendronate is the cause, but there seems to be an association between the medication and an increased risk of the development of osteonecrosis of the jaw. Some have estimated the risk of developing osteonecrosis of the jaw to be about one in 1,000 for every year that the medication is taken. As with any medication, the potential benefits and risks of this medication should be discussed with your physician and your pharmacist. And please make sure to inform your dentist if you take alendronate. — JOHN R. WHITE

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BRAIN EXERCISE

Sudoku

7 5 9

3 6

6 9 5 9 1 4 4 3 3 2 5 9 6 7 2 4 8 2 9 1 5

RATINGS: Tough (left), Diabolical (right) To complete Sudoku, fill the board by entering numbers 1 to 9 such that each row, column and 3x3 box contains every number uniquely. Answers to all puzzles on page 40

PUZZLES BY JEFF WIDDERICH & ANDREW STUART www.syndicatedpuzzles.com

Codewords

Each letter has been replaced by with a number. Using the starter clues, work out the words that must go in each cell on the codeword grid. Some well-known phrases and names may also be found. For a two-letter clue, turn to page 22. 17

11 4

24 8

8 18

6 3

16 19

13 26

22 19

25 25

18 14

26 22

8 6

16 8

2 18

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

2 8 4 9 3 9 3 6 1 3 4 2 5 3 1 7 3 5 1 8 7 3 5 6 2

Str8ts

RATING: Moderate Like Sudoku, no single number can repeat in any row or column. But rows and columns are divided by black squares into compartments. These need to be filled in with numbers that complete a ‘straight’ — a set of numbers with no gaps but can be in any order. Clues in black cells remove that number as an option in that row and column, and are not part of any straight. Glance at the solution above to see how ‘straights’ are formed.

1 4

6 5 9 5 2 6

3 5

4 7 4 2 3

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NEWS

t e e w S n o i t c u d e S IN-DEPTH

Can sugar be part of a healthful, balanced diet? BY DEANNA PAN

n 2009, Robert Lustig, an endocrinologist at the University of California, San Francisco, School of Medicine, posted a lecture on YouTube called “Sugar: The Bitter Truth,” in which he argues that sugar isn’t just empty calories, it’s “toxic.” Sugar, particularly fructose, he said, is the root cause of diseases plaguing modern America: The video has since been viewed more than 3.9 million times and his views have been widely publicized in the New York Times, National Geographic, 60 Minutes and The Oprah Show. “Ultimately, this is a public health crisis,” Lustig told Sanjay Gupta in an interview last year. “And when it’s a public health crisis, you have to do big things and you have to do them across the board. Tobacco and alcohol are perfect examples. We have made a conscious choice that we’re not going to get rid of them, but we are going to limit their consumption. I think sugar belongs in this exact same wastebasket.” Lustig’s proclamation begs an important question: Should we eschew pecan pies smothered with whipped cream? Roasted hams glazed in sugar? Cookies of all kinds? Anything frosted, sprinkled or dipped in chocolate? ...continued on next page

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NEWS “SWEET SEDUCTION,” CONTINUED... Could something that tastes so good really be so bad? Not so fast, says Shaekira Collins, a clinical dietician at Providence Sacred Heart Medical Center. “Everything you read from him or in the mainstream media, you have to take it with a grain of salt,” she says. “Or a tablespoon of sugar.” Sugar in and of itself isn’t a problem; the problem is our supersized consumption of it. The average American adult consumes 79 grams, or 20 teaspoons, of added sugar a day. For a 2,000-calorie diet, the United States Department of Agriculture recommends less than half of that amount — 32 grams, or just eight teaspoons. People who consume high amounts of added sugars are often taking in excess calories and eating low-quality diets, increasing their risk for obesity, insulin resistance, Type 2 diabetes, and cardiovascular disease. Most of the fructose in our diets doesn’t even come from fresh fruits anymore. While our consumption of added sugars has steadily fallen in the past decade (blame the rise of non-nutritive sweeteners, like Splenda and stevia, and the growing

Watch out for empty calories, advises Spokane dietitian Craig Hunt. STEPHEN SCHLANGE PHOTO popularity of sugar-free everything), we’re still eating too much and exercising too little. Obesity rates, meanwhile, continue to climb.

“Our food environment has changed. We’re not moving as much. We’re eating more. We’re eating different,” says Collins. “Everything in moderation is fine. I think

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people’s problem is that they have a problem with the ‘moderation’ part.” So what’s driving our massive added sugar intake? The occasional office baked good? The candy stashed in our desk drawers? Our second serving of ice cream on a Saturday night in front of Netflix? Nope. The biggest culprit, the data shows, is our copious soda consumption. Soft drink consumption in the U.S. has risen sharply from about two servings a week in 1942 to two servings a day 60 years later. And kicking that soda pop habit, says Spokane dietitian Craig Hunt, would do our bodies some good.

“When people decrease their sugar intake the equivalent of a can of soda, about 45 grams, you do see an improvement in cholesterol and body fat,” Hunt says. “That’s the equivalent of about three tablespoons of sugar per day.” The type of sugar we consume doesn’t matter all that much. Even so-called “natural” sugar substitutes like evaporated cane juice, agave, honey and maple syrup are no better for our waistlines when ingested with abandon, To our bodies, it’s all the same. Our digestive system breaks down the sugars and turns them into ...continued on next page

WHAT’S THE GLYCEMIC INDEX?

he glycemic index (GI) is a handy tool for measuring how various foods affect your glucose or blood sugar levels. High glycemic foods cause your blood sugar levels to spike, and that’s a problem, says dietitian Shaekira Collins, because consistently elevated blood sugar levels can lead to chronic health problems. “It means we have a lot of sugar in our system, so our pancreas has to work harder to pump out more insulin,” Collins explains. “When things have to work harder, they’re more prone to fatigue.” And that’s how insulin resistance develops, and later, Type 2 diabetes, when your body doesn’t produce enough insulin to maintain normal blood

sugar levels. For those with diabetes or insulin resistance, nutritionists recommend choosing foods with low GIs and eating anything with high GIs sparingly. High glycemic foods, which have a GI of 70 or more, include white bread, white rice, sugary cereals, cookies and crackers. Low glycemic foods, which have a GI of 55 or less, take longer for your body to digest. These include whole grains, fibrous fruits and vegetables, beans, lentils and nuts. Anything with a GI between 56 and 69 is considered moderate. LOW GI FOODS: peanuts (7), chickpeas (10),

grapefruit (25), skim milk (32), carrots (35), apples (39), brown rice (50), 100% whole grain bread (51), quinoa (53), yams (54), oatmeal (55). MODERATE GI FOODS: pumpernickel bread (56), grapes (59), honey (61), bananas (62), Coca-Cola (63), Kraft Macaroni and Cheese (64), couscous (65), Special K cereal (69). HIGH GI FOODS: white bread (71), watermelon (72), vanilla wafers (77), Gatorade (78), rice cakes (82), white rice (89), cornflakes (93), baguettes (95), russet potatoes (111). — DEANNA PAN

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glucose, our bodies’ preferred fuel source. In fact, how we eat our sugar is far more important. One of the drawbacks of sugar, says Hunt, is its “minimum satiety value.” “Sugar by itself tends to be what they call ‘empty calories,’” Hunt says. “So it has a minimal effect on feeling like, ‘Yeah, I really got something. I’m full.’” When we eat carbohydrates, our blood sugar or glucose levels rise. Refined sugars — also known as simple carbohydrates, which have no nutritional value — cause our blood sugar levels to spike rapidly. Our pancreas detects that rise and secretes insulin to control our blood sugar. “It’s dangerous to have elevated glucose in your blood,” Hunt explains. “If your body has to handle a high carbohydrate load day after day, eventually the cells that produce your insulin become desensitized. Basically they start to die off so our pancreas becomes less functional… and then people become pre-diabetic.” But when you combine sugar with protein or healthy fats — for example, if you drizzle your agave on oatmeal with flaxseed meal and chia seeds rather than dumping it in your tea — the effect is tempered and your blood sugar rises more slowly.

“W

hat are you going pair that up with? Make it something that has some nutritional value to it, so it’s far less harmful to the body,” Hunt says. If you’re concerned about added sugar intake, eliminating it from your diet completely probably is not a good idea, says Hunt. “I’ve watched people’s blood sugars

and cholesterol for over 20 years,” he says. “The people that I see who are adamant that they’re going to get all their added sugar out, when they finally do eat sugar, they binge on sugar.” Lactose, the sugar found in dairy products and breast milk, is, after all, the first taste we learn as newborns, says Cindy Coberly from the Greater Spokane Dietetic Association: “I think we set up ourselves up for failure if we tell ourselves we can’t have that ever for the rest of our lives.” Non-nutritive sweeteners, like Splenda and stevia, are good weight-management options, but Coberly prefers honey: “It’s got immune-boosting properties, and it’s loaded with B vitamins, and you’re getting more bang for your buck.” If you’re interested in using natural alternatives to decrease your sugar load in baked goods, Collins recommends substituting mashed bananas or dates for the sweet stuff. “If you’re thinking about it from a health standpoint, pick what you think is best for you and eat it in moderation,” Collins says. There are easy ways to cut back your added sugar intake: Limit your soda and energy drinks. Satiate your sweet tooth with fresh fruit. Get full loading up on whole foods, like fruits, veggies and lean protein. Bottom line: Eating a cupcake every now and then certainly isn’t going to kill you. “I wouldn’t say anyone should avoid sugar. Rather than avoiding sugar, I’d say choose better options; get your glucose from fruits and vegetables and whole grains rather than donuts,” says Collins. “Be mindful of what you’re eating throughout the day.” 

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The word “sugar” doesn’t always appear in the ingredients list on the backs of our favorite sweetened junk foods. Here are the sweet stuff’s most common aliases:

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Lactose Malt Syrup Maltose Maple Syrup Nectar Sucrose

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NEWS

Cole Whitworth with the furry friend that helped him stay connected to home in Montana during his cancer treatments. STEPHEN SCHLANGE PHOTO CANCER

Serious Monkey Business A stuffed monkey can keep kids connected to classmates during hospital treatments BY JACOB JONES

ole Whitworth, a shy 7-year-old with a mischievous grin, peeks out from underneath an oversized, neon-green New York Yankees cap. In the basement of the Spokane Ronald McDonald House, he holds up a stuffed monkey with a similarly wide smile. Sporting a bright yellow T-shirt and long, floppy arms, the plush primate has served Cole as a sort of stunt double, travel companion and steady connection to his friends back home. For much of the past 15 months, Cole has traveled back and forth to Spokane for cancer treatments. While he has recuperated at the Sacred Heart Children’s Hospital, his mother Cecile Lafromboise says the monkey held his place in class in Polson, Mont.

“We saw his monkey sitting right in his spot at the table,” Lafromboise says of a recent classroom visit. “[The monkey] is going down the halls with all of the kids. They have him hand-in-hand, and he goes everywhere with them.” Cole’s family received the monkey through the national Monkey in My Chair program. The Cincinnati-based organization offers monkey kits to elementary age children undergoing long hospital treatments that keep them out of school and away from friends. The monkeys provide a physical presence in class and become a tool for helping other children understand their classmate’s illness and absences. Each kit contains two stuffed monkeys and support materials. One full-sized

monkey goes to the school to stand in for the child, while a smaller, doll-sized monkey stays with the sick child. The child’s teacher gets lesson plans to help classmates comprehend what the sick child is going through. To help bridge the social gap, the kit also includes notebooks and a camera for passing letters and photos back and forth between classmates. Kim Ramirez, a family advocate with the Children’s Hospital, says about 15 Spokane-area families have participated in the program since 2010. With young oncology patients often missing long periods of school, the Monkey in My Chair program provides some additional continuity for children balancing class and cancer treatment.

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“A lot of the schools embrace it,” Ramirez says. “It’s a way to still keep that child connected to the classroom. … It really helps in that transition, when they come and they integrate back into the classroom. It’s not like they were just gone and all of a sudden they’re back again.” Lafromboise says doctors discovered Cole had a brain tumor just as he had started kindergarten in the fall of 2012. The family traveled regularly to Spokane for treatment, often gone for three weeks at a time as Cole underwent surgery, radiation and chemotherapy. During his absences, his first-grade classmates carried around their matching monkey with his name on it. His friends whisked the monkey around to various activities, visiting the library or lunch room. The monkey even sat in for Cole in class photos. Lafromboise says hospital programs provided tutors to help Cole keep up with his schoolwork, but the monkey helped keep Cole attached socially to his friends four hours away in Montana. “This program, it’s not only good for Cole, but it’s good for his buddies at school,” Lafromboise says. “Being that age, they don’t understand what’s going on. … I think this program helps [explain] the big picture and where he’s at and that he’s doing good.” The kits also include a storybook with a touching story about what many of the sick children face. Lafromboise says the story and other materials do a great job of helping children cope with illness. Inspired by the memory of Chloe Watson-Feyerherm — a 7-year-old from Salina, Kan., who died of cancer in 2007 — the Monkey in My Chair program now partners with more than 130 hospitals nationwide. Ramirez says the local hospital keeps several kits on hand for future families. Additional monkey kits can be sponsored online for $75. “Every family gets a new kit,” she says. “They keep it.” Lafromboise says Cole received a clear diagnosis in November following a final round of chemotherapy. After a long and trying fight, the family has started preparing to head home for good. Cole will return to class and the stuffed monkey will get a long-awaited break. “It’s been a long haul,” Lafromboise says, praising the program. “It’s just been really helpful.” n

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NEWS

Tori Westacott uses “kangaroo care” to bond with her premature twins, Paisley and Presley. YOUNG KWAK PHOTO PREEMIES

Holding Them Close Among the newest — and oldest — techniques in caring for premature babies: skin-to-skin contact BY HEIDI GROOVER

waddled in pink blankets, Paisley and Presley’s little faces peek out, their eyes closed peacefully. Miniature tubes pump air through their noses and milk into their bellies. Here, everything is tiny. Twice today, and every day until she can take them home, Tori Westacott will hold each of her 34-week-old twins (born at 32 weeks) against her bare chest, feeling their fragile bodies move up and down with each breath. The technique, known as kangaroo care or simply “skin-to-skin contact,” has become more common here in the Neonatal Intensive Care Unit at Deaconess and in other hospitals around the globe. Researchers and doctors say the process improves respiratory function (one of the most difficult challenges facing babies born prematurely is breathing properly, since most of them have not yet formed fully

functioning lungs), enhanced cognitive dale, about 40 miles southeast of Spokane, function, weight gain and stronger motherand they’re first-time parents. She had her child bonding. And while it’s new to North baby shower the day before rising blood America, kangaroo care was born long ago pressure forced her doctors to perform a Cout of necessity in developing countries section and transfer her babies to their beds with scarce access to care and technology. in a small room in the NICU, where the “In high-income countries, access to lights are low and holiday cutouts cling to modern technology and resources may the windows. Not only is it difficult to leave alleviate the need to use [kangaroo care] them each night, Westacott says, but it’s to improve survival of hard to imagine that it could low-birthweight infants,” be nearly a month before they wrote Ann Jefferies of the can come home with their parfrom the puzzle on page 13 Canadian Paediatric Socients. (Babies born prematurely 8 = O; 26 = N ety in an overview of the are usually released near the method last year. “Nevermother’s due date.) theless, the practice of skin-to-skin contact “When I go out, I’ll see people with between the preterm infant and parent … their babies and I’m like, ‘Why did they is one way of involving both mothers and get their baby?’ It’s hard,” Westacott says, fathers in the care of their at-risk infant and looking down at Presley. “You don’t think helps to humanize the NICU experience.” about your babies having to stay here. You For Westacott, that has been especially imagine the day they’re born, you imagine true. She and her husband live in Oaksbeing in the hospital a day and then taking

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them home.” Skin-to-skin contact can help parents with those feelings of disconnection and help finish the process of bonding between mothers and babies that begins in the womb. “They’re with the mom. The warmth, the heartbeat’s there,” says Patrice Sweeny, the director of the Deaconess NICU. “It’s as close to a womb-like environment as you can get. … It just promotes total well-being of these infants.” Sweeny says the practice has taken hold in the past few years as the hospital has focused more on premature babies’ “developmental care.” With well-developed technology to help them breathe and eat, techniques to ensure healthy mental development are becoming a bigger focus. Because babies’ senses are developing quickly, Sweeny says doctors and nurses are even more gentle with the babies than in the past, careful not to provide too many stimuli too quickly when caring for them. Efforts are also underway to improve neonatal care at Sacred Heart. Keith Georgeson, a pediatric surgeon at the helm of Sacred Heart’s children’s hospital, says the recent industry shift toward requiring women to be at least 39 weeks pregnant to have an early C-section, sometimes called “designer delivery,” has been “astounding” in reducing the number of problems premature babies face. He points to various efforts: doctors are able to better cool down babies who didn’t get enough oxygen to their brains during birth in order to reduce their risk of neurological damage; minimally invasive surgery is now possible on babies; intubation is used less often in favor of less invasive and damaging techniques, like masks, to help babies breathe; efforts like intravenous Tylenol are replacing narcotics for some babies; and new technologies are allowing anesthetics to be applied through the skin without a needle. “We’re in a war against pain right now,” Georgeson says. Both hospitals offer smaller rooms for premature or at-risk babies as opposed to large nursery rooms, offering more privacy for families and a more intimate, homelike connection. “When technology first started to develop, we sort of put a wall between parents and premature babies,” Georgeson says. “More and more, we’re getting parents involved in care even when their baby is hooked up to all kinds of monitors and devices. There’s a definite physiological improvement in babies, and it’s good for parents as well because otherwise they feel helpless.” n

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LIVING HEALTHY BEAUTY

No More Frowns Can Botox play a role in mental health? BY LISA FAIRBANKS-ROSSI

eople aren’t exactly upfront about receiving Botox therapy for facial wrinkles. Maybe it seems a little vain, in a world full of problems, to focus on erasing a few wrinkles from your face. Could there possibly be anything gained, aside from a youthfully smooth brow, by taming the ability of our faces to fully express our inner thoughts? Eric Finzi thinks there just may be. Equal parts physician and artist, Finzi runs runs two successful dermatology practices in Maryland, and also creates emotive epoxy resin portraits that are featured on the walls of a swanky San Francisco art gallery. You could say he is obsessed with expression, with how our inner thoughts are reflected on our faces. And, lately, with how changing the way our faces respond may have a remarkable effect on those emotions.

RIGHT BETWEEN THE EYES

Finzi’s notions are not really new. In 1872, 13 years after Charles Darwin shook up the field of biology with On the Origin of Species, he debuted another controversial work — The Expression of the Emotions in Man and Animals. In it, he asserted that not only do we all react similarly when upset, but we can also alter the process by simply changing how our facial muscles are set. “The free expression by outward signs of an emotion intensifies it. On the other hand, the repression, as far as this is possible, of all outward signs softens our emotions,” wrote Darwin. The philosopher William James famously reinforced Darwin’s theory that facial expressions themselves help to cue up our emotions. “The more rational statement is that we feel sorry because we cry, angry because we strike, afraid because we tremble, and not that we cry, strike or tremble because we are sorry, angry or fearful, ” James stated. “Without our bodies’ ability to express the emotion, it ceases to exist.” ...continued on next page DECEMBER, 2013 - JANUARY, 2014 LIVING LEADinhealthDEC2013.indd 25

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LIVING HEALTHY BEAUTY “NO MORE FROWNS,” CONTINUED... And that’s where Finzi and botulinum toxin come in, albeit a century later. The relationship between facial expressions and emotion — touted as the facial feedback hypothesis — has been real for Finzi since long before he knew he’d be a doctor, or even an artist. “I didn’t understand what I saw, but I knew it was important,” he writes in his book The Face of Emotion: How Botox Affects Our Moods and Relationships, published in 2013. As a 5-year old, he observed his depressed mother and realized, “I was hard-wired to react to what my mother was expressing on her face … But this day was different. Mom looked at me with a deeply etched and furrowed brow … etched from many moments of angst, moments hidden except by the telltale signs between her eyes. That day her frown spoke to me in a very visceral way, alerting me to her inner suffering.”

MUSCLE MEMORY

Whenever we are sad, angry, worried or scared, the corrugator supercilii muscles — they’re located between the eyes — pull the eyebrows together. Since 2002, nearly six million people have elected to receive a series of botulinum toxin injections into that corrugator, paralyzing it and resulting in a relaxed, younger-looking forehead. After treating dozens of happy, appreciative patients in the year following initial FDA approval of cosmetic Botox, Finzi the dermatologist began to conceive something that a younger Finzi couldn’t have grasped. “As I became aware of an important feedback loop between the brain and the muscles of facial expression, I began to suspect that Botox could help control the flow of negative emotions … Could I change moods and help depression simply by preventing a negative facial expression?” he writes. Finzi followed up on his epiphany with a small clinical trial. He tested 10 patients of a clinical psychologist, all assessed at 20 or higher on the Beck Depression Inventory (BDI), indicating they were moderately to severely depressed. Two months after the Botox injection and halfway through its effectiveness, since it lasts 4 to 6 months, nine out of the 10 patients in the initial trial “were no longer clinically depressed by DSM-IV criteria or by their BDI-II test scores,” Finzi first reported in a 2006 issue of the journal Dermatologic Surgery. The bulk of The Face of Emotion details both the background of facial/ emotional connection studies and favorable results

Amy Schaffner of Elite Salon and Day Spa: “Happiness is the one emotion I associate with Botox.” from Finzi’s intensive research with 74 moderately to severely depressed patients, using randomized, double-blind placebo controls. The book has been out for nearly a year, and while he waits for word from two psychiatric boards, as well as “phase 3 studies” and ultimately, he hopes, FDA approval of Botox treatment for depression, Finzi says he’s “pleasantly surprised” by the response so far. “People are reading the book and realizing that there’s a lot of information out there, and one of my tasks was to get different fields of medicine to talk to each other. I’m trying to forward the research, and I believe it will be accepted down the road,” Finzi says, speaking from the office of his dermatology clinic in Chevy Chase, Md. “Like all new things, people are kind of cautious.” And the majority of the population still

YOUNG KWAK PHOTO

resists injecting a poison between their eyes. “But any drug, improperly used, can have an adverse effect,” Finzi asserts. “If you take too many aspirin, you might create a hole in your stomach, or you take several Tylenol and go out drinking, that might just kill you or put you into liver failure. If you take any pill, no matter what its purpose, there’s a good chance it will do something to a different organ. With Botox, you go after what needs treatment; in this case, selective muscles. It’s a fantastic medicine because it stays where it’s put.”

BENEATH THE SURFACE

Spokane advanced registered nurse practitioner Amy Schaffner, a Botox proponent, took little convincing about the plausibility of Finzi’s potential treatment regimen. “It’s a new thought,” she says, “and all psychosocial research is a little avant-garde. That’s just the way it is … but I believe

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it’s possible that the change in expression dictates the emotion. And happiness is the one emotion I associate with Botox.” Schaffner admits to being happier when her frown is frozen. “I’ve let my own Botox treatments go before, and I feel old and not as confident, and a little depressed about feeling old, tired and down. Part of it is because when you feel pretty and confident, it affects how other people respond to you.” That, in turn, informs the way you perceive yourself, she says. “There was a new patient — a Botox ‘virgin’ in her late 30s who told me, ‘I look at myself in the mirror and I am always frowning, and I look so angry and sad. And I’m not that way,’ At first I thought, ‘She’s too young for that to be happening’ … but then I saw her,” Schaffner says. “Treating the corrugator smoothes all of that out, and I think they do feel better.” In “The Muscle of Joy” chapter, Finzi examines the influential power of the smile: “If you want to sell anything, sell it on the promise of delight, the promise of happiness.” But he promises that treating depression is nothing like selling happiness. “There is a difference between being non-depressed and depressed, and it’s not happiness. It’s just feeling normal,” he says. Psychologists are weighing in about the pros and cons of treating deep psychological pain with subdermal therapy. Spokane psychologist Kristina Roberts has a few concerns about the efficacy of Botox for depression. She asserts that treatments should not be done in isolation, and that erasing frown lines may make her job harder. “I use facial expressions so much as an access to what’s going on inside. Those facial cues help me to get a truer read,” she says. “On the other hand, I’m humbled every day by the challenge of people in the midst of suffering. Who am I to close the door on a type of treatment?” Roberts estimates that only one of her current patients is operating at level 20 or above on the BDI scale. “Severe depression requires a concrete behavior focus: In a state of deep depression, life is so tenuous ... people are barely managing to care for themselves,” explains Roberts. “They have lost the sense of hope and self-worth. We are often monitoring suicidal ideation.” She points out that most severely depressed people don’t even seek out help, because they don’t want anyone to see how bad it is. “Just to get up out of bed, shower ...continued on next page

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LIVING HEALTHY BEAUTY They Grow It, Make It, Catch It, & Sell It

This holiday season, shop at Spokane’s year-round farmers & artisan’s marketplace Downtown at 24 W. 2nd Ave Thur-Sat 10-6pm Sun 11-5pm

“NO MORE FROWNS,” CONTINUED... and get out of the house is a victory,” Roberts concludes. Finzi says his acute awareness of depression stems both from his professional work and his own memories. “Having seen it firsthand from the time I was a little child, I’ve never been able to ignore [the struggle of depression],” says Finzi. “That’s one Dr. Eric Finzi’s book reason why after my mother died, I really got so interested in this work... I felt so powerless that modern medicine couldn’t help her: ‘Couldn’t there have

been something I could have done?’ You replay it in your mind with a different ending.” Finzi says the tendency to “sweep mental illness under the rug” could work against FDA approval of Botox for depression, but he hopes that’s not the case. “Getting depression out of the closet would be an important step ... to realize it is a powerful negative influence in our culture; one of the biggest causes of disability.” Just as cosmetic Botox procedures led to the discovery of medical uses including migraine relief and stopping excessive sweating, Finzi believes expanded research, and ultimately FDA approval, can open up the possibility of more mental health applications. “There are multiple groups of researchers replicating the work now,” he says. “As with every new advance in medicine, it has to undergo the test of time.” n

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nce the holiday rush is over, January’s lull is welcomed. With the start of a new year, it’s an opportune time to focus on ourselves, and that’s just what Rachael Swanson had in mind when she organized the first Health & Beauty Spa Show nine years ago. The two-day vendor show features nearly 100 local beauty and wellness service providers, offering express spa treatments including facials, waxing, hair styling, makeup application, massages and more — at sample-sized prices of $5 each. “It’s a very hands-on event, and [attendees] can try different services for about half or less than half of what you would pay full price,” says Swanson. “It’s a fun thing for women to do in the dead of winter when there is nothing else going on.” Though the show is centered around pampering and de-stressing, Swanson also turned it into a channel to give back to women in the community who are in less-favorable circumstances, by

2012 Health & Beauty Spa Show collecting donations for the YWCA’s Alternatives to Domestic Violence Program. Show attendees who donate any non-perishable food or women’s hygiene item at the door receive $3 off the regular admission price of $10. Each year Swanson estimates the donated items are worth as much as $3,000, along with about $1,500 in cash donations from vendor’s service fees and event admission proceeds. “Domestic violence is something close to my heart — I was a victim for 10 years — so I wanted to help other women facing the same thing,” Swanson says. — CHEY SCOTT Health & Beauty Spa Show • Jan. 18-19, Sat from noon-6 pm, Sun from noon-5 pm • $10 admission, $7 with donation • Spokane Community College Lair • 1810 N. Greene • healthbeautyshow. com • 218-6519

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Your health. Our focus.

At Kootenai Clinic we are part of the community, living and working throughout northern Idaho and eastern Washington. Internally, we are connected as a community as well. We are physicians and providers, from family medicine, surgery, cardiology, oncology, and more. Weâ&#x20AC;&#x2122;re all working together, sharing vital information and resources, and focused on making your health care the very best it can be. Because after all, at the center of our community is you.

For a list of all Kootenai Clinic locations visit kootenaiclinic.org or call (208) 625-4652. DECEMBER, 2013 - JANUARY, 2014 LIVING LEADinhealthDEC2013.indd 29

Health 29 11/20/13 10:31 AM

LIVING HEALTHY BEAUTY

Truth at Hand

Jill Turner, salon trainer at The Spa Coeur d’Alene, helps clients combat winter’s ravages on their hands. YOUNG KWAK PHOTO

Beautiful hands are a workshop for manicurists and plastic surgeons BY JORDY BYRD

n ways that seem comical now, beauty faux pas were exposed in the ’50s and ’60s – a time when baby boomers were truly babes in diapers. Advertising agencies targeted beauty campaigns to the iconic housewife, who cooked and cleaned and somehow remained glamorous. Cleaning product companies took advantage of the demographic. They warned against dreadful dishpan hands — scaly, unseemly hands that resulted from days spent cleaning. Ivory campaigns claimed, “Ivory liquid hands keep your age a secret” and featured Mrs. Robert Thompson, a 35-year-old housewife and mother of five. The copy? “Every woman in the room was staring at her! She dared to drink a Cosmo with dishpan hands.” Though much has changed, women still want beautiful hands, and there are many ways to achieve that at any age. Jill Turner, salon trainer at The Spa

Coeur d’Alene at the Coeur d’Alene Resort, says women who take care of their hands “show a level of self-awareness.” “Typically women who take care of their hands are a little more self-confident,” she says. “Your hands are the first thing you offer someone when you introduce yourself. It’s a good representation of who you are.” Turner and her team provide hand treatments, manicures and acrylic nails to beautify women’s hands year round. For starters, she recommends products with antioxidants to hydrate skin and reduce discoloration. If skin is getting thin and wrinkled, she recommends trying a firming lotion — The Spa offers offer Eminence Coconut Firming Body Lotion, an organic product made with bamboo and coconut milk. “The firming lotion physically plumps your skin for a few days,” she says. Manicurists at The Spa Coeur d’Alene

also use Creative Nail Design’s Nail Solar Oil to preventively treat brittle nails. The conditioner contains almond oil and vitamin E to help soften cuticles and strengthen nails. “The oil prevents hangnails, dry patches and brittle nails,” Turner says. “It’s like my go-to wonder drug.” To combat dry skin during bitter winter temperatures, Turner pairs hand treatments — exfoliants, massage and paraffin wax — with basic manicures. The last key to a beautiful pair of hands is a coat of nail polish or shellac. Turner recommends OPI Products nail polish, in rich shades like charcoal, oxblood and eggplant, when the weather turns cold.

ometimes hands require more than surface regeneration, which is why baby boomers have turned to cosmetic surgery. “Women come to our office with two

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main complaints,” says Dr. John Lundeby, owner of Shape Cosmetic Surgery & MedSpa in Spokane. “One is age spots, the other is loss of volume, or the appearance of bony hands.” He adds, “A lot of women are concerned their hands will age them prematurely… I think women have had this concern for a long time. And with the general increase and acceptance of cosmetic surgery, we’ve seen an increase in patients seeking hand treatments.” To treat sun spots and discoloration, Lundeby provides patients with three treatment options. Topical medication is available to reduce the production of melanin by melanocytes, causing brown spots to fade. Intense pulsed light therapy also removes age spots. The technology uses specific light frequencies and wavelengths to target melanocytes and melanin granules. Carbon dioxide lasers are used to aggressively treat age spots and even out the skin’s texture. To deal with thin, bony hands, Shape Cosmetic Surgery & MedSpa offers artificial or natural fat fillers, which are injected into hands to increase volume and create a youthful appearance. “The procedures have been around for many years, but have recently been repurposed for use in different areas of the body, such as the hands,” Lundeby says. “We’ve seen this repurpose with fat transfers, fillers, intense light therapy and other laser-based technologies.” Lundeby says patients can opt for an artificial filler called Juvederm, which is injected into the back of the hand where volume loss is most noticeable. The injection fills and tightens the appearance of skin for nine to 12 months. Patients can also undergo fat transfer surgery. In this procedure, a small amount of fat from the thighs or abdomen is removed by liposuction, then injected into the back of the hand via small needle punctures. The procedure is performed under a local anesthetic and light sedation and is considered a permanent alteration, subject only to continued aging. “Once the fat has successfully transferred it is very much like the person’s own tissue,” Lundeby says. “It’s soft and smooth and it gains and loses weight with you.” While cosmetic hand procedures make up a small percentage of Lundeby’s overall practice, he says the demand is growing. And that may mean those so-called dishpan hands are as much a relic of the past as the Mad Men who wrote about them. 

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Health 31 11/20/13 3:18 PM

LIVING HEALTHY BEAUTY

Makeup artist Julie Farley suggests techniques to achieve luminous winter skin. YOUNG KWAK PHOTO

Making Winter Wonderful Keeping your skin and hair healthy requires extra care in harsh weather BY CHEY SCOTT

ost of the time we consider ourselves fortunate to have four distinct seasons in the Inland Northwest. Yet winter’s dry, dark months challenge our bodies. Contending with the flu and nasty colds saps our strength. Skin grows dry, sallow and flaky. Hair becomes brittle, frizzy and more prone to breakage. It’s hard to feel good when you look dreary, so we turned to several local experts for their best tips on how to keep the winter beauty blues at bay.

MAKEUP

The first rule of winter makeup application, according to Julie Farley, who’s worked as a makeup artist for 28 years and owns The Make-Up Studio in downtown Spokane, is to make sure the canvas — your skin — is healthy. “Your makeup can only look as good as your skin looks,” Farley emphasizes. Now that it’s dark before 5 pm and that warm glow of summer has long since faded, most Inland Northwesterners are experiencing some level of dry skin. Farley

says that, combined with the naturally paler winter complexion, means women are looking to achieve more coverage with their foundation. In attempting to better mask variations in skin pigmentation that can become more visible in winter, Farley often sees women apply more foundation than necessary, a technique that usually makes problem areas look worse. Instead, she recommends a foundation or mineral powder with some luminosity or light shimmer to it, versus a matte foundation. “A little dewiness and luminosity in winter gives the illusion of more hydrated skin,” she says. Also during winter, Farley suggests switching from a powder to a cream blush, which adds to the appearance of healthy, glowing skin. “Some people think cream blush is synonymous with 80-year-old ladies without their blush blended in, but it looks great on younger skin,” she says.

HAIR

Damage to hair caused by cold-weather ele-

ments can be easily overlooked or forgotten until it’s too late. No one wants to be stuck trying to repair and hide broken and brittle strands until the average temperature climbs above freezing. At Salon Nouveau, a longtime fixture in downtown Spokane, co-owner and stylist Terri Brazil explains there’s more to winter hair care than the hair itself. She sees lots of clients come in with damaged hair that could partly be caused by a dry scalp. “When the climate changes, and because we’re so dry here, keeping your scalp moisturized and using a scalp treatment oil is key,” Brazil says. Deep conditioning treatments on a weekly basis, whether in a salon or at home, can also help with breakage, frizziness and other damage caused by low humidity and heat styling, she says. Brazil recommends, once a week, applying a heavy conditioner after shampooing hair, then wrapping wet hair in a hot towel and placing a plastic bag over the towel to trap moisture. Then she says to let the conditioner soak into hair until the towel cools.

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For women who use flat irons or curling irons on a regular basis, Brazil says using a good heat protectant spray is always crucial to protect hair, not just during winter. Keeping locks trimmed at the ends with haircuts every 3 to 8 weeks, depending on the length, is also a key to maintaining damage-free, healthy-looking hair, she adds. Finally, she says not to underestimate wearing a hat, which protects hair from potentially damaging elements in addition to keeping you warm.

SKINCARE

As skin is exposed to cold, dry winter air, it can lose moisture fast. That means it’s time to rethink your cleaning and moisturizing regimen. Julia Logie, assistant spa director at Spa Paradiso, says an easy winter switch to keep skin less stressed is using a cream cleanser instead of foaming soap on both the face and body. She says most cream-based cleansers also contain alpha hydroxy acid, which works as an exfoliant. To gently exfoliate dry, flaky skin over the whole body without too much extra effort, Logie recommends using a body brush or getting an extension handle for a Clarisonic cleansing brush to use while in the shower with whatever soap you already use. Farley advises women — and men — to step up their facial moisturizers by one or two levels, depending on skin type. Using a thicker moisturizing cream at night helps skin rehydrate and repair from being exposed to the cold, dry air and icy wind of Inland Northwest winters, she says. To ensure that makeup goes on smoothly over thirsty winter skin, Farley encourages women to use an exfoliating and hydrating mask at least once a week. She likes the GlamGlow mud mask ($69), which offers noticeable results after one use, making skin brighter and smoother. Farley swears by it for special occasions like weddings or parties. For even more exfoliating, both Logie and Urbanna Natural Spa & Salon owner Linda Biel say a clinical or at-home facial peel can work wonders for dull winter skin. Gentle skin peels help break down the dry exterior barrier of the skin that can build up over time as the face is exposed to cold air and wind, Biel says. Adds Logie, “It’s really great to get rid of hyperpigmentation or discoloration you may have gotten from the sun during summer, and it does a great job getting any dry or uneven patches off. It’s a great thing to transition from summer to winter.” n

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LIVING

Chef Colomba Aguilar and scenes from her family restaurant. YOUNG KWAK PHOTOS

COOKING

Of Superfoods and Soups Latin fusion flavors enliven lunches at Coeur d’Alene’s Cafe Carambola BY CARRIE SCOZZARRO

ncorporating nutrient-rich foods from around the world is something Cafe Carambola’s Colomba Aguilar does naturally. “I try my best to re-create foods we discover through our travels,” says Aguilar, who explains the origin of the style of cooking she calls Nuevo Latin Fusion:

“When I was in culinary school [at San Francisco’s Le Cordon Bleu], I had the chance to volunteer and attend an incredible food conference in Napa that I felt was life-changing.” Aguilar attended college at Brigham Young University, then spent 18 months in Argentina, eventually realizing her

future needed to involve food. “[The conference] showcased foods from all over Latin America, along with music and dancers from these countries. I decided I wanted to experience firsthand what each of these countries has to offer.” During an internship in the Yucatan,

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Your Downtown Grocery Store & Deli Aguilar met her future husband Carlos. The couple relocated to Coeur d’Alene in 2005, and within a short time, started a family and opened Cafe Carambola. “I plan our trips around different foods and specialties that are found in different regions of wherever we are visiting,” says Aguilar. “We love to eat our way through different places and to meet locals and get into their kitchens.” That means a menu chockfull of fresh, zesty salads and sandwiches at the weekday lunch spot. Tabbouleh, for example, gets a twist with farro grain, green apples, red peppers, garbanzo and pepitas (pumpkin seeds), while the Incan quinoa salad marries tangy tomatillo and queso fresco with the crunch of sweet corn and radishes. Although her travels have taken her throughout Central and South America, the flavors she knows best are from Mexico. Her parents — both excellent cooks, says Aguilar — are from the north, while Carlos introduced her to central Mexican cuisine. “I feel it is because of our love and appreciation of natural, clean and wholesome food that we tend to seek out and create food that fits this same description,” says Aguilar, who also teaches cooking classes and offers catering services. Subjects of her past classes this year at the Jacklin Arts & Cultural Center include tamales — once considered fit for only the gods — Mexican brunch and a range of soups. “I absolutely love teaching,” she says. “I feel like I’m the one who learns the most from doing so.”  When she’s not cooking — her parents and Carlos help run the cafe — Aguilar enjoys photography, dancing, being with her family and “entertaining friends with fabulous meals.” Even outside the kitchen, she loves to learn about food: “I also make it a habit to read cookbooks, along with books that are all about the nutritional benefits of different plants and foods.” n always online at

inlander.com/inhealth

RECIPE

Sweet Potato and Quinoa Soup with Gingered Yogurt SWEET POTATO AND QUINOA SOUP  2 medium-sized red garnet sweet potatoes 1 medium-sized white onion ¼ teaspoon ground cinnamon  ½ teaspoon ground cumin  1 large bay leaf  ¼ teaspoon ground cayenne pepper  ¼ cup quinoa (white or red)  3 cups chicken or vegetable stock  1 cup coconut milk

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GINGERED YOGURT TOPPING  ½ cup plain Greek yogurt, room temperature  ½ teaspoon fresh ginger, grated  2 tablespoons cilantro, minced  juice of half a lime  salt to taste  1. Scrub sweet potatoes, leaving peel on, and dice into half-inch pieces. 2. Dice the white onion. 3. Preheat a medium stockpot over medium heat. 4. Add ground cinnamon, cumin, bay leaf and cayenne. Stir spices until well-toasted and very fragrant. 5. Immediately add diced onion and cover. Let the onion sweat for 5 to 6 minutes. 6. Add sweet potato, quinoa and soup stock. 7. Cover and bring to a boil, then reduce heat to a simmer. Check mixture after 15 minutes. The quinoa should be cooked and the sweet potatoes should be softened. 8. Purée the soup in a blender until completely smooth (remove bay leaf first if you’re not using a high-speed blender). 9. Return soup to the pot and stir in coconut milk. 10. Consistency and thickness of soup will vary according to the size of sweet potatoes used; add more stock as needed. 11. Season to taste and keep on lowest heat. 12. In a food processor or blender, combine yogurt, ginger, cilantro and lime juice. Process until smooth. Add a pinch of salt. 13. Ladle soup into bowls and garnish with a dollop of the gingered yogurt topping. Serves 4 to 6

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Health 35 11/20/13 3:07 PM

LIVING

PARENTING

Body of Knowledge How much should moms talk about weight with their daughters? BY LISA FAIRBANKS-ROSSI

atie DeBill asked one of her 9-yearold twin daughters to please change her shirt. “‘Mom, I’m very comfortable with my body,’ she told me, and I told her, ‘That’s great! I’m so glad you are; however, your shirt is just too small.’” DeBill, a Spokane mom, isn’t afraid to speak directly with her daughters this way. They discuss bodies, food, activity and health freely. And she doesn’t necessarily agree with the therapist quoted in a recent Indianapolis Star article (“Do I Look Fat in This? A Question to Never Ask Your Daughter”). “Zero talk about dieting, zero talk about weight,” Dr. Leslie Sim, clinical director of the Mayo Clinic’s eating disorders program

and a child psychologist, asserts in the story. “Zero comments not only about your daughter’s weight, obviously, but zero talk about your weight and even other peoples’ weight.” The premise of the article, as well as myriad well-researched books about girls’ body image, is that our daughters absorb, and often pattern their own self-worth, from what we say and do. DeBill’s identical, ginger-haired fourthgraders are precocious, confident, opinionated and engaged in school, athletics and every family conversation. “We discuss how we’re going to eat better as a family on a regular basis,” says DeBill. “We bought The Flat Belly diet books, and we talked about different foods,

how there can be good fats, bad fats, the role of Omega-3s and fruits versus fruit juices… We discussed that the word ‘diet’ is really just a description of ‘what we eat.’” Monique DesChane, a Spokane counselor who specializes in adolescent health and eating disorders, concurs that “open lines of communication” between mothers and daughters is vital, and the word “diet” isn’t necessarily negative. “If you are promoting ‘health’ in a home, discussing what healthy eating habits are, that is not dieting. A normal eating routine includes breakfast, lunch, dinner snacks and dessert,” says DesChane. But there is a caveat. “Our actions speak far louder than our words. I would say that kids pay little attention to what we say, and watch everything we do.” To illustrate DesChane’s point, DeBill doesn’t remember talking about diet and weight with her own mother, but remembers what she did. “She was always dieting. She was never overweight, but she was not ‘where she wanted to be.’ We would go through phases like ‘the grapefruit diet,’ but we all lived an active life, and we were all pretty happy.” Summing up her child experience as an athletic kid with muscular legs and a taller older sister, DeBill says she was “Never the thin girl.” “I have always read articles and studies about how mothers affect their daughters’ body image,” says Jovanka McKee, mother to a 9-year-old daughter and 6-year-old son. Accordingly, McKee says she decided even before having children that she would cultivate and project confidence. “I was raised by a mother in the 1980s,” she says, “the Jane Fonda, Sweatin’ to the Oldies, Jazzercise home workout video generation. My mom was on again, off again with workouts and diets,” McKee recalls. “But she always showed she loved herself

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and wasn’t ashamed of her body.” McKee tries to follow her mom’s lead. “I work really hard to talk about us eating healthy things, so that our bodies work their best and so we have energy and health. They see me savor a good meal every day.” But she’s almost certain she’s let something slide. “I often worry, have I made a face one too many times when getting into my swimsuit? Have I said, ‘I need a longer shirt so you can’t see my muffin top,’ with my daughter within earshot? Have I rolled my eyes when my husband compliments the way I look? I know I must have. My mind has wandered to that self-loathing place at least a few times in nine years.”

n her book, You’d Be So Pretty If…, author Dara Chadwick writes about the high degree of misinterpretation between mothers and daughters when it comes to weight and appearance. “Moms are powerful,” Chadwick writes. “What we say about our bodies — and those of our daughters — has a lasting effect on the way they see themselves.” DeBill says she hasn’t shied away from making fun of herself.

“I have maybe joked with them, ‘You don’t want to look like me,’” she laughs. “We never say the word ‘fat’ or talk about being skinny or overweight.” But after interviewing dozens of grown women about the lasting negative impact of their own mothers’ seemingly innocuous comments, Chadwick advises us to keep our quips to ourselves. “Sometimes it’s tempting to let loose with a wisecrack or a disparaging comment about your body when you look in the mirror,” she writes. “But if your daughter’s in the room, think of her and bite your tongue.” The Centers for Disease Control and the National Association of Eating Disorders report that 42 percent of first to third graders ‘want to be thinner,’ and more than half of teenage girls are on diets. “I would agree that family still has the greatest influence,” says DesChane, who also believes young people form their ideas from the onslaught of unfiltered content on social media. “You’d be shocked to see what comes up in a Google search of ‘body image’ or ‘eating disorders’,” she says. “My kids recently have made jokes about my big belly or jiggly butt,” says

McKee. “I always tell them ‘I used my body to bring you into the world, and it was worth it.’” But she says she lets them know those comments still sting. “I say I know they love me, but saying things like that can hurt feelings and would make anyone else super-sad, so we can’t ever joke about bodies.” DesChane says the same kind of conversation helps when we catch ourselves spouting self-deprecating comments. “Ask your child, ‘What is it like for you to hear Mom say things about her body?’ Find out what meaning it holds for her.” And if it’s your child struggling with developmental weight changes, DesChane advises giving “unconditional love and acceptance, no matter where your child is on that spectrum. Tell them young bodies don’t know where they are going to land; that our body shape ebbs and flows until we develop a set weight.” “Being sensitive to body issues has forced me to be kind to myself, and I hope it gives my daughter a good foundation,” says McKee. “But I wonder if I bring it up enough to make an impact… or too much, so it lingers too big in their minds? It is a scary and very long experiment.” 

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Health 37 11/20/13 10:03 AM

LIVING

BOOMERS

Spokane’s Mary Ann Wilson preaches — and practices — fitness on her TV show Sit and Be Fit. YOUNG KWAK PHOTO

Conquering Falls and Fears Stepping up to improve strength and balance BY DANIEL WALTERS

wo years ago, the morning after Thanksgiving, 83-year-old Phyllis Forster fell. She found her sock-clad feet sliding out from under her on the bathroom linoleum, and when she hit, she hit hard. The impact

broke her kneecap. She managed to pull herself to her good leg, limp over to the phone and call 911. She’s not alone. Falls are the leading cause of accidental injury and accidental death among seniors — nearly one third of

those older than 65 fall every year. Some seniors, afraid of falling, become less active, leading to weaker muscles, slower reflexes and ultimately even more risk of falling. But not Forster. “I never was fearful,” she says.

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Instead, she’s committed to being active. Every Monday and Wednesday, Forster attends Sit and Be Fit classes at her retirement community to work on balance and strength. Exercising isn’t easy. Now 85, her arthritis can make it a little painful. But she knows taking control of her health is the secret to preventing falling in the future. “If I don’t exercise,” she says, “I’m stiff as a board.”

BUILDING STRENGTH

Spokane’s health community wants to inspire more seniors to be like Forster: to understand the risks around falls, but also understand how to prevent them. In Spokane County, the rate of falls among those older than 65 is significantly higher than in the rest of the state. Lately, while emergency room visits because of falls have been decreasing, the rate of fall-related deaths has increased. A few years ago, local groups formed the Fall Free Spokane coalition as a way to push back against the problem. “The coalition did this project to find out: Are senior classes in the community focusing very much on balance and fall pre-

vention?” says Gretchen Wilson, producer of Sit and Be Fit, a nationally syndicated fitness show based in Spokane that is hosted by her mom, Mary Ann Wilson. “There wasn’t as much as we were hoping.” But the coalition is trying to change that, holding Balance Enhancement Training sessions for fitness instructors. “We put together a four-hour course to train instructors on specific balance skills,” Wilson says. “Part of that class is broken down into basic body mechanics: posture, gait, breathing and transferring weight.” Today, senior-targeted programs, like the weekly aerobic-and-balance “Stay Active and Independent for Life” program, are held in Spokane at community centers, gyms and retirement homes. The Institute for Extended Learning provides a long list of similar classes, organized by location at iel.spokane.edu/act2. In particular, Wilson recommends Tai Chi: The martial art’s slow, focused movements targets leg strength, flexibility, range of motion and reflexes, and has been shown to reduce senior falls by up to 45 percent, according to Harvard Medical ...continued on next page

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LIVING “CONQUERING FALLS AND FEARS,” CONTINUED... School researcher Peter Wayne. But Wilson cautions that not every class is led with the same expertise. “It’s about the instructor,” Wilson says. “You want to make sure [they are] well-trained.”

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Every senior is different. One person may be unbalanced because of an inner ear problem, another because of weak leg muscles. Seniors may want to talk to their doctor or call home health care provider Gentiva (1-888-GENTIVA) to ask about the “Safe Strides” program. It’s often covered by Medicare, and if seniors qualify, Gentiva will send a specialist to the home to examine medications, home safety and physical health: That means everything from the seniors’ strength, flexibility, range of motion and gait, to the sensitivity of their feet and the health of their inner ear’s vestibular system. “You have to find out which part of it is

not working,” says Kym Wright, a physical therapist with Gentiva. Together, the client and specialist come up with an individual plan to fix whatever’s wrong. A survey of more than 10,000 Safe Strides patients found 96 percent were able to reduce their risk of falls. Some seniors may hesitate to seek help, brushing off a fall, or a near fall, as an isolated incident. The Spokane Regional Health Department recommends that family members broach the subject at family gatherings. Instead of focusing on the dangers of falling, they suggest family members concentrate on how their loved ones can remain active and independent by improving their strength and balance. When seniors approach staying healthy and balanced as the secret to remaining independent, balance and strength training become a lot easier. “This is your job now,” Wilson says. “Keeping yourself functionally fit and lowering your risk for falling to maintain your freedom.” n

HOW TO PREVENT FALLS

PUZZLE SOLUTIONS

from page 13

Codewords

Str8ts

C O F F I N V O O L E A N WA T E R P O G L I B D O E S M E N U S R O C K E D R A O G M P U N J A B AM I S N EWL Y Q U I D G W U N OM I N A L E P N Y D A L E K S S P

2 7 8 9

9 6 7 8 3 5 4 4 5 3 2 1

T I N A L O C R U T T H E O I D S O A X E L Y L Y I N

7 8 5 8 9 5 4 6 4 3 6 7 4 5 6 2 3 7 2 1 2 3 1 4 8 6 2 3 7

4 6 3 5 2 2 4 1 7 6 8 7 9 9 5 8

G A Z Z E R T I D I N G

2 1 3 9 8 7 4

Sudoku Tough (left), Diabolical (right) 8 6 7 5 9 3 2 1 4

2 9 3 6 1 4 5 7 8

4 1 5 8 2 7 6 9 3

7 8 1 9 4 6 3 5 2

5 3 6 1 8 2 7 4 9

9 4 2 7 3 5 8 6 1

1 5 9 3 7 8 4 2 6

3 7 4 2 6 1 9 8 5

6 2 8 4 5 9 1 3 7

3 6 7 1 8 5 4 2 9

4 8 9 2 7 6 3 1 5

1 5 2 9 4 3 7 8 6

5 4 1 3 2 9 6 7 8

7 2 3 8 6 4 5 9 1

6 9 8 7 5 1 2 3 4

2 3 5 4 1 8 9 6 7

8 7 6 5 9 2 1 4 3

9 1 4 6 3 7 8 5 2

TRAIN YOUR BODY: The CDC says exercise has the biggest impact on fall prevention. Here are a few tips to improve your balance, strength and flexibility. 4 Stand up with your feet together, close your eyes, and remain as steady as possible. 4 Set a metronome — they can be downloaded online — to 100 beats per minute and walk 10 steps, turning your head to the rhythm. The beat can improve the consistency of your gait and improve the brain’s timing, a little-known influence on tripping. 4 Exercise your pelvic floor by flexing the muscles that stop the flow of urine. By strengthening bladder control, you can decrease the number of those dangerous late-night runs to the bathroom. 4 Ride a bike. Cycling not only provides balancing practice, it improves endurance. The Spokane Bicycle Club has around 240 members who regularly go on fast trail rides, and the vast majority of them are seniors. 4 Play the Wii. St. Luke’s Rehabilitation Center uses the videogame Wii Fit in their therapy. The game comes with a balance board, enabling seniors to practice their balance and have fun while doing it. 4 Join a game of balloon volleyball. Such games can improve balance and reaction time. Reaction speed relies on fast-twitch fibers that be retrained, making it easier to adapt to quickly changing situations and to catch yourself when falling.

IMPROVE YOUR VISION: Poor vision can literally trip you up, especially in the dark. Get your eyesight checked regularly, so you’ll more easily spot that step or curb. 4 When you get up at night, put on your glasses, and take a moment to let your eyes adjust before standing up. 4 By looking ahead and using your peripheral vision, instead of staring at your feet, you’ll retrain your eyes to sense obstacles. 4 Turn on the lights — or use a night light — to make walking around the house at night safer.

REVIEW YOUR MEDS: The sleepy/dizzy effects can get worse when drugs interact. 4 Stick with one doctor and one pharmacist. Ask them to review and help you manage your medications. 4 Remembering to take the right pills at the right time can be a bit complicated, but automatic pill dispensers from companies like Lifeline can dispense cups of pills at predetermined times.

FIX UP YOUR HOUSE: Make sure that your space is free from dangerous obstacles. 4 Exposed cords or tubing — in devices ranging from lamps to oxygen tanks — can be a tripping hazard. Throw out your throw rugs, which present a frequent trip risk. 4 Install grab bars in places like the shower. A place to hold can mean the difference between a mere slip and a painful fall. — DANIEL WALTERS

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11/20/13 10:03 AM

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not just news.

amazing

stories INHealth

“rehab reality,” june-july, 2013

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LIVING

ALT MED

Instructor Loretta West works on a large Zentangle in her home studio. STEPHEN SCHLANGE PHOTOS

The Art of Meditation Zentangle offers relaxation and focus through pen and paper BY E.J. IANNELLI

he couches are thick and pillowy: standing up isn’t a simple shift-andhoist movement; it’s a protracted process of self-extraction. Classical music — recognizable pieces by Debussy, Satie and Pachelbel — plays quietly in the background. The lights are low. It is, in a word, relaxed. But tonight the small group gathered here won’t be drifting into a soothing, otherworldly plane with hypnotic ohms, or contorting our bodies into transcendental poses named after animals. We will be doodling. Here in this basement room of the New Moon Family Wellness Center, however, “doodling” is a loaded term. This is Zentangle, which takes an activity more commonly associated with notebook margins and boredom and transforms it into a structured, meditative, accessible form of art. Zentangle got its start in 2003 when, as the movement’s lore runs, Rick Roberts tried to get the attention of his wife Maria Thomas, who was absorbed in her drawing of an illuminated manuscript. So rapt was she that he couldn’t help but highlight the parallels between her drawing and his

Buddhist meditation. Out of this moment came the artistic method that Roberts and Thomas would champion under the name Zentangle. As is often the case, a cottage industry quickly sprang up around it. The movement acquired its own jargon — a square sheet of drawing paper is a “tile,” for example, and a line drawn from one point to another is a “string” — as well as a trademark. As its commercial arm became the focus of increasing debate, proponents of Zentangle worked harder to distance the activity from mere doodling. “My feeling is that if a person is making art of any sort and it makes them feel good, who cares what it is called or what it looks like?” says Loretta West. “My personal experience is that with the repetitive nature of drawing tangles, that sense of relaxed focus, which brings inner peace, is achieved more quickly when I practice Zentangle than any other art form I’ve tried.” West discovered Zentangle about two years ago through a friend. Her father had recently passed away, and though she was already an artist and art teacher, Zentangle offered a unique combination of therapeutic

solace and creative outlet. In 2012, following a coincidental chain of events she might consider kismet, West made a pilgrimage eastward to complete an intensive training course and become a Certified Zentangle Teacher. With the CZT designation behind her name, West has held roughly one class per month in the Spokane and Coeur d’Alene area since then. On this evening, not counting myself as a participatory observer, she is instructing a class of five female first-time Zentanglers. Although they are more or less in the same late-middle-age demographic, each cites a slightly different reason for attending, whether it’s curiosity, creativity, relaxation, or a hard-to-articulate amalgam thereof. West offers each of us the choice of black or white paper and distributes a corresponding Zentangle-branded pouch that contains similarly branded materials: a pen, a pencil, a soapstone, some tiles. And then, to the swaying soundtrack of Pachelbel’s Canon, she methodically instructs us how to decorate our roughly 4-inch-by-4-inch tile like a New Age Bob Ross. We draw four dots. We connect those dots with strings,

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dividing the tile into quadrants. We draw patterns — with names like “river” or “verve” — in each quadrant. Each step, she emphasizes, is a discretionary command, a mere suggestion at the mercy of our personal whim. As West runs through the sequence, her bracelet tinkling with each stroke, she talks. She relates the history of Zentangle. She explains how drawing can be broken down into five basic symbols, namely, • O C S —. Perhaps referring to widely cited studies in Applied Cognitive Psychology and Science, she also notes the putative scientific advantages of doodling, such as improved memory and better grasp of intricate concepts. In purely anecdotal, unscientific terms, Zentangle’s vague claims are borne out by the end of our nearly two-hour session. The woman who arrived fidgety and high-strung has settled down, immersed in sketching her designs. The woman who said she hoped Zentangle would help reignite her creative spark is tranquilly admiring the patterns she’s created. “When I was first introduced to it, I was a little bit skeptical,” says Candy Thomsen, a former student of West’s, “but it was a very short period of skepticism. I’m a fine artist, and Zentangle opens up my creative blocks because there’s no preconceived notions about what it’s supposed to look like. It’s also a way of meditating without having to sit and close your eyes.” Despite Thomsen’s shared professional background with West, not all dedicated Zentanglers are artists. Retired excavator Larry Cook admits that he’s “always been a doodler” but, given his former career, says he’s naturally “partial to rocks.” He began Zentangle in earnest about two years ago after coming across elaborately decorated rocks on Pinterest. Since taking area classes with West, he now delights in applying “hundreds of different patterns” on his preferred medium and employs Zentangle methods in craft projects with his grandchildren. “It’s for everybody,” West says. “There are a number of ways of approaching [Zentangle], but one of them is to have a scaffolding, which is similar to classical drawing. By breaking things down and giving you something to hang the design on, it’s easier to learn.” The apparent complexity of a completed Zentangle belies its simplicity, which makes it “a metaphor for life.” “Zentangle is all about the process, never about the end product,” she says. “Any problem that you have, you can distill it by breaking it down.” n

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