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healthy living in the inland northwest • free

P wer Beat stress, kick bad habits and get healthy | page 15

F e b r u a ry- M a r c h , 2 0 1 3

supplement to the inlander

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collaboration innovation collaboration drives innovative health care

At INHS collaboration drives everything we do. Through innovative health care technology, education and patient care solutions, INHS is reaching out to the region and creating tomorrow’s health care − today. St. Luke’s Rehabilitation Institute Information Resource Management (IRM) Northwest MedStar Northwest TeleHealth health@workTM Community Health Education & Resources (CHER) Center of Occupational Health & Education (COHE) Health Training Network Center of Philanthropy

Health SPOKANE • EASTERN W ASHINGTON • NORTH IDAHO 9 S. Washington St., 4th Floor, Spokane, Wash. 99201 phone: 509-325-0634

editor Anne McGregor

managing editor Jacob H. Fries a r t DIRE C TOR Chris Bovey calendar editor Chey Scott photographer Young Kwak contributors Markus Burns, Cat Carrel, Nicholas Deshais, Lisa Fairbanks-Rossi, Heidi Groover, E.J. Iannelli, Jacob Jones, Peter Mumford, Joe O’Sullivan, Marshall E. Peterson Jr., Stephen Schlange, Baris Simsek, Leah Sottile, Matt Thompson, Daniel Walters, Lisa Waanenen, John R. White production manager Wayne Hunt a d v e r t i s i n g SALES MANAGER Tami Booey director of marketing Kristina Elverum advertising sales Jann Harris, Kristin Wagner, Carolyn Padgham-Walker, Bruce Deming, Emily Walden, Jamie Albertini, Jean Russell Sales coordination Raevyn West, Rebecca Rison, Angela Rendall design and production Tom Stover, Derrick King, Alissia Blackwood DISTRIBUTION MANAGER Trevor Rendall

We improve patient outcomes. We lead health care innovation. We create healthier communities.

business manager Dee Ann Cook credit manager Gail Golden 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. Inland Northwest Health Services (INHS) is a non-profit corporation in Spokane, Washington providing collaboration in health care services on behalf of the community and its member organizations Providence Health Care and Empire Health Foundation.


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Welcome to the New InHealth

Suit up and buy a “believe” t-Shirt at

THE FIGHT STARTS HERE. Anne McGregor is the editor of InHealth. Email her at



Dr. Stiller is a board certified General and Cosmetic Surgeon by the American Board of Surgery and the American Board of Cosmetic Surgery. At Linea Cosmetic Surgery, you can

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ere at InHealth, we’ve been working for the last couple of months on a revamp of the Inland Northwest’s only healthy living magazine. Finally, here it is! For starters, you may notice our logo has a new look. We’re proud to be a part of The Inlander, and we wanted to make that clear. That “IN” you see is shared between InHealth and The Inlander. You’ll also notice our publishing schedule has changed: This February-March issue is our first of 2013, and we’ll continue to have issues every other month. But you can keep up with the latest local health news any time at our InHealth Facebook page. I’m excited about our new section, CHECK-IN, a roundup of health-related news and tips from community experts. We’ve even added a puzzle page! I hope you’ll keep my inbox full of suggestions for this forum. While we always try to offer a good variety of stories, now we’ll publish two longer, more in-depth stories in each issue — one to lead off our LIVING section and one in NEWS. I’d like to send out a special thanks to Inlander Editor Jacob Fries and Art Director Chris Bovey for all the creative energy they’ve put into this project. In the end, journalism is all about connecting people with information — whether it’s news that affects your personal health care decisions, inspires you to try something new, broadens your awareness or just makes you proud to live in the Inland Northwest. And we take that responsibility seriously. To your health!

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CHECK-IN STAY CONNECTED Send letters and story ideas to InHealth Editor Anne McGregor at Join the conversation on the InHealth Facebook page and at


What’s the best health-related advice you’ve ever received? MARY MIMI RORIE: Exercise daily. FENDER BENDER: Be good to your body. You’ll miss it when it’s gone.



Healing Place

ROBERT SHUGERT: Don’t ever, ever, ever make toast in the bathtub. KAT PANZA: “Perimeter shopping”: Most of the healthier stuff in the grocery store (fruit, veggies, dairy, etc.) is located around the edges of the store. Only go into the canned/processed/junk food laden middle aisles for specific items. STEVE JAMES: Exercise is a “Life Savings Account”; deposits today ensure a healthy retirement! ASHLEY LOOMIS: Start NOW, you’ll wish you had. DAVID OAKES: Hydrate… Daily water even when not thirsty! JESSICA ULLMAN: Eat colorful food. AMY COWIN: Eliminating processed foods and grains. KEN HARVEST: 9 out of 10 people know their own bodies better than their doctor. KIMBERLY MARIE LAWRENCE: If your great-grandmother wouldn’t recognize it as food, it probably isn’t. VANESSA D HAYDEN: Do something everyday that your future self will thank you for. 


etting in touch with the unique needs of cancer patients guided the design of CANCER CARE NORTHWEST’s $15 million facility that’s now under construction in Spokane Valley. “We thought of putting our building out on the main thoroughfare, but then we asked why?” says CEO Warren Benincosa. “People won’t be driving by and see our sign and think to themselves, ‘Oh yes, I have been meaning to stop in there for a visit.’” Instead, he says, “Our business is mostly referral-based, and we want our patients to see something different when they turn into our driveway. The building is on the back of our lot, and there will be a nice, peaceful passageway up to our very ‘noninstitutional’ looking building with gardens and water features.” And the building, housing 40 employees, including a team of seven physicians, will offer convenience via a more integrated approach to treatment. Medical, surgical and radiation oncology services will all be available under one roof. “That same patient who came in one day to see their medical oncologist would not have left the building without seeing their whole team of integrated specialists,” says Benincosa. “[They will] all work in concert to render the best services in the optimum way to get the best results and outcomes. The project, designed by Spokane’s Blue Room Architecture and Design, is expected to open in October. — ANNE McGREGOR


Ladies In Red


eart disease is the No. 1 killer of women, and the AMERICAN HEART ASSOCIATION wants that to stop. The organization is sharing its message of prevention through outreach events like its Go Red for Women Luncheon, which has been educating Inland Northwest women and their families on heart health for a decade now. During this year’s event, attendees will learn how to combat stress through laughter during a presentation from motivational speaker Kay Frances, and also hear survivor stories from several local women. Attendees can also choose to participate in two of four brief educational workshops being offered. “Go Red was created to create awareness for women’s heart health because 9.1 million women die of heart disease each year,” says Heidi Hershly, the American Heart Association’s Inland Northwest chapter director. “That is more deaths than all forms of cancer, malaria, HIV/AIDS and tuberculosis combined.” — CHEY SCOTT Wednesday, Feb. 6, 9:30 am-2 pm • $125 • Spokane Convention Center • 334 W. Spokane Falls Blvd. • • 536-1500 FEBRUARY-MARCH, 2013

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Food For Thought

Percentage of women who died suddenly of chronic heart disease with no previous symptoms, according to the American Heart Association.


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

Percentage of adults in Spokane who identify illegal drug use as a problem in their neighborhood, according to the Spokane County Health District’s 2012 Health Iniquities Report

Why do you take some medications with food? Do you have to eat a whole meal? Often food is recommended because taking the medication on an empty stomach can cause a significant amount of gastrointestinal pain or distress. If your prescription label tells you to take the medication with food, then you can usually take that particular medication with a portion or two of your food of choice. In some cases, as with the drug metformin, which is often prescribed for diabetes, you may need to take the medication with a larger meal. In addition, with some medications, you may be asked to avoid particular types of food. Food and some fruit juices, usually grapefruit juice, may significantly increase or reduce the effectiveness of a medication. One example of a bad interaction occurs when the drug buspirone is taken with grapefruit juice. This drug is normally taken for anxiety and is generally very well tolerated. However, a person who decides to take the medication with grapefruit juice could run into significant problems. Taking one tablet of buspirone with grapefruit juice (or even a few hours after drinking juice) can result in an effect similar to taking eight tablets. The person may become drowsy, nauseous and feel very ill. The bottom line? Always read your medication label, talk to your pharmacist and pay attention to warnings about food and juices. — JOHN R. WHITE


Driving Dilemmas


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

s dusk fell, snow began to flock the trees and street outside our home. My 16-year-old son stood crestfallen upon hearing my response to his request to drive over the hills and through the woods to his girlfriend’s house. My newly minted driver quickly recovered his willful teenage countenance, asking, “Can I see the data to support your position?” I was ready. Car crashes are the No. 1 cause of death for 16- to 19-year-olds in the U.S. The risk of death in a car will never be higher than during these years — and the absolute highest risk period is the month after a kid gets his or her license. Teens overestimate their skills, they follow too closely,

they travel too fast, they are prone to impulsive decisions. Risk rises for teens when they are driving in the dark, in winter conditions, with deer jumping about, while they’re messing with a phone or radio, and especially when there are one or more other teens in the car. Risk rises hugely if alcohol is involved. There’s some good news: All those white-knuckle experiences with your student driver do pay off, as risk is lower for teen drivers who have had more practice. A number of states have enacted graduated driving programs that reflect this evidence, regulating when teen drivers can be behind the wheel and who can be in the vehicle with them. And the results, so far, are encouraging. Experience is what any new driver needs most — best gotten alone, in the daytime, well rested and alert, on familiar streets with a known destination. — DR. MATT THOMPSON

Stay Connected, Wherever You Are Follow the Inlander on Pinterest, Twitter, YouTube and Facebook for exclusive content, contests and more!

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Elaine Couture


You started out as a nurse. What part of your patient care experience do you bring to this job? What’s important for me is I never forget what it was like to be at the bedside. I saw so many different people’s eyes. It gets into your soul — the pain and the suffering that people go through, how frightened they become. We’re used to hearing bad news about health care — money woes, doctor shortages and not enough bang for our buck. What makes you excited about your new post? The transformation of health care, I think, is absolutely exciting. We’re going to provide care closest to home, giving people high quality with great satisfaction and at the lowest possible cost, by looking at different venues where care can be provided. Our IT is going to be absolutely instrumental in that. It’s going to transform the way people interact with their providers. And with all [Providence] hospitals being on the same IT platform, we’re going to have one of the largest research databases available. What’s the best piece of health advice you’ve gotten? To always make sure I’m taking care of myself. You can’t change your gender, you can’t change your family genetics, but those things that you can control are the things you have to do. I think that in America we got away from understanding the impact of wellness and prevention in terms of our overall health. We’re swinging back into that now, and there’s a lot of discussion about people taking personal accountability for that. Nobody can force you to eat your fruits and vegetables, to exercise and all those kinds of things. Only you can take accountability for that. — INTERVIEW BY ANNE McGREGOR


Up in the Attic


ave you ever wished you could solve life’s problems the way Sherlock Holmes solves mysteries? That’s the premise of Maria Konnikova’s new book, MASTERMIND: HOW TO THINK LIKE SHERLOCK HOLMES. The Russian-born Konnikova writes the “Literally Psyched” column for Scientific American magazine while she pursues her PhD in psychology at Columbia. She’s also a big Sherlock Holmes fan — especially the recent BBC series.

“I consider that a man’s brain originally is like a little empty attic,” Holmes’ creator Sir Arthur Conan Doyle has him say in A Study in Scarlet. “And you have to stock it with such furniture as you choose.” Weaving in a lot of Holmes’ adventures along the way, Konnikova takes that attic idea, adds in a review of modern research on human memory, and offers up a “method of mindful interaction with the world.” You can sharpen your brain if you just do what old Sherlock did, Konnikova says. “We have to move from passive absorption to active awareness. We have to engage … not just sight, but each sense, each input, each thought.” — TED S. McGREGOR JR.

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Your Inner Voice



All Hail Kale ATTRIBUTES: Kale is high in fiber, calcium, iron and vitamins A, K and C. It also contains numerous carotenoids. SUPER POWERS: It has the broadest range of antioxidants in the health-enhancing cabbage family. It has been found to fight inflammation, promote heart health and aid in regularity. Kale may also reduce the risk of breast and colon cancers. WEAKNESSES: Vitamin K promotes clotting and might be a problem if you are on blood thinners. Raw kale is difficult to digest and may affect thyroid function in some people; cooked kale, however, does not present the same problem. HOW TO USE IT: Cook it in with your soup or pasta sauce, or use it raw in a salad. Try kale chips by tossing washed and thoroughly dried leaves with olive oil and a little salt, then roasting them at 300 degrees for 20 minutes. — ANNE McGREGOR

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ver wake up with a negative notion fluttering in your brain? Merely thinking “I’m a failure at…” or “I don’t have time to do that today!” can sabotage your ability to achieve your goals. Our thoughts are directly related to how we feel, and how we feel is directly related to what action we take. If I think to myself, “I’m a failure at healthy eating,” that thought is, of course, going to make me feel bad. And by feeling bad, I am not inspired to do anything that might change my mind about my perception that I’m a failure. Which reinforces the original thought. It’s a negative cycle that keeps playing itself out in our minds. The idea that “I don’t have enough time!” makes us feel anxious, which in turn makes us unproductive. And voila! Thoughts have managed to manifest themselves into reality. Instead, say to yourself, “I have plenty of time to do everything I want to do today.” That thought alone may give you peace, which allows you to calmly prioritize and be productive. Thoughts — positive or negative — turn into feelings that affect actions. It may seem like a simple concept, but it’s one that can have great consequence. What thoughts could you change to help you feel better? — CAT CARREL Cat Carrel is a certified professional life coach (CPC) in Spokane.

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7 1 5


6 8 2 3 4



4 9 5


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


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


6 3 7 4 9


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 19. 20

21 7



9 16

25 23




15 16


















17 13











25 25


15 2










25 6






26 11














































15 25








20 20


14 20


15 21






20 5


25 26





25 4






5 6

Codewords 19





2 1 7 5

RATINGS: Gentle (left), Tough (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 45




RATING: Gentle 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.




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Health 13 1/24/13 8:04 AM

Deb Smith, ARNP, and her Portugese water dog, Pip

Get into the swim of fitness and transform your life Want to ring in the New Year by shaping a new you? Deb Smith, a

than cons, Smith offers these advantages: People who exercise

senior lecturer in Gonzaga University’s Department of Nursing, says

have more energy, are less stressed, feel more comfortable in

the first step in your personal fitness quest should be stacking the

their own bodies and generally enjoy a better mood and have

deck for success.

a more positive outlook on life. Next, identify an activity that

A nurse practitioner and researcher, Smith recently co-authored a

you would enjoy on a regular basis. She likes to swim, but

study of exercise and attitudes about exercise among people who

says jogging, dancing, bicycling or even just walking can be

are overweight or obese. What she found is that people can truly

equally beneficial. “Do something you really enjoy,” Smith says.

transform their lives with a commitment to physical activity. Not only

“Understand that small steps are meaningful. Don’t minimize your

will your heart, lungs and immune system benefit, but exercise will

accomplishments. And resist the urge to push too hard too fast,

even improve your emotional well-being and sharpen your creative-

which is a recipe for injury.” Finally, commit to sticking with your

thinking ability. “I can’t think of a system in the body that is not

new workout regimen for at least three weeks. “If you hang in

improved by regular exercise,” Smith says.

there for 21 days, I promise you will start to see the benefits,”

Get started by making a list of the advantages and disadvantages of

Smith says. “You will feel better and feel better about yourself.

exercise. In the interest of helping you stack the deck with more pros

Everything improves with exercise. ”

To learn more about the benefits of excercise, check out Deb Smith’s report on her research at

Join the celebration

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Kathy Jo Avery (left) with a patient at her Heartfelt Hypnosis clinic. Avery works with people struggling with anxiety, depression and panic attacks. marshall e. peterson jr. PHOTO in-depth

Retraining Your Brain By using hypnosis, people are coping with overeating, PTSD and the pain of childbirth By heidi groover


hen she describes giving birth to her son, Xylina Weaver uses a word you may not be used to hearing associated with childbirth: “easy.” “I had maybe a total of five minutes of discomfort during the whole experience,” she says now. In a photo from that day, she looks

calm, submerged in a birth pool closing her eyes behind thin rectangular glasses, with her husband by her side. Weaver credits the stark contrast between that birth and the screaming and thrashing you see on TV to a cocktail of breathing techniques, visualization, affirmation and relaxation she learned from a curriculum called “HypnoBirthing.”

But for most, the idea of hypnosis almost immediately conjures images of carnivals or sideshows. Black-and-white spirals spin and spin, or a sharply dressed man sways a time piece, telling people they’re “getting very sleepy,” then convincing them to embarrass themselves in front of an ...continued on next page February-March, 2013

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Hypnobirthing instructor Xylina Weaver leads a recent class, as mom-to-be April Egly finds a relaxed state. YOUNG KWAK PHOTOS

“RETRAINING YOUR BRAIN,” CONTINUED… enthralled crowd. Hypnosis professionals have long contended there’s verifiable science behind the practice, which essentially involves inducing a state of relaxation that allows someone to access a deeper, subconscious part of the mind. The practice as we know

it dates back to the mid 1800s, but some research suggests it harkens back to ancient religious techniques. Today, it’s accepted by the American Psychological Association. “Although hypnosis has been controversial, most clinicians now agree it can be a powerful, effective therapeutic technique

“ Top 5% in

for a wide range of conditions, including pain, anxiety and mood disorders,” states the APA. “Hypnosis can also help people change habits, such as quitting smoking.” Its history with the American Medical Association is shakier though. After being approved for medical purposes in the

the nation”

emergency medicine 2 years in a row.


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1950s, the Association rescinded its support of hypnosis in the ’80s. Since then, clinical hypnosis groups have warned their members against falsely citing AMA support of hypnosis for any purpose. Still, hypnosis is being used in various ways across the country and in our region, from childbirth to treatment of addiction and stress disorders.


ioneered in the 1980s as a rebirth of ancient ideas about natural birth, HypnoBirthing teaches women techniques for reaching deep relaxation during labor. The philosophy centers on the idea that if a woman is anxious or tense during labor, stress hormones will flood her body and her energy will be used up in her extremities (like by clenching a bed rail). Techniques to stay calm can keep energy flowing to the uterus instead. HypnoBirthing teaches women to conjure and repeat positive visions about birth, so that the goal to have an easy birth will sink deep into a woman’s mind and be with her when she’s actually in labor. Women listen to a relaxation CD repeatedly before the birth — when they’re relaxing around the house or falling asleep. They practice deep breathing and relaxation techniques, which are mostly ways to clear their minds of worry and distraction. After having her second child with the help of HypnoBirthing, Weaver says she couldn’t help sharing the experience with other soon-to-be moms. She acknowledges she can’t promise every woman a painless birth, but she gives them “a series of tools and skills” to take with them when the time comes. “We teach women in my classes to reduce stress by building confidence and decreasing fears,” she says. “We’re retraining the brain to believe in the body’s natural ability to give birth.”


ou’re going down a descending staircase,” Washington State University professor Arreed Barabasz tells his patient. There’s a stone structure, “like in a James Bond film,” he says. There are waterfalls and ferns, and there are three doors. The patient opens one door and makes her way down a hallway to a safe room. There, she’s 6 years old again and her brother’s in the room, the brother who abused her when she was that age. The trauma has given the woman post-traumatic stress disorder and she’s with Barabasz to see if, through hypnosis, she can revisit the memory of the trauma and reframe the way she thinks about it.

Barabasz wants to know too because he believes this is the future of treating PTSD for civilians and combat veterans alike. As the woman revisits the image of the perpetrator standing over her, Barabasz assumes the role of perpetrator and his female assistant becomes a supportive therapist. She tells the patient to “tell him off,” but the patient fears she’s too small and he’ll hurt her. The supporter promises she won’t let him and keeps up the encouragement. This is repeated over and over until the patient begins to shift her feelings. Soon, she’s empowered to tell the perpetrator he can’t hurt her, and to realize she’s not at fault for the trauma she’s endured. They repeat the process, again and again. Scenarios like this are how Barabasz arrived at his most recent breakthrough in hypnosis research. A group of patients suffering from post-traumatic stress disorder was divided into two groups. Half of them received up to six-hour-long hypnosis sessions, while the other half did not receive the treatment. Barabasz found that while all the patients showed lessened symptoms of PTSD, the improvements only persisted for those who actually received the hypnosis.

“Hypnosis can give you the motivation to exercise. Can we make you go exercise? Absolutely not.” Today, a year after the experiment, 70 percent of those who were treated with hypnosis have maintained lessened PTSD symptoms. “Anything above 50 percent is remarkable,” he says. “It’s pretty neat to be able to achieve this.” Barabasz has spent more than 40 years studying hypnosis and is the editor-in-chief of the International Journal of Clinical and Experimental Hypnosis. He’s published books and manuals on hypnosis techniques, and today, along with his research, he teaches graduate courses at WSU in ethics, advanced psychotherapy and hypnosis. With the latest findings, Barabasz hopes to train military psychologists to administer this type of therapy to combat veterans suffering PTSD, work that may eventually ...continued on next page

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news “retraining your brain,” continued… evolve into treating soldiers much sooner — on the battlefield. A key cornerstone of hypnosis in therapy is identifying ego states, which are various parts of the human personality that don’t always act in concert. They’re not mappable parts of the brain, but metaphors for the way the mind works. Ego states can be as simple as the differences between your personality at work and at a party, Barabasz explains. One may be more friendly or outgoing than the other, and they take turns dominating your personality, depending on your surroundings. “Every normal person has ego states,” he says. “Normal people have different parts of themselves and they’re aware of those parts.” When he hypnotizes PTSD patients in order to help manage the thoughts associated with their trauma, Barabasz is looking to access the ego state they were in when the trauma occurred (like the fearful, 6-year-old state of the woman who had been abused). Before beginning, patients map their ego states to give Barabasz a sense of which states they’re aware of, but, he says, during hypnosis they may access states they never knew existed. “Communication among ego states helps to resolve the trauma through the collective interactions of all the states working toward mutually agreed-upon goals,” Barabasz writes in a paper on the recent PTSD research for publication in the International Journal of Clinical and Experimental Hypnosis. “For example, a fearful ego state learns it can depend on other ego states for courage and support.” The breakthrough for PTSD patients undergoing hypnosis is called the “moment of abreaction” — the point when the ego state that is harboring the trauma realizes that it “no longer needs to be fearful, guilty or a victim,” Barabasz writes. “This is the basis for personality reconstruction.” Barabasz argues this therapy is not only more effective for treating PTSD, but it makes more financial sense, too. For example, while the hypnosis treatment required just six hours, traditional PTSD counseling can often require months — or even years — of weekly meetings where patients talk about their trauma, but ultimately aren’t able to make any changes to how it lives in their mind. Cost-savings were also demonstrated in a 2000 study by Harvard Medical School radiologists, who found that patients receiving hypnosis during surgery required less

navigating the inner self Kathy Jo Avery, owner of Heartfelt Hypnosis, uses this diagram with patients to explain how hypnotherapy can help change behaviors by accessing the inner parts of the mind. Behaviors are often the result of deeper thoughts or feelings. Changing a negative behavior can require changing deeper thoughts and feelings a patient might not even be aware of. LISA WANNENEN GRAPHIC

medication and had fewer complications. The researchers concluded that hypnosis could save $338 per patient. And with the sustained, long-term results in the area of PTSD treatment, Barabasz thinks he and others can convince those in doubt of hypnosis’ effectiveness. “Evidence-based [research] is what we need,” he says, “Evidence-based is what we have [in this study].”

Avery began training to use hypnosis after she was in a late-night accident where a drunk driver slammed into her car. She had been enrolled in a master’s nursing program at Gonzaga University, but the injuries set her behind in her work. She went to counseling to work through the disappointment, and found that hypnosis was a more effective method for her than traditional therapy centered on talking. That, she believes, is because hypnosis accessed a

“Every normal person has ego states. Normal people have different parts of themselves, and they’re aware of those parts.”


athy Jo Avery spent 17 years as a nurse and still works the occasional shift in Sacred Heart’s emergency room, but today she practices therapy that she says some of her former co-workers view as less than mainstream. Avery owns Heartfelt Hypnosis, a local practice where she works with people struggling with ailments ranging from anxiety, depression and panic attacks to addiction or uncontrollable anger.

deeper part of her mind that has more connection to her feelings and behaviors. To help new patients understand this, Avery starts by telling them about their two minds — “the conscious and the unconscious.” The conscious, she says, is judgmental; it’s worried about black-and-white reasoning, about economics and to-do lists. The unconscious mind is emotional and holds memories. Through hypnosis, Avery says, she can get beyond the mind’s

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the BEST

who has tendency toward judgment. A negative behavior — like overeating — may be a result of a negative thought or feeling deeper within, something a person may not even be aware of — like loneliness or inadequacy — so the habit can’t truly be dealt with until its root is altered. “It’s not as simple as hypnotizing someone and saying, ‘You don’t like potato chips,’” Avery says. “It’s more like helping them understand the meanings they’ve applied to things.”

ing,” Oliver notes. “People have a fear that you’re going to get in my brain and make me do things I don’t want to do. Hypnosis can’t make you do things you don’t want to do.” In fact, he says, it usually won’t work for people who might be trying to lose pho florist weight to please a spouse, or quit smoking jewelry mall happy hour ster roa ee coff because a doctor told them to. karaoke artist Oliver says the company is committed to helping people make healthy changes,local celebrity natural foods festival including moderate weight loss that is susDJ tainable. “If you need to lose 200 pounds, charity mexican it is not healthy to do that in a year. We can rs burge hile it may ultimately be imporgive them the tools so that at some point, clothing tant to find peace and meaning they will become the weight they want tattoos barista thai with what’s happened in your to be. Everything we do, especially with past, at Spokane’s Positive Changes, the weight loss, is about doing it in a healthy casino pho happy hour concern is your future behavior. fashion.” “People who have PhDs and doctorates florist barber n a recent snowy night, in an old in counseling have learned to use hypnosis gifts radio station yellow Victorian house on the in their work as a therapist,”says Kevin lower South Hill, Weaver shows Oliver, vice president of marketing for the fast food the five couples in her class a photo of a Spokane location of the nationwide comlocal hero rk developed baby inside a womb, then of an pany. “That’s great. They want to get into pa g do vote to nce cha r you is w No opening blossom. She tells them to find the the why. We are not counselors. We are not r nd Northwest he r Inla you image that resonates best with them and photogr therapists. We do not do therapy. We do forap hang it up where they’ll see it often. She hypnosis that moves the client forward in a favorites! Hundreds of dims the lights and plays a DVD on her program.” The focus is on modifying your businesses and individuals laptop. The dated video — “videotaping actions and habits because the organization isn’t allowed so much in hospitals anycontends that, “Almost all unwanted behavwill be awarded the more,” Weaver explains ior is treatable,” says Oliver. best of the best - tell us to the class — shows Specific programs have who they should be! a woman with a large been developed for a number from the puzzle on page 13 round belly smiling as of issues including nail biting, she watches TV and eats anxiety, smoking cessation and 15 = N; 25 = I Jell-O in a hospital bed. pain relief. Programs for more Soon she starts breathesoteric things like sports pering more deeply, and within moments a formance, sales and “success motivation” rubber-gloved doctor is cleaning off her are also available. tiny, wiggling newborn. But losing weight is the focus of most of the Inland Northwest “It’s like she’s sedated,” one of the soonthe company’s advertising. Oliver says the to-be moms whispers. weight-loss approach at Positive Changes is Weaver smiles and says, “Well, she kind based on helping clients “learn to eat like a of is because of all the endorphins.” naturally thin person.” Soon, she shows the class how to relax That means specific fat-inducing beinto a deep state, clearing their minds of haviors are identified — from drinking too distractions. The five very pregnant women much pop and not wanting to exercise, to — and the men by their sides — will spend never venturing into the produce section of most of the weeks between now and labor a supermarket — and targeted for change reaffirming to themselves that their births through subconscious suggestions placed will be positive, not negative experiences. by the company’s hypnotists. Weaver is careful to remind them that it’s “What if you liked drinking water unlikely they’ll have totally painless births, as your favorite drink? Would that be but that their bodies are capable of giving something you would be willing to work birth. on?” says Oliver. “Maybe you think, ‘I “Just like any athlete who is successhate to exercise.’ Hypnosis can give you the ful visualizes having the perfect game, I motivation to exercise. Can we make you encourage moms to envision what [they] go exercise? Absolutely not.” want,” Weaver says. “Once your brain sees That’s because hypnotic suggestion it over and over it’s much easier for that to only allows you to do something you happen.” n already desire to do. “It’s not brainwash-

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news stroke

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very second counts for someone experiencing stroke symptoms. Stroke — a loss of blood supply to the brain — is the nation’s fourth leading cause of death, according to the Centers for Disease Control, and requires immediate medical attention. The good news for Inland Northwest residents, though, is that another major Spokane hospital has joined the region’s lineup of Primary Stroke Centers. Being recognized as a Primary Stroke Center by the Joint Commission, which accredits health care providers throughout the country, means Deaconess Hospital’s procedures for treating stroke patients are aligned with the latest and most effective treatment standards, says Jon Ween, a neurologist and the medical director of the hospital’s stroke program. Deaconess received Primary Stroke Center Certification late last summer, joining Providence Sacred Heart Medical Center and Providence Holy Family Hospital. “If you come to a Primary Stroke Center, you know you will get expert evaluation, tests, treatments, nursing care and everyone on staff has been specifically educated to do those things according to guidelines,” says Ween. “Even more so, the guidelines are continually evolving and we are continually educating ourselves about stroke.” A key step is efficient and accurate diagnosis of the possible stroke. “We do an MRI if we can because it’s very sensitive in showing early changes after stroke. We nail down what and where and the likely cause … imaging the blood vessels in detail right off the bat,” Ween says. In becoming certified as a Primary Stroke Center, Deaconess was also evaluated for its stroke rehabilitation protocol. “The recovery outcome is always better the quicker you get going with the rehab, and we spend time getting patients up and in chairs and doing physical, speech and occupational therapy as soon as possible,” Ween says. And, he adds, “We try very hard to help them understand what caused it so they can try to prevent another stroke.” While Deaconess’ sister hospital, Valley Hospital, hasn’t applied for or received Primary Stroke Center Certification, Ween says the two facilities’ medical teams have collaborated to ensure stroke patients are getting the

Neurologist John Ween: “We are continually educating ourselves.” MARSHALL E. PETERSON JR. PHOTO same level of urgent care. After the initial diagnosis and treatment is administered to stroke patients at Valley Hospital, they’re transferred to Deaconess’ stroke center for continued care and therapy. Rather than worrying about getting to a medical facility that’s received Primary Stroke Center Certification, Ween says to call 911 if you are, or think you might be, experiencing a stroke. Symptoms to be aware of are sudden and severe headache, confusion, numbness, abrupt changes in physical coordination or sensations like hearing, taste and touch. “Don’t try to sleep it off. Don’t call a family member to drive you to the doctor’s office. Getting to a hospital is the most important thing,” says Ween. n

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A preview of one of Holy Family’s spacious new suites. NAC ARCHITECTURE RENDERING

Labor Underway Holy Family is expanding its birthing wing BY CHEY SCOTT


ork began early this year to overhaul Providence Holy Family Hospital’s family maternity center as part of a nearly $10 million remodel that’s

been three years in the making. As part of the project, Holy Family’s labor, delivery, recovery and postpartum suites — which allow new mothers to receive all

necessary care in just one room — will be expanded, says Providence Women’s Services Director Susan Stacey. “The rooms that exist are just about half the size of what is now considered to be an appropriately sized labor and delivery room,” Stacey says. “We will be rebuilding them to be large enough to accommodate families and all equipment. It will be state-of-the-art — and more home-like and comfortable.” New features to be included in each of the 16 maternity suites include a bed for the mother’s spouse or partner, two computer stations for nurses and physicians and a large soaking tub in the bathroom. The remodel and expansion will increase Holy Family’s special care nursery beds — used to care for babies who need special monitoring or additional treatment — from three to five, and Stacey says the maternity center will also gain five new triage rooms for pregnant women who aren’t yet in labor but need immediate medical care. Labor and delivery wait for no one, so the remodel is being done in two phases to allow patients to continue to get care while work is underway. Stacey says the first phase should wrap up in July, while the second phase should be finished by February 2014. 

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Manuel Herrera arrived in Washington illegally 30 years ago; now he is a citizen. Finding health care is tough for illegals — many of whom work in agriculture. PETER MUMFORD PHOTO immigration

Reaching Out How do undocumented workers receive health care in Washington? By joe O’Sullivan


n the shifting goalposts of United States law since World War II, Hispanic immigrants have gone from being legal seasonal laborers to undocumented laborers considered illegal, and finally to being considered a threat to national security worthy of deportation. While many immigrants in the region fill a need — picking apples and cherries and other fruits in Washington’s orchards — they also present a public policy problem. Medical oaths and government mandates to provide health care to everyone are complicated by the country’s hodgepodge immigration policy that makes the presence of many immigrants illegal. Immigrants without papers are generally not eligible for government health care, including under the recent health care reform. And although it may be possible for them to buy health coverage, the jobs

undocumented immigrants take rarely lend themselves to the paychecks necessary to buy private insurance. Nonetheless, hospitals are required by federal law to provide emergency care for people in need. Cassie Sauer, spokeswoman for the Washington State Hospital Association, says that’s a good thing, because a community is healthier when everyone has access to health care. “We believe it is in all our best interests [for undocumented immigrants to] get care,” Sauer says. But who picks up the tab? A few programs created by the Washington Legislature work to provide government funding to pay hospitals for such care. One is the Alien Emergency Medical Program, which allows hospitals to be reimbursed when an undocumented immigrant

enters an emergency room for life-, limb- or organ-threatening problems. “The clinician has to establish that indeed it was an emergency,” says Gail Kreiger, section chief of Health Care Benefits and Utilization Management for the state’s Health Care Authority (HCA). The eligibilities only last for the period of time when the immigrant was in the hospital, Kreiger adds. Immigrants must apply after such an emergency to have their issues considered under the program. But Kreiger says hospitals have an incentive to help with this. “Hospitals can facilitate it, because they of course want to be paid,” she says. While the numbers are still being tallied, about $44 million in state money is estimated to have been spent on undocumented immigrants in 2012 through this program. The program also allows immigrants to get cancer care or dialysis that has been predefined by a doctor. In those cases, according to Kreiger, the coverage period starts the day you enter dialysis or cancer treatment (surgery, chemotherapy or radiation), ends at your last session and covers strictly those procedures. In 2010, about 270 undocumented immigrants around the state received this sort of care, according to the HCA.

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A second program, the Children’s Health Program, covers minors and currently has about 20,500 kids enrolled, according to Jim Stevenson, communications director for the HCA. In fiscal year 2013, it will cost the state approximately $26.4 million. “Children are our healthiest caseload and much of that care translates as preventive, which should avoid longer-term expensive care,” Stevenson says. A third program deals with the discrepancy between an undocumented immigrant mother and her child being born on American soil. That makes the infant a U.S. citizen and, by that logic, Washington state provides prenatal care to pregnant women. That program has an enrollment of 23,155 people and in 2013 cost around $90.5 million, according to Stevenson.


auer, the WSHA spokeswoman, says she can’t quantify how much so-called charity care results from undocumented immigrants. But with the passage of the Affordable Care Act, Sauer says undocumented immigrants will become the biggest bloc of people without access to health care. Stevenson, communications director of the state Health Care Authority, points out that the amount spent on medical coverage in Washington is far larger than the bills racked up by immigrants without papers. The three programs — emergency care, children’s health insurance and prenatal care for mothers-to-be — fold into a budget that Stevenson says approaches $5 billion each year on medical assistance and Medicaid. So the three that offer help for undocumented immigrants represent about 3.2 percent of that segment of health care spending. But if you add the Medicaid money that goes for long-term care disability and behavioral health care (about $3.2 billion) and the approximately $2 billion spent on purchasing health care for Washington state employees, government spending on undocumented immigrants is closer to 1.5 percent. When it comes to public services, undocumented immigrants actually do pay into some systems, systems from which they will never benefit. Every worker who gets a job with a false Social Security number (a common way for undocumented immigrants to get jobs) winds up paying into Medicare and Social Security, programs that he or she won’t ever be able to use. In that sense, immigrants help subsidize entitlement programs for citizens. Those numbers aren’t small, either. Just in 2010, it’s thought that as much as $2 billion for Medicare and as much as $8.7 billion for Social Security came from undocumented immigrants, according to a study published by 

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Doug Crafton (left) and his Medication Review team helps patients in rural areas keep their meds in order. sigma photo Technology

Pharmacists for the Farm Thanks to emerging technologies, pills are being delivered to rural areas more efficiently By Daniel Walters


emember young George Bailey, in It’s a Wonderful Life, saving Mr. Gower, the druggist, from accidentally poisoning a young child? Today, it’s a different world. With health care transformation under way, thanks to new technology and electronic medical records, the pharmacy and pharmacist are changing as well. At the Spokane offices of Medication Review Inc., CEO Doug Crafton presides over one of the most dramatic changes. Since 2009, Medication Review has been a leader in longdistance telepharmacy in the region. Plenty of rural hospitals are peppered throughout Eastern Washington, in Quincy, in Prosser, Sandpoint and Klickitat. State and federal

law requires pharmacists to carefully dispense the more dangerous drugs often found in hospitals. Yet for years, Crafton says, these laws were ignored by rural hospitals because they couldn’t afford to have professional pharmacists manning their internal pharmacies 24 hours a day. “They weren’t reviewed by a pharmacist,” Crafton says. “The nurse would walk into the pharmacy, grab the med and give it to the patient.” The board mostly looked the other way. Now, with Medication Review, there’s a simple solution. A doctor at a community hospital writes a prescription order, scans it into his computer and sends it to Medication

Review, where the company’s pharmacists double-check it for safety. They examine the dosage, look at the patient’s medical history and the drug’s potential side-effects as well as its interaction with other drugs. Once the medication is approved, a signal goes out to an automatic dispensing machine at the hospital. “They look like a big chest of drawers, with miniature cubicles inside each drawer,” Crafton says. A nurse can then retrieve the medication. The next step in providing medication is to make sure the right patient gets the right drug in the right way — by pill or IV — at the right time. St. Luke’s Rehabilitation Institute, in Spokane, was one of the first rehab hospitals

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in the nation to implement a bar code-reading system to reduce medical errors. “We attach a unique identifier to each medicine,” says St. Luke’s Pharmacy Manager Chris Greer. Each patient’s wristband also sports a unique bar code, and by scanning the med and the patient, “you can avoid people taking the wrong doses,” Greer says. The hope is that all this technology will make taking your medicine safer. Software now flags dangerous drug interactions and offers alerts when it appears an improper dose has been prescribed; machines can fill prescriptions and place labels on bottles, even when the pharmacy is closed for the night. And smart caps can signal patients when it’s time for a dose. So what’s left for the pharmacist? With technicians and technology taking over some of the tedious work of filling and delivering prescriptions, and integration of electronic medical records becoming standard, their role is shifting. More and more, pharmacists will be working closely with front-line care providers. After all, earning a pharmacy doctorate requires a rigorous and highly specialized postgraduate education. That’s a lot of expertise that could be put to use. At Group Health Cooperative in Spokane,

One of Medication Review’s secure, automatic dispensing machines. sigma photo the shift is already under way. “Group Health is an integrated care delivery model,” says Mike Norwood, associate director of Pharmacy Operations. “We actually have

pharmacists that are members of the care team.” A Group Health pharmacist might be assigned to two or three doctors, and interacts much more with the patients than the typical model, where a pharmacist answers any questions you might have when you pick up a prescription. In the Group Health system, pharmacists consult with patients as well as other members of the health care team in the same way a dietician or physical therapist might. “So you come in one day for your annual checkup with your doctor. Your doctor ran your usual labs, and says, ‘Oh, your blood sugar’s up a little bit,’” Norwood says, “‘you’re in the early stages of diabetes.’ Then the doctor says, ‘Here’s my plan for you. We need to do some lifestyle changes. And we need to start you on a medication. And we’re going to have you meet with the pharmacist.’” Ultimately, allowing pharmacists to take a more direct role in selecting medications, Norwood says, could not only relieve overburdened physicians, but also result in better drug choices, helping patients get healthier, faster. “It’s kind of the concept of building a medical system where everyone is working at the top of their skills,” says Norwood. n

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Kerrianne Thronson of the Bar Method Spokane

t’s not easy staying fit in this world. Everyone knows the benefits — looking good, being healthy, having more energy — but everyone also knows the excuses. You’re way too busy, way too tired. You’ll start a new plan next week. Really, you mean it this time. About half the people who embark on a fitness plan will drop out within six months, says Sarah Ullrich-French, an assistant professor at Washington State University who studies exercise psychology and motivation theory. “Instead of making a lifestyle change,” she says, “they’re trying to do one thing.” The good news is that making a fitness plan and sticking with it isn’t impossible — we’re just not doing it right. We asked local trainers and experts about how to set yourself up for fitness success. ...continued on next page

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Trainer Ted Schuh instructs Jessica Hoffmeister at Giorgio’s Fitness in Spokane Valley.

“6 ways to get fit,” continued...



With a whole range of classes, gym memberships and trendy programs out there, it can be hard to know where to begin. And despite what the infomercials may promise, there is no one magic program. “We’re all different, so you can’t just say that this is good for everybody,” says Giorgio Usai Sr., the owner of Giorgio’s Fitness in Spokane Valley. Lots of people show up at the beginning of January and hop on a treadmill thinking all their problems will be solved, he says. But there’s a reason working with a trainer can help you make progress more quickly. It’s just like learning a new language or a new instrument, he says. “If you want to learn how to play the

guitar, you buy the guitar first and maybe you play with it a little,” he says. “But then you have to get a coach or a teacher, or take lessons.” Jeff Campbell, a certified personal trainer, says his clients always start with a screening to assess the person’s current fitness level. “A lot of times that’s a real eye-opener for people,” he says. Clients who feel a little out of shape may be surprised to weigh in at almost 300 pounds. Facing that reality motivates them to work out more often than the once-aweek sessions they’d been planning. It’s important to be honest with yourself about where you’re starting from, says Shawn Brow of South Perry Yoga. It’s easy to get discouraged — or injured — if you leap into a program you’re not ready for.

“You need to be really realistic at the beginning,” she says. “Sometimes you can bite off more than you can chew.”



It’s good to try out new fitness trends or new activities, as long as you don’t give up too quickly. For example, Brow says, disliking one yoga class you tried one time doesn’t mean you don’t like yoga — you just might need to explore a little more to find the class you enjoy most. Even within a single yoga studio, some instructors lead with a more physical style while others may emphasize the meditative aspects. “You have to find a type of class and an instructor that rings true for you,” Brow says. ...continued on page 30



he newest fitness craze in Spokane is inspired by dance, but this isn’t Zumba. Spokane has two new studios — SPOKANE BARRE and THE BAR METHOD SPOKANE — that borrow from ballet training for intense fitness classes with results. The idea is ballet-inspired leg exercises paired with core strength, with variations each time so the routine doesn’t get dull.

“It’s one-inch movements, but it’s pretty intense,” says Kerrianne Thronson, owner of the Bar Method Spokane. She initially liked the program for its attention to detail, but was won over by the effects. “It worked,” she says. “It worked quickly and it was challenging.” Certified instructor Mary Conklin first tried the program at Thronson’s recommendation and was impressed

by how well it worked. “I had ab muscles that I thought were shot after having three babies, and they’re back,” she says. Spokane Barre is owned by Emily Rogers, who was previously a corporate trainer. She designed the barre program after seeing that a lot of women weren’t getting the results they’d hoped for. “They weren’t getting that lean,

feminine look that they were really wanting,” she says. Because the classes target hard-to-reach muscles, they’ve been popular with runners and other athletes as a complement to their other activities. And since they can accommodate many ages and skill levels, it’s popular for moms and daughters to sign up together. — Lisa Waanenen

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LIVING “6 WAYS TO GET FIT,” CONTINUED... Even if you find a program that works for you, switching up the routine isn’t just about avoiding boredom — it’s also gets you more fit. Danna Snow, a personal trainer who runs boot camp classes for women, says doing the same exact routine over and over just adjusts your body to that routine. “Then you’ll plateau,” she says, “and you won’t make any more progress.” If it sounds daunting to get yourself out of bed and come up with a whole new way to challenge yourself, that’s where joining a class can be a big help. The appeal of a boot camp class is essentially the same as Zumba or other classes led by instructors, Snow says. “You just have to go to the class and do what you’re told to do, which people love.” At Giorgio’s Fitness, Usai says they rearrange the equipment every once in a while to keep things interesting. But he’s also glad to see that people pick up new activities outside the gym once they start feeling more fit and energetic. “We’re not talking just a gym, I’m talking a lifestyle,” he says. “If the gym gets you going, that’s great. If the mountain bike gets you going, that’s also great.”


Kerrianne Thronson brings ballet and exercise together at the Bar Method Spokane.


We’re not always very good at reaching our goals, Ullrich-French says, because we’re not good at setting them. The common goal to “lose weight” is much too vague, she says. “They

don’t say when, how, how much. They’re not giving themselves tangible markers that will help them see progress and feel successful.” Ullrich-French teaches that goals should be SMART — Specific, Measurable, Attain-


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able, Realistic and Time-based — so you can actually tell when you’re achieving them. It’s a mistake to plan your goals around the scale, Usai says. Your weight can fluctuate three or four pounds just with water changes. “If that’s the biggest thing on your program, the scale, it’s going to be a big letdown,” he says. “The mirror, and how you feel, is going to dictate whether your program is working or not.” It’s also a mistake to start off with a daunting goal like going to the gym six days a week, Usai says. “You’re not going to be hungry or desire the gym at all after four continuous days of working out,” he says. “You need the recovery, and you need to be excited about coming back to the gym.” You’re better off starting with a manageable schedule, like three days a week, and making those days a solid commitment, he says. No canceling to have lunch with friends. No rescheduling because something else comes up. “Those days are gym-first and everything else second, because you are trying to better yourself,” he says. And though it can help keep you accountable if you tell other people about

your goals, Usai says he’s seen some of the most powerful success stories from people who quietly focus on taking one step at a time. “If you spend more time in telling people how you’re going to do this and that,” he says, “you’re not on the machine doing what you’re supposed to be doing.” Setting smaller goals on the way to your big goal is the key to staying motivated, Ullrich-French says. “It’s like the little carrot in front of you — it’s what gets you out the door in the morning,” she says. Snow suggests a good carrot could be signing up for a fun run a couple of months down the road. It gives you a specific date to aim for, and you can look forward to seeing how much progress you’ve already made.



It turns out you can follow your exercise schedule perfectly and still sabotage your fitness plan with poor nutrition. Most trainers say they spend a lot of time fighting the myth that you can eat whatever you want as long as you exercise. “The one thing we can’t control as instructors is what you put in your mouth,” ...continued on next page

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here’s no doubt that it’s hard to find time to work out, which is why a number of the most popular new fitness programs aim to give you the most fitness in the shortest amount of time. At H.I.T. FITNESS in Spokane, workouts are only 15 minutes long — and that’s all it takes to reach complete muscle fatigue by, paradoxically, weight training in slow motion. P90X, which is designed for 90 intense days of workouts, gained popularity during last year’s election because super-fit former vice presidential candidate Paul Ryan was an adherent. (He lamented on the campaign trail that Portland’s famous Voodoo Doughnuts doesn’t make an asparagus flavor.) INSANITY, another video program from Beachbody, upped the ante with a total conditioning program in only 60 intense days. — Lisa Waanenen

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ou don’t need machines to build your body. BOOT CAMPS and other bodyweight workouts are still popular ways to get fit without crowding the basement with equipment gathering dust. Danna Snow, a personal trainer and powerlifter, has been running a boot camp for women in Manito Park for more than five years and — despite the name — most participants have a lot of fun. “I’ve designed the program kind of like an obstacle course,” she says. Gyms and fitness centers have been adding more boot camp classes to their schedules, and taking a class is a good investment — you can do the exercises on your own once you leave the gym, as long as you can be your own drill sergeant. — LISA WAANENEN

“6 WAYS TO GET FIT,” CONTINUED... Snow says. Even people who want to make positive changes mistakenly think tiny things — like switching from a regular latte to sugar-free — are going to be enough. “Unless you have awesome genetics, it’s really hard to exercise your way out of bad habits,” Campbell says. Some people can take dramatic steps and quit junk food cold turkey, but others are more successful with a few small changes — no soda, no cookies, less wine — and working more gradually toward better nutrition. “You can make little changes like that and over time they add up,” he says. Whether your weakness is ice cream while watching TV in the evenings or wine with dinner, realize it’s holding you back from making progress. “Some people think, ‘Oh, I splurged a little Send your ideas bit, but I’m going to do to an extra 10 minutes on the treadmill.’ If you put it in, it’s not going to be that easy to burn it off,” Usai says. And good nutrition isn’t just about cutting out the bad stuff. Usai says the first thing he’ll ask someone coming to work out is whether they have eaten breakfast. Oftentimes the answer is


no. Without that, “you don’t have anything moving the machine,” he says.



Exercise itself can feel like punishment, so one challenge of staying motivated is to think about fitness activities in a more positive way. Ullrich-French says she tries to avoid the word “exercise” altogether. “It’s a word we associate with bad things,” she says. Campbell says some of his personal training clients get so psyched out about how hard or painful it’s going to be that half the time they call and cancel. It is going to be a lot of work, he says, but they make it seem much worse in their minds. “There have been people who finally break through that,” he says. A lot of people who start working out are really doing it for someone else, Snow says. They’re worried about how they look to other people, and they don’t last long. The ones who succeed go into it with a more empowered outlook. “They’re really at that point when they’re ready to achieve something,” she says, “and they’re doing it for themselves.” In the Spokane Barre studio in downtown Spokane, there’s a poster that reads: “I work out

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because I love my body, not because I hate it.” Owner Emily Rogers says she thinks it’s a good message to remember, because too many people go into exercise with negative thoughts about being too fat or out of shape. “Positive reinforcement is just so much more powerful than negative,” she says.



Essentially, there are three main reasons people exercise, UllrichFrench says. Some people happily do it because they enjoy it. Some people reluctantly do it because someone told them to. The other people do it because it has become part of their identity: “I’m a person who exercises.” It’s that last reason that can be most powerful for people in the long-term, she says. If you think of yourself as someone who goes to the gym regularly, or someone who meets up with friends to walk every morning, then you’re a lot more likely to stick with it. At South Perry Yoga, a group of older women have made the so-called “Tween” class for people ages 50 to 100 part of their

Giorgio Usai at Giorgio’s Fitness: “You need to be excited about coming back to the gym.” social routine, with group lunches afterward. Similarly, women in the prenatal/ postnatal classes often make friends there. “Those things can help generate that staying power,” Brow says. Once you reach your initial fitness goals, the benefits reinforce each other — you feel healthier and more energetic, so you’re more motivated to work out. Usai says the best success stories are when this

cycle can change a person’s whole life for the better. A year after one man first walked into Giorgio’s Fitness 100 pounds overweight, he was like a whole different person, Usai says. And not just slimmer and healthier — happier and more confident, too. “And he’s not bragging to anybody,” Usai says. “He’s just so happy with his new self.” 

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Diane Sherman teaches at Harmony Yoga in Spokane — and at the Airway Heights Corrections Center.


Yogic Confinement Inmates across Washington and Idaho are discovering the ancient exercise while behind bars By Nicholas Deshais


icture if you can a man serving a states have cut funding for programs at life sentence in prison for a violent their corrections facilities. But in more and crime. Before him and a dozen more prisons and jails across the country, others like him is a slight woman teaching officials are discovering the joys of yoga, them to stretch purposefully, breathe minda low-cost way for their inmates to reflect fully and to practice ahimsa, a tenet of hatha on their wrongdoings while getting a bit of yoga that is Sanskrit for “do no harm.” exercise. “There’s a guard down the hall, but it’s “We are very much for it,” says Risa just me. I trust them. We have a rapport,” Klemme, public information officer for says Diane Sherman, a volunthe medium security facilteer who has taught beginning ity in Airway Heights. “It’s Join the conversation a positive thing to be doing and advanced yoga classes at the Airway Heights Corrections on InHealth’s Facebook page. with their bodies. It is a stress Center since 2010. “For some of reliever. Being in prison is them, the only way to feel a sense of liberastressful. You’re away from your home, tion is through this. It’s a possible route to your family. … And [yoga] comes at no them being OK with their predicament.” cost to the taxpayer.” It wasn’t that long ago that the ancient It’s no wonder prison administrators practice of yoga entered the American are looking for ways to save money. In mainstream, but now it’s found it’s way Washington state, the governor’s proposed into even unlikelier venue: prison. budget for corrections in the upcoming In an era of slashed budgets, many biennium is $1.7 billion. In Idaho, posi-



stephen schlange photo

tions in the state’s corrections department were eliminated, the remaining staff faced furloughs and in a bid to cut long-term costs, the state shifted money to privately run prisons. But it’s not all about money. A recent study published in the International Journal of Yoga Therapy showed that inmates who stuck with yoga classes while behind bars had a significantly lower re-incarceration rate than those who attended just a class or two. “There is growing evidence to support the teaching of spiritual practices, such as yoga and meditation, in prisons,” the study reads. “[Yoga] can safely and effectively be taught in prison to a varied population, irrespective of religion or race.”


anner Murphy, a 17-year-old Coeur d’Alene native, has been in the Kootenai County Juvenile Detention Center “like 15 times for drug problems,” he says. “The last time was for six months.” He’s been out for a while now, but during his most recent stint, he took a yoga class for kids taught by Jenifer Harbour. “Being [incarcerated] was super stressful, so it was nice to have something relaxing,” he says. “I can still struggle with not being calm. It helps me relax. … [Yoga] helps me be quiet for a while.” Murphy’s obviously a believer in yoga. But Harbour, who was a court-appointed special advocate for many years, says it

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took her more than a year to convince officials at the detention center to give the class a shot. “It was very clear that many of the staff thought I was the devil,” Harbour says. “They thought I was going to come in and burn incense. They said I was going to come in and convert these kids. Convert them to what?” Her persistence won out. Now her weekly class is filled with 25 to 80 kids. “The thing they love about it is they do it for themselves,” she says. “Nobody’s watching over them.” Harbour says it’s not so much the spiritual, reflective side of yoga that interests the kids she teaches. It’s the physical side. “What yoga does is it puts you in your body,” she says. “Many of these kids don’t want to be in their own skin. They’ve turned to drugs, fighting, prostitution. … Yoga is an alternative to all of these things.” While she’s had her share of sour practitioners, she says the positive responses she receives far outweigh the negative ones. “There’s just not a lot of opportunity for change with adults,” she says. “Kids can change. We don’t want them going to the big jail.”


atalie Cielle, executive director of the Redmond-based nonprofit Yoga Behind Bars, says change is still possible, even for the most hardened adult. “Change is our nature,” she says. “I’ve seen amazing changes. Students in my yoga classes in prison are more receptive and they take it seriously. A lot of them are ready for change.” Cielle’s group has 35 yoga teachers that practice at seven different facilities — all at no charge to the state since the nonprofit is fueled by individual donations. “We teach in prisons and jails, we teach men and women and we teach adults and children. So we see everything,” she says. “Across the board, it matters to them a lot. They are incredibly grateful for the opportunity. There are just not a lot of programs left in prison. They’ve been gutted.” Sherman, who teaches men in Airway Heights, says she believes adults have the capacity to change as well. In fact, she’s staked her livelihood on it and is currently developing a yoga and writing program called Bare Bones, which she says will enhance the therapeutic qualities of yoga. She hopes to bring the practice to her students in prison. “I am very interested in inner and outer freedom,” says Sherman. “Yoga has the power to change their lives. If they stick with it, they definitely can reform.” n February-March, 2013

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Don’t Forget It Five ways to improve your memory BY JACOB JONES


veryone forgets things now and again. Where are my car keys? Did I pay the rent? What did I do with that list of ways to improve my memory? Ah, here it is. Dr. Maureen Schmitter-Edgecombe, a psychology professor at Washington State University, says many factors can affect memory as people age, including diet, stress and social engagement. Since 1994, Schmitter-Edgecombe has studied the connections between aging and memory, working with people 50 years and older to identify patterns in mental behavior. She now oversees a study on cognitive aging in hopes of developing new technology to help bridge memory gaps as people get older. “The goal of my research is to keep people functioning independently for as

long as possible,” she says. In the not-too-distant future, memoryaiding technology could provide digital reminders about prescription schedules, medical appointments or family events. Until then, Schmitter-Edgecombe recommends a combination of these health and habit strategies to bolster your memory power.

1.Use Notes

Most people can get organized and help themselves keep things straight by simply writing stuff down. Schmitter-Edgecombe says people with either mild or severe memory issues can benefit from leaving sticky notes around the house or keeping a to-do list. “We’ve been doing a lot of work with a memory notebook, like a daily planner,” she says.

Many small reminders can serve as prompts for the brain. Some people will set regular alarms on watches or cell phones. Others will hang notes on the bathroom mirror. Environmental reminders help jog the memory throughout the day, she says. Some people also like keeping a list of things they’ve finished to remember what is already checked off the list.

2.Stay Active and Socialize

The Mayo Clinic, which conducts research into memory and Alzheimer’s, recommends regular social interaction to reduce stress and keep the brain engaged. “Look for opportunities to get together with loved ones, friends and others — especially if you live alone,” the clinic reports. “When you’re invited to share a meal or attend an event, go!” Schmitter-Edgecombe and other experts also suggested conversation and card games can help promote an active memory. healthy, exercise

It takes a healthy body to maintain a healthy brain. Schmitter-Edgecombe says her research has reinforced the notion that a combination of diet, exercise and healthy routines help prevent memory loss. “It’s very holistic,” she says. Exercise regularly. Whether taking a

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MARK YOUR MEMORY As part of her ongoing research, Dr. Maureen

Schmitter-Edgecombe says Washington State University continues to accept volunteers 50 years and older to participate in her study on memory and dementia. Participants can receive a free report on their cognitive health and memory. For more information, contact the WSU Memory in Older Adulthood and Parkinson’s Disease Research Program at (509) 335-4033, ext. 2. walk or pumping iron, the physical activity improves blood flow and increases oxygen in the brain. Seek out nutritious foods. The AARP recommends a diet stocked with omega-3 fatty acids, antioxidants and vitamins. Fish, fruits, leafy greens, nuts and beans all seem to help slow mental decline. Alcohol, drugs or poor sleep can also undermine memory, she says. People should also keep track of any ongoing medical conditions that could complicate mental functions.

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Some people forget because they don’t really listen well, Schmitter-Edgecombe says. Pay attention. Focus on the information you want to retain. When processing that information, it can help to associate it with an image or a mnemonic device that can help file the information away. Small routines can also help people remember daily tasks, she says. If you always take your pill after brushing your teeth, one task will naturally prompt the other. Those pesky car keys will probably be easier to find, she says, if you establish a habit of keeping them in the same spot all the time. Write yourself a note if necessary, she says, to start to reinforce steady habits.



Don’t fall into too much of a rut. Learn a new language. Explore a different part of town. Take up an unusual hobby. Schmitter-Edgecombe says the brain needs to be challenged. Break old routines and embrace new experiences. “Doing crosswords is good,” she says, “but you also want to make sure you’re trying new things.” The AARP reports even surfing new websites on the Internet appears to boost learning and mental activity. The AARP offers “Brain Games” on its site to strengthen memory and problem-solving skills. “The more you exercise it,” she says, “the more you challenge your mind.” 

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This grilled chicken breast with fregula pasta by Anna Vogel (facing page) bucks the reputation Italian food has for being too rich.




Great Italian food isn’t all cheese and bread — in fact, it can be quite healthy By Leah Sottile


bet I can get your salivary glands firing on all cylinders with the mere mention of Italian food. You’re thinking long strings of mozzarella dribbling from a slice of thick crust pizza, right? Ah, AmericanItalian food: a delicious refuge of big carbs and bigger calories. Fret not: Italian flavors aren’t out of the question in a healthy diet. In fact, Bethe Bowman — general manager and co-owner at Italia Trattoria in Browne’s Addition — says homemade Italian food can be quite healthy. “The use of olive oil, tomatoes and a lot of vegetables and lean proteins makes

it a healthy cuisine,” she says. For home cooks looking to lighten up their own Italian fare, Bowman and Italia Trattoria chef Anna Vogel suggest not only going light on the cheese and olive oil, but also on garlic, which can be difficult to digest. They suggest replacing heavy cream sauces with ones constructed using broth and parmesan cheese. A hearty, veggie-rich minestrone soup can be dolled up without adding lots of fat by putting the hard rind of a wedge of parmesan into a simmering pot of broth for a couple of hours. During her years of bringing gourmet

Italian cuisine to the Inland Northwest, Vogel says one of her own favorite healthy dishes — grilled chicken breast with broccoli, fregula pasta and diavolo sauce — has also become a crowd favorite when she puts it on the menu. The dish features fregula pasta: a rolled semolina pasta with “more character than a spaghetti noodle” that is similar to Israeli couscous, and that delivers a nutty flavor. And there’s even a surprise ingredient: dried apricots (never fresh, she says), which add depth to the dish and complement the acidic flavor of the tomatoes. n

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Spokane County Commissioner Todd Mielke with his now-college student daughter Ciara. Mielke had to switch careers — twice — to fulfill his parenting duties. PARENTING

The Balancing Act Words of wisdom from some prominent local single parents who have had to juggle their careers and their kids BY LISA FAIRBANKS-ROSSI


he 2008 election and Beijing 2008 Olympics should have had a lasting effect on the way we view the potential success of non-traditional families. Both the newly elected president of the United States and the most gold medal-studded athlete ever were stunning outcomes of single-parent households. Yet most Americans don’t feel assured the next Barack Obama or Michael Phelps could be walking to the bus stop holding

hands with just one parent. When surveyed about our attitudes toward changing familial trends, it turns out even the most liberal among us still get weird when it comes to “single moms.” Nearly 2,500 respondents in a recent Pew Research Study had more progressive views of multiracial and gay couples raising children, but of “single women having children without a male partner to help raise them” 61 percent said it’s “bad for society.”


Sociologists and advocates of non-traditional families point out that what concerns us isn’t the single mothers themselves, but the poverty, social instability and failures that often occur when moms are forced to be sole breadwinners on a national median annual income of $25,000. Former State Senate Majority Leader, and current WSU Spokane Chancellor, Lisa Brown, was an unmarried mother to a newborn when she started her legislative career in 1992. She had a steady income and reliable child care across the street from the capitol, but there was no child care for impromptu late-night sessions. So Brown toted her infant son Lucas in his car seat onto the House floor for a vote. “At some point, I just sat down in my seat with him; I wasn’t thinking I was making any kind of a statement,” Brown recalls. But a news photographer took a photo, some people complained and the chief clerk “let me know that children were not allowed on the floor.” The media frenzy began that night,

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after Brown’s colleague told the story to reporters. Just months after national voters had declared 1992 “The Year of the Woman,” for having elected so many females (among them freshman Senator Patty Murray), now some Washington voters were questioning

“I always had a fantastic network of support from family and friends. That was the key…” whether it was “appropriate for a young mother to even be in the Legislature,” Brown recalls. While she may not have intended to start a controversy, the topic of conversation swirling around her was familiar. “My academic background had been about the role of women in the labor force; how while the economy and labor force were changing, the social structure wasn’t,” Brown says. She and baby Lucas had provided an appropriate case study. “If you have health care, stable housing and an income, you can build a support network and raise happy, healthy kids,” Brown contends. “I always had a fantastic network of support from family and friends. That was the key to being able to resolve the challenge” of balancing work and parenting without a spouse. “But women in poverty don’t have those stabilities,” she adds. It was for women who lacked access to health and child care that Brown says she continued to advocate.

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round the same time Rep. Brown was carting her baby to the House floor in Olympia, Celeste Shaw was improvising child care for her young sons in Spokane. Before the beloved restaurateur was running Chaps restaurant and Cake the Bakery, she worked as a registered nurse. “There were times my kids slept in the back seat of my car — the security guard kept an eye on them because I couldn’t afford child care and I had to work nights,” Shaw remembers. “You do what you have to do, but it was incredibly difficult,” she adds. “My ...continued on next page • 509.482.3556 • February-March, 2013

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Lisa Brown raised a ruckus when she brought her son, Lucas (pictured here in 2004), onto the floor of the House of Representatives in Olympia.

“the balancing act,” continued... lights got shut off. I sold baby clothes to pay for baby food for the kids; I would regift at Christmas” Shaw and her husband had tried to make their young marriage work, but they lacked the basic skills. “We were little kids together,” Shaw says. Growing up in Havre, Mont., “he was the only boyfriend I ever had. We got married when I was 18, and I had my first son at 20. By 21, we were already broken up.” During the four years they tried to reconcile, she got pregnant again, then moved to Spokane for nursing school. “Even though we couldn’t be a good married couple, we both loved our children so much; he was always fair and thoughtful… and he was active with the boys,” she says. There were times when Shaw could have pushed harder for child support, but she wasn’t willing to let things get ugly. “I didn’t want to damage our relationship; flawed as it was, he was part of my family, and my friend,” Shaw says. “I knew my children would be fathers someday. I wanted them to learn grace and understanding, tolerance and how to resolve family issues. And you can only do that work

between the two parents.” As Shaw’s position at the hospital grew stronger her standard of living improved, and she maintained her relationship with her ex-husband. “We always celebrated holidays together so the kids would have a complete family,” she says. With the wedding of her eldest son, Jeff, last summer, and the birth of a grandchild, Shaw is convinced the compromises she reached with her ex-husband are panning out. “My sons are as solid as sons could be in a home that had a good marriage,” she says.


hird District State Senator Andy Billig (Lisa Brown’s successor) makes a similar assertion; that he and his ex-wife have created an alternative family just as solid as a traditional family. As co-owner of the Spokane Indians, and as the winner of both elections for which he’s campaigned, it should be no surprise to his constituents and fans that the even-tempered, smiling Billig is even successful at divorce. “I don’t really feel like a single parent most of the time. Kendra and I are raising

Bella together. Just like parents who are married, we talk about major decisions: discipline, school challenges and after-school activities,” he says. Having their two homes only about a mile apart helps with the logistics of Billig’s joint-custody agreement. “We split the week so Bella is with me Wednesday, Thursday, Friday and every other Saturday night. We’ve talked about other scenarios, but this seems to work best for all of us,” Billig says. “I would say we get along with each other related to Bella probably just as well as — or better than — many parents that are still together.” His daughter will visit freshman Sen. Billig in Olympia during his legislative sessions, and stay with him when he’s on recess.


he circumstances Billig describes are what Spokane County Commissioner Todd Mielke had in mind when he realized his marriage was ending. Like then-Rep. Brown, Mielke had a solid job with health benefits, but he ended up leaving his five-year post in the Legislature in 1995. Even running his own excavation business wasn’t feasible when

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Washington State Sen. Andy Billig with his daughter Isabella on election night, 2010. MARKUS BURNS PHOTO non-flexible schedules conflicted with his first priority: a bright-eyed 4-year-old with long, dark shiny hair. Ciara was welcome neither on the floor of the House, nor at a construction job site at 5 am. In Mielke’s case, his daughter’s mom took a job across the country. Shortly after that, a judge awarded Mielke full custody. “My ex-wife and I had challenging times, starting with the argument over who would be custodial parent, then negotiating joint custody and visitation, yet we always stayed cordial and respectful. Still, I believe strongly that both parents need to

during a morning commute.) “There are times when there are school functions… as an employer and supervisor, I understand when people need to leave during the day to go on field trips,” says Mielke. Mielke knows how fortunate he’s been to have had the support of his extended family to help raise his daughter, who’s now in her second year of college. Brown, too, says she will be forever in debt to her friends and family for what they contributed to her and her son Luke, who, like Ciara, is now a university student.

“I believe strongly that both parents need to be involved to the highest degree possible.” be involved to the highest degree possible,” says Mielke. “Fathers and mothers parent differently, and our kids need to experience both.” After leaving government, Mielke worked at a private sector job, but ended up quitting that after a few years because it involved too much travel time. Mielke says the empathy that’s come from the first-hand experience of single parenting in the trenches has made him a better manager. (Mielke knows how to find his way around Michael’s craft store, and diffuse a middle school-aged breakdown

“He’d have sleepovers with my friends and their children. When I was home, they’d cook meals and we’d eat while they did the dishes,” Brown recalls. “During those years, they gave more to the friendship than I was able to give back.” Once Lucas reached school age, his father moved back to Spokane and he lived with him during legislative sessions. “His father and I provided him with a broad support network,” says Brown, “but at every stage, for single parent families, there is tension and compromise. The balancing act is never-ending.” n



WEEKEND with the help of The Inlander’s Award-Winning Editorial Staff




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hances are, you’re not a glamorous Hollywood star. But you can still feel like one by getting dressed to the nines for Spokane AIDS Network’s long-running Oscar Night Gala fundraiser. Now in its 15th year, the formal black-tie event features both a live and silent auction, and is held out at the swanky Northern Quest Resort and Casino. Attendees can revel in the stars’ dress and tux choices as they make their acceptance speeches, with the awards broadcast on six large flat-screens throughout the room. Gala guests will also be treated to a delicious four-course meal served during the broadcast, says SAN’s Executive Director Gaye Weiss. “This is the one and only fundraiser for SAN, and is the only time we ask the community for a donation,” Weiss says. “Bring your friends, buy a table and experience something new.” — CHEY SCOTT

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february-april events INLAND NORTHWEST NONPROFIT CONFERENCE Oneday educational and professional workshop with 11 workshops on topics including grant writing, sustainability, finance, leadership and more on Feb. 7. Workshop times vary. $45-$170. The Lincoln Center, 1316 N. Lincoln St. Visit: Call: 999-6333

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CPR SATURDAY Providence and AMR experts will conduct 30-minute CPR training sessions from 10 am-3 pm on Feb. 9. Free. Gonzaga University Cataldo Hall, 429 E. Boone Ave. Visit: Call: 474-2397 MOSTLY MERLOT Cancer Patient Care’s biggest annual fundraising event, now in its 18th year, features a multicourse dinner prepared by chefs from top Inland Northwest restaurants, with each course paired with regional wines, on Feb. 23 at 5:30 pm. $200/person; sponsorships available. The Spokane Club, 1002 W. Riverside Ave. Visit: Call: 456-0446

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KIDS AT HEART Fundraiser luncheon with proceeds benefiting the neonatal intensive care unit at Sacred Heart Children’s Hospital on Feb. 26 from 11:30 am-1 pm. Spokane Convention Center, 334 W. Spokane Falls Blvd. Visit: Call: 474-2819

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HEALTHY COOKING CLASS Learn to prepare a healthy new meal during this monthly class on March 14 from 6:30-8 pm. Free. Holy Family Health Education Center, 5633 N. Lidgerwood. Visit: Call: 232-8131 BLOOD DRIVE Donate blood by appointment or on a walk-in basis on March 15 from 9 am-4 pm. Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 800-423-0151



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BLOOMSDAY CLINICS Get in shape for Bloomsday at free training clinics hosted by Providence and Group Health on Saturdays at 8:30 am from March 16-April 27. Free. Spokane Falls Community College gym, 3410 W. Fort George Wright Dr. Visit: Call: 474-2397 TASTE OF LIFE Celebrate life with an evening of wine, beer, spirits and gourmet food as part of an annual fundraiser benefiting Hospice of Spokane and its end-of-life support programs on March 29 from 5:30-8:30 pm. $75. Spokane Club, 1001 W. Riverside Ave. Visit: Call: 532-6731 CHOCOLATE AND CHAMPAGNE GALA The 29th Annual fundraiser benefitting Lutheran Community Services of Spokane’s Sexual Assault and Family Trauma Response Center features champagne, decadent chocolates and desserts, hors d’oeuvres, drinks, a silent auction, live entertainment and more on April 6. Cost: TBA. Mirabeau Park Hotel, 1100 N. Sullivan Rd., Spokane Valley. Visit: Call: 343-5053 SPOKANE WOMENS SHOW Enjoy live music, entertainment, demonstrations, vendors, lectures, exhibits and more from April 19-21. Times vary. Cost: TBA. Spokane Convention Center, 334 W. Spokane Falls Blvd. Visit: RACE FOR THE CURE Participate in a 1-mile survivor’s walk or 3-mile fun run to benefit the Susan G. Komen Eastern Washington Affiliate on April 21 at 9 am. $15-$25. Spokane Convention Center, 334 W. Spokane Falls Blvd. Visit:

WOMEN’S CANCER SURVIVOR RETREAT Join other women who have gone through or currently have cancer in a weekend retreat of rest, reflection, presentations and more from March 15-17. $195. The Franciscan Place, 1016 N. Superior St. Visit: Call: 483-6495

MARCH FOR BABIES SPOKANE Get a team together and raise money to support March of Dimes’ programs that help babies born premature or ill as part of a 3-mile fun run and other events celebrating the organization’s 75th year on April 27 at 9 am. Gonzaga University Jundt Art Museum, 202 E. Cataldo. Visit: Call: 328-1920 n

MARCHTINI MADNESS A portion of the proceeds from each “Shamrock Drop” martini will benefit the Family Maternity Center at Providence Holy Family Hospital on March 13. All Twigs Bistro and Martini Bar locations. Call: 474-2819

The calendar is a free service, on a space-available basis. Mark submissions “InHealth Calendar” and include the time, date, address, cost and a contact phone number. Mail: 9 S. Washington, 4th Floor, Spokane, WA 99201; Fax: 325-0638; or E-mail:

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Certified nurse-midwife Shelley Northern measures fetal growth during a prenatal visit with patient Sarah Manfred. stephen schlange photo

Healthy Renaissance Midwives bring special care to pregnant women By E.J. IanNelli


here have been midwives almost as long as there have been babies. In the Biblical story of the exodus, it was the Israelite midwives who spared the newborn sons from Pharaoh’s infanticidal decree. Back in ancient Greece, midwives were key figures among the all-female circle present at childbirth. Several centuries later, midwives continued to accompany births during the medieval period, when they used herbs and bloodletting — state-of-theart medical practice of the day — to bring about a quick and healthy delivery. Today, midwives are still common throughout Europe, attending around 75 percent of all births. In Germany and England, they also provide valuable postnatal care through follow-up home visits. In America, however, midwives’ fortunes have waxed and waned. Over the

Shelley Northern and fellow CNM Liz Britain work together at Northwest Ob-Gyn. stephen schlange photo past 200 years, their presence or absence at childbirth could be seen as an indicator of the prevailing social attitudes. At times

when they’ve been in favor — such as during the immigration boom in the mid-19th century — one could be expected to be on hand at almost every birth. And when midwives have fallen out of favor, they have become virtually extinct. As recently as 1989, certified nurse-midwives (CNMs) attended just 3.3 percent of all births in the United States. Since then, midwifery’s ups and downs have continued. The 1990s saw a rapid increase in CNM-attended births, but the 2000s brought further dips and plateaus as scheduled cesarean sections became popular. Yet the mood is shifting again, and the number of professionals who practice this modern medicine with an ancient pedigree is on the rise. In recent years, their attendance at births has bounced back from earlier lows. Shelley Northern, a CNM at Northwest OB-GYN in Spokane, says there are any number of reasons why a woman might prefer to be accompanied through her pregnancy by a midwife rather than an obstetrician. What it generally boils down to is the “personalized approach” that midwives tend to provide.

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Acquire a Permit for lay midwives, who have no formal training, to CNMs, who are educated, tested and accredited. “When you say ‘midwife’ to a physician, their hair can sometimes stand on end, because there have been many times when they’ve had to accept a transfer from a home birth that was not managed safely,” Northern says. “That’s where a lot of the medical community’s cold shoulder toward midwifery comes from.”


s the American public — and perhaps just as importantly, hospitals 5.0 h and health care providers — becomes more aware of those distinctions and the benefits of a midwife-led pregnancy, Northern and Britain are watching the profile of their profession rise, both regionally and nationally. “A greater percentage of women are seeking out nurse-midwifery care as a means to having a more positive birth experience,” says Northern. “Generally speaking, nurse-midwives have one foot in the essence and art of midwifery, and we have the other foot in the world of science, medicine and technology. It’s really the best of both worlds.” n

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“I think women choose certified nursemidwives because they’re hoping to avoid what they might perceive as unnecessary testing or unnecessary medical intervention during their pregnancy or during their birth. I allow the visits to be patient-guided. I don’t walk in with a specific agenda other than the basics of safe care,” she says. There’s also the sense of kinship that can get lost in the hierarchical patient-physician relationship, says Northern. “When a 25-year-old woman comes for a prenatal visit and she’s being cared for by another female who’s maybe 10 or 15 years older, it’s more comfortable to talk about pregnancy and concerns surrounding pregnancy. It feels like you’re meeting with your older sister — only your sister happens to be an expert in pregnancy and birth.” Liz Britain, Northern’s partner at Northwest OB-GYN and a 26-year veteran of the field, says that CNMs offer two distinct advantages over obstetricians. As trained nurses, they adopt a more “holistic” mindset, which includes advice on nutrition, exercise, stress management and childbirth preparation. They also have a smaller “scope of practice.” Unlike physicians, they don’t have to accommodate busy surgery schedules, leaving them more time to converse with patients. Despite their more limited range of services, midwives have often found themselves at odds with obstetricians — an antagonism that can be traced back to the 18th century, when their roles in birth were reversed. Britain and Northern say that antagonism naturally arises where their areas of responsibility overlap, but each profession has unique — and necessary — strengths. “Our training is based on normal, healthy women,” says Britain, who estimates that more than 80 percent of all pregnancies are straightforward enough to fall under that kind of care. “You don’t really need a trained surgeon to deliver a baby, but you certainly need them available 100 percent of the time. You need the expertise of a physician if things go wrong.” “The relationship between a nurse-midwife and her physician is critical,” Northern adds. “Having a clinical practice that has both nurse-midwives and obstetricians is a really nice balance.” Any professional friction might also stem from the historical misconception that midwives are untrained. Northern and Britain, both of whom are certified nurses with a decade of higher education under their belts, note that there are roughly three tiers of midwife training. These range from

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