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FROM THE EDITOR

Getting in the Flow

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

DEDICATION

“We’re not just a transport team, we’re critical care where and when you need it most.” – Terri Tickner, rn, nreMT-P

Terri is one of 1,000 dedicated inhs employees making a difference in our communities for the last 20 years. Find her inspirational story at inhs .org/inhs20

norThWesT MedsTar

I

n this issue, I’m so pleased to introduce you to four local folks you may not have heard of, but whose contributions in their various fields are getting noticed by their peers — even earning them national recognition. Despite their varied fields — two are doctors, one’s a pharmacist and the other is receiving her Ph.D. in nursing — you’ll see they have some key things in common. Intellectual achievement, obviously, but also in all four, a humble spirit of service is abundantly evident. And in spite of the long hours they work at very demanding occupations, they all express a profound sense of gratitude for the gifts of ability and education and mentoring, as well as for the opportunity to work with others who inspire them. Sometimes that sort of conjunction of passion, perseverance and professional achievement is referred to as being “in the flow.” While many of us aren’t working on life-saving challenges, there’s no reason we can’t all experience some degree of that convergence — where time seems to stop and our full attention lands easily on whatever task we’ve assigned ourselves. Getting into that state of flow more easily — and more often — is the subject of the first column by our new life coach Carla Brannan (page 10), who helps people in Spokane reach their full potential. I hope you’ll give her quick and easy personal assessment quiz a try and go wherever your flow takes you. To your health!

INSPIRING COLLABORATION. CONNECTING COMMUNITIES.

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CHECK-IN STAY CONNECTED You can reach Editor Anne McGregor via email at annem@inhealthnw.com. The conversation continues on the InHealth Facebook page, and stay in touch with us at Inlander.com/InHealth.

ON OUR FACEBOOK

Did your child’s birth go as planned? Was there anything you wished you’d known or done differently? JONNA MAULE SMITH: Wished I would have checked out the hospital here prior to going — was in hard labor and couldn’t find Labor and Delivery. By the time I got there, my son was born in eight minutes. A little harried. MARISSA HERNANDEZ: 33 1/2 hrs with my first and then they say she’s stuck… then try to vacuum her out and finally she’s out. Yeah, something could have been done differently. ROBBIN WOOD: I wish I would have skipped the whole experience — period. Had a horrible… doctor both times. I now understand why so many of my ancestors died in childbirth. KRYSTEN KOLE: Had a wonderful experience delivering at home, can’t wait to do it again. JESSE HALL: I wish I had known to wait on going into the hospital (even if your water is broken) until you have contractions. Pitocin is no joke. I had no expectations — aside from leaving with an adorable baby boy, it was blissfully uneventful. MARY K. SIMMONS: I’m quite pleased with both my birth experiences. I had home births and they were wonderful. Yeah, the pain was there, but only for four hours at the most. I’ve heard horror stories about hospital births. KIM BENNETT: First time I wish I would have been more assertive about my needs… some nurses were great and others were awful. 

MAKING A DIFFERENCE

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ack before Ryan Lewis was half of the Grammy-winning, furcoat-wearing, world-famous Macklemore and Ryan Lewis, he was just a kid growing up on the South Hill in Spokane. And his tight-knit, middle-class Christian family had a struggle that set them apart from other South Hill families: His mother, Julie Lewis, was HIV-positive. The cause was a blood transfusion in 1984, a time when the stigma of HIV and AIDS made it something the family didn’t share for years after the diagnosis. “I think it really just opened up the door, as a kid, to life experiences that most of my friends didn’t know anything about,” Lewis told the Inlander in 2013. “I didn’t get it, my sisters didn’t get it, my dad didn’t get it. It could’ve been a totally different thing. I could not be here. And she could not be here. But she is.” Inspired by his mother — a 30-

year survivor — and improvements in treatment for those who are HIVpositive, Lewis launched the nonprofit 30/30 Project with his family earlier this year to build health care centers around the world. He called on fans to help with the initial funding goal of $100,000, and the crowdsourced campaign raised $152,178 by the time it ended on May 21. The first project is a center in Malawi, where a high percentage of the population is HIV-positive, with additional locations planned in Kenya and Uganda. In each location, the 30/30 Project is working with an established nonprofit already involved with delivering health care services, such as Partners In Health. Though the initial campaign is complete, the 30/30 Project is still welcoming those who wish to contribute or get involved. Visit 3030project. org for more information. — LISA WAANANEN

CHARITY CORNER

Defeating Tumors

A

t age 3, Grace Carney was diagnosed with the genetic disorder neurofibromatosis type 1, or NF1. The disease causes tumors to grow on nerves throughout the body, which can lead to blindness, bone abnormalities, cancer, deafness, chronic and disabling pain and learning disabilities. Now, at age 12 and after nine years of treatments, Grace received good news about her latest MRI, says her mom, Janet Carney. Though Grace still has hundreds of tumors on her spinal cord, the recent MRI showed that no new tumors had developed and none had grown in size. Janet says Grace won’t need to be screened again for three years. Neurofibromatosis affects about one in 3,000 people — and is more prevalent than cystic fibrosis,

Ryan Lewis

muscular dystrophy and Huntington’s disease combined. In support of Grace’s battle with the disease and other children like her, Janet is chairing, and her family is participating in, the upcoming Summer Solstice 10K and kids run. The event is co-hosted by Fleet Feet Sports and the Spokane Swifts running team. For the event’s second year in Spokane, the goal is to raise $15,000, surpassing the $11,000 raised in 2013. Funds will support research of NF — currently there is no cure — via the Children’s Tumor Foundation. The New York City-based foundation also oversees local chapters to assist families of children with NF, helping put them in touch with local doctors and a support group of others who’ve navigated the complex disease. Spokane doesn’t have a clinic that specializes in treating NF, so many families travel to Portland or Seattle, Janet says. Her hope — other than bringing awareness to her daughter’s condition, a disease that many people haven’t heard of — is “getting the word out so people know about the local chapter, and we get an NF clinic here in Spokane eventually, too.” — CHEY SCOTT Summer Solstice runs • Fri, June 20; kids run at 6 pm, 10K at 7 pm • Starts at Riverfront Park, route along the Centennial Trail • 10K/$25-$35, kids run/$15; team fundraising encouraged • ctf.kintera.org JUNE-JULY, 2014

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CHECK-IN ASK DR. MATT

Mad Men and E-Cigs

I

must confess, on Sunday nights I kick back with my teenage sons and watch Mad Men. Sometimes we wear suits and ties, and you will always find us clutching double Arnold Palmers (iced tea and lemonade) on the rocks, and see Matt Thompson is us periodically taking slow, contemplaa pediatrician at tive drags from pretend cigarettes held Spokane’s Kids Clinic. delicately between our sophisticated fingers. We find a dull golf pencil makes for the perfect ersatz cigarette. I support this ritual, as it allows us to explore and discuss the perils of the philandering cocktail culture of mid-20th-century America (that’s my story). What is the allure of smoking? For me and my boys in the context of Mad Men, I think it is the desire to embrace the calm, intense importance of Don Draper. Yet for more and more teens, it is no fantasy. They are reaching for another pseudoincendiary device that actually delivers a nicotine payload — the e-cigarette. Although e-cigarettes may not

involve the inhalation of tar and other nefarious toxins that arise from a burning cigarette, it’s too soon to tell what impact the inhalation of a vapor of propylene glycol laced with liquid nicotine and “flavor additives” may have on the delicate respiratory tract. So what exactly is in an e-cigarette? Who knows? E-cigarettes remain an unregulated product with no oversight from the FDA. Part of the concern with any unregulated chemical substance — ingested, injected or inhaled — is the uncertainty about what chemicals are actually being delivered. Studies have shown that the dose of nicotine delivered from device to device, and formulation to formulation, is highly variable. Additionally, substances added for flavor are a complete wild card. As far as real-world risk, with custom blends shared by friends, I worry what other substances — legal or illicit — might be added to a solution. I never underestimate the creative capacity of

humans when it comes to ways to harm themselves and others; unfortunately, this holds especially true for adolescents. Indeed, calls to poison control centers related to e-cigarettes are up 200-fold over the past four years. But even when used exactly as intended, a major concern is that the availability, funky fresh flavors, and relatively stealthy operation of e-cigarettes may serve as an entry point — with accompanying nicotine addiction — to uninitiated youth who would never have used tobacco in any of its other formats. This concerns me as a parent and a health care provider. For now, we need to convey to kids that even if the e-cigarette is vegan-friendly, gluten-free and broccoliflavored, it is still the vehicle of an addictive, detrimental chemical derived from a tobacco plant, and should be avoided. They should stick with a golf pencil if they want to be cool. — MATT THOMPSON, MD

LIFE COACHING

Back in Balance

I

am grateful for days that flow: When carpool duties include sing-alongs, clients leave with a spring in their step, my hairdresser crafts an especially chic cut and the day wraps up with a perfectly timed hug over ice cream. However, it seems that being “in the flow” — finding that perfect balance among career, family and social lives — isn’t a place we permanently land, but Carla Brannan is a rather a state we seek to return to again and again. personal life Maybe that’s because we aren’t really clear about what our coach in Spokane. ideal balance looks like and the ways we can guide our actions to create that balance more quickly and, with practice, for longer stretches of time. Here’s one way to get there. Do you have your notebook and pen ready? Create a list of your top priorities. These are the areas

of life — your unique set of Balance Zone Indicators — where you want to devote your time, energy and resources. They may be related to family, career, spirituality, health or social relationships. When you’ve got your own personal categories, take some time to rate your current level of satisfaction in each area on a scale from one to 10. What areas are out of whack with your values? Here’s your alignment opportunity! Take a small step, maybe two, to raise your satisfaction level. You are on your way to being in balance once again. And if you alignment opportunity happens to be in the area of family, perhaps more hugs (ice cream optional) could be your first small step. — CARLA BRANNAN

memorable

5 0 9 . 2 7 9 . 7 0 0 7 w w w . s p o k a n e c e n t e r. c o m

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SUPERFOOD

Cheers to Cherries! ATTRIBUTES: A sure harbinger of spring, snowy white cherry blossoms are celebrated in literature and art. Every year in Washington, D.C., thousands turn out to ogle them. Cherry trees are picky, though. They can take up to five years to start producing cherries, requiring the assistance of bees and at least one other tree to set a notoriously fragile fruit, highly susceptible to damage from wind and rain. And every single cherry has to be hand-picked. SUPERPOWERS: Cherries are loaded with anthocyanins. Research has shown these antioxidants may decrease levels of inflammation and may be helpful in relieving gout. Cherries also contain significant amounts of potassium, fiber and vitamin C, and they’re a rare fruit source of melatonin. One study found that drinking sour cherry juice twice a day helped older people with insomnia get more rest. WEAKNESSES: The sweet cherry season is short, and preserving cherries through freezing seems to significantly degrade nutrient levels. So don’t delay. Eat cherries while they’re around. HOW TO USE IT: Cherries offer a rare opportunity for competitive fruit-consumption. At what’s billed as the “largest pit spitting event this side of the Rockies” on July 17, you’ll have a chance to see just how far you can send a cherry pit flying. The current records at Green Bluff’s Cherry Pickers Trot and Pit Spit are 32 feet, 9 inches for women, and a whopping 43 feet, 2 inches for men. Sign up for the four-mile race at eventbrite.com. — ANNE McGREGOR

PILL BOX

An Aspirin a Day? I am 62 years old, male, and have a family history of heart disease. Should I take a daily aspirin to prevent a heart attack?

John R. White chairs WSU-Spokane’s Department of Pharmacotherapy.

T

he answer to this question is one that continues to evolve. On May 5 the FDA came out with a new recommendation that essentially says only those who have already had a heart attack should take a daily aspirin for prevention. They evaluated the use of aspirin in many studies and concluded that in those who had not had a heart attack, the risk of bleeding from the use of aspirin outweighed the potential benefits. This recommendation

is rather controversial and runs contrary to the suggestions of other organizations such as the American Diabetes Association. If you are already taking a daily aspirin, don’t abruptly stop before discussing this with your health care provider. If you believe that you are at risk for a heart attack, talk to your health care provider before starting aspirin. — JOHN R. WHITE

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CHECK-IN

NOW OPEN

Form Follows Function

P

roviding comprehensive health care in one location was the guiding vision behind the new Providence Medical Park in Spokane Valley. “The key in designing it was that it was convenient for patients, and the second thing was that it was efficient for people that work here,” says Kathy Tarcon, chief operating officer of Providence Medical Group. “The architects were there to put our ideas in place. They influenced the feel of it — the lighting and things. But we had teams of physicians, nurses, medical assistants and man-

agers that actually put together and designed each different place.” The $44 million facility sits on an 11-acre site with ample parking, just east of the Sullivan Road exit off of I-90. Efficiency begins at the central hub, where patients check in and receive a badge containing a radiofrequency identification (RFID) chip. They are then given a room number, “just like you would check into a hotel,” says Tarcon. From there, providers will come and go through the room’s private entry — preserving patient confidentiality and avoiding lengthy stays with potentially

infectious people in a waiting room. Physicians also wear badges, allowing them to easily locate colleagues for a consultation. All that efficiency plays into an additional goal for the building: “The other really core piece of this building is to provide the care at lower cost,” says Tarcon. The urgent care center, where services can be provided at much lower cost than in a hospital ER, has been “stepped up” to offer full lab and radiology services from 8 am to 8 pm every day, with a Rite-Aid pharmacy also on the premises. Family and internal medicine, as well as specialties including cardiology, neurology, gastroenterology and orthopedics, will be available in coming months. The airy building and grounds are designed to mitigate the apprehension that can come with a doctor visit: Thomas Hammer coffee in the lobby, a small chapel and a nearby labyrinth offer respite. “We’re hoping people will just come in and have a cup of coffee,” says Tarcon. — ANNE McGREGOR

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2

6 7 1

Sudoku

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

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

Codewords

Each letter has been replaced by with a number. Using the starter clues, work out the words that must go in each cell on the codeword grid. Some well-known phrases and names may also be found. For a three-letter clue, turn to page 23.

26 10

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Answers to all puzzles on page 42

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

Str8ts

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.

3

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2 3 4 1 5 6

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5 3 7

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9 3

© 2014 Syndicated Puzzles, Inc.

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n o i s s i M

NEWS

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These inspiring Spokanites are attracting the esteem of their colleagues locally and beyond INTERVIEWS BY ANNE McGREGOR PHOTOS BY YOUNG KWAK

Katherine Tuttle Katherine Tuttle, MD, is the Executive Director for Research at Providence Health Care and Clinical Professor of Medicine at the University of Washington School of Medicine. Her recent research has focused on what she terms the “global pandemic” of diabetic kidney disease in an editorial published in the December 2013 New England Journal of Medicine. Her research on the subject earned a spot in the November 2013 issue of the respected journal. She’s also a marathoner and a survivor of sudden cardiac death in 2012. Tell us about your work. My work entails overseeing the full spectrum of health research at our academic medical center, conducting my own research focused on translational studies in kidney disease and diabetes, teaching the next generation of physicians and scientists, and caring for patients. I also hold national-level leadership positions with major governmental agencies (NIH, FDA, Veterans Administration) and professional societies (American Society of Nephrology, American Diabetes Association, National Kidney Foundation). ...continued on next page JUNE-JULY, 2014 NEWS-MAIN inhealth 6-1-2014.indd 15

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NEWS “KATHERINE TUTTLE,” CONTINUED... You sound amazingly busy. What’s the most important aspect of your work — in the short term and further down the road? The most important aspect of my work is the opportunity to serve by advancing knowledge that improves care of people in need of better solutions to serious health conditions. I am wholly committed to the Providence Mission of service to the poor and vulnerable, defined not only by socioeconomic status, but also by conditions of the mind, body and spirit. What early life experiences made a difference in getting you to where you are now? I was given exceptional gifts of education, opportunity and ability. And to whom much is given, much is also required. I was inspired to answer a call to service focused on need, compassion and social justice.

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What do you enjoy most about your work? One my greatest joys is meaningful achievement, whether it’s a scientific breakthrough that improves the lives of many, or finding a simple solution to relieve the distress of a homeless patient at the House of Charity. Why do you make the Inland Northwest home? I grew up in the Northwest, but was away for many years through college, medical school, internal medicine residency, two sub-specialty fellowships (diabetes and metabolism, and nephrology), and early faculty positions. I lived all over the United States, from the West to East coasts and in between, but I always longed to return to the Northwest. None of the other places ever felt quite like home. I am very fortunate and grateful to have a career in academic medicine here. What do you do for fun? Do you have a favorite book you’ve read recently? The Book of Awakening by Mark Nepo inspires me to be a better person every day. I run for meditation and fitness. Since my work entails so much travel, a wonderful break is staying home with my husband, daughter, and dogs, cat and fish. n .

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Jon Boyum Jon Boyum is a thoracic surgeon at Rockwood Clinic who uses a highly specialized, minimally invasive approach for chest surgery. A graduate of the University of Washington Medical School, Dr. Boyum grew up in Ellensburg, attended Gonzaga University and returned to Spokane to be near his extended family. Tell us about your work. If you know someone who has had knee surgery or their gallbladder removed, it was most likely done with small incisions using a camera. Minimally invasive surgery has become standard in many types of surgery because patients do better, have less pain and can return to normal life in less time. Chest surgery has been one of the last fields to adopt to a minimally invasive approach … [because] the operations are difficult to perform and it is very hard for practicing surgeons to learn without specialized training. For this reason, only 10 to 15 percent of thoracic surgeons across the country are able to perform minimally invasive surgery in the chest. I was fortunate enough to be trained in these techniques, and routinely do surgeries through small incisions that would normally require a large incision, including spreading and sometimes breaking the ribs.

about is a new technique that we have started using to help with the diagnosis and surgical removal of lung cancers. The technique is called navigational bronchoscopy. It works by creating a 3-D computer map of the lung from a CT scan. This allows a camera to be guided to a spot seen on a CT scan using GPS, much in the same way you are guided by GPS in your car. The spot can either be biopsied or marked. We use markers that can be seen on X-ray, or a blue dye which stains the area. We have started using this technique during surgery, so that I can completely remove lesions that are typically to small see or feel. What early life experiences made a difference in getting you to where you are now? There is one experience in particular that sent me on the path to becoming a surgeon. I spent my first year of medical school as part of the WAMI (now WWAMI) program at WSU. As part of our program, every Tuesday I went to Lewiston with one of my classmates to observe and spend time operating with two surgeons. They probably wouldn’t remember me, but I remember being with them when I had that ‘a-ha’ moment. I knew that this is what I wanted to do. It’s funny how the right person at the right time can be so influential. I sometimes wonder if they had been dermatologists, that today I would be passionate about skin disease. Both my classmate and I went on to become surgeons.

Mission

Heal

What’s the most important aspect of your work — in the short term and further down the road? Lung cancer is the leading cause of cancer death in the United States. More people die from lung cancer than colon, breast, prostate and pancreatic cancer combined. Minimally invasive surgery is ideal for patients with early lung cancer. With this approach, patients can expect less pain, a shorter stay in the hospital and have fewer complications than patients treated with a large incision. One of the things that I am really excited

What do you enjoy most about your work? That most of the time it doesn’t feel like work. In my field, medicine is a combination of technical work — surgery — and collaboration. I work with a great group of assistants, nurses and other physicians who all have one goal in mind: providing the best possible care for the patients. Patients place an enormous amount of trust in your ability to give them the best possible treatment. Living up to those expectations is one of the most fulfilling feelings. Do you have a favorite/impactful book you’ve read recently? A recent favorite is The Long Walk. It’s an amazing survival story about a group who escape from a labor camp in Siberia during WWII and their trek to freedom. n

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NEWS

Joshua Neumiller Joshua Neumiller is a Doctor of Pharmacy and Associate Professor at WSU and was recently named Editor-in-Chief of a national medical journal. In an editorial, he described a pivotal moment in his career — when a doctor informed him that he had diabetes. “I was a health care professional, yet what knowledge I had gained through my education seemingly went out the window at the moment I heard those words. It was a very humbling realization.” Tell us about your work. yond — to assist them in the care of their patients I am currently on faculty in the Department and clients. of Pharmacotherapy in the College of Pharmacy at Washington State University... and a What early life experiences made a difference in Certified Diabetes Educator. At WSU, I am getting you to where you are now? an investigator on multiple clinical trials I knew from a young age that I wanted to be involving the care of people with Type 1 involved in science and health care — I just didn’t and Type 2 diabetes. know exactly where my specific interests would lie. More recently I have taken over At the age of 25, I was diagnosed with Type 1 diaas Editor-in-Chief of the American betes. My diabetes diagnosis was a personal and Diabetes Association (ADA) journal professional turning point in my life. After benefitDiabetes Spectrum. The ADA has ing from the care of many physicians, nurses and a total of four journals, and I am diabetes educators, I knew that I wanted to use my the first pharmacist to act as Chief personal experiences with diabetes to help others. Editor of an ADA journal. What do you enjoy most about your work? What’s the most important asMy editorial work is very rewarding. I have the pect of your work — in the short privilege of working with a distinguished group of term and further professionals from across the country down the road? that comprise the journal’s editorial Working with board. It is also an honor to serve an to and educating organization such as the American people with diabetes Diabetes Association (ADA). is a passion of mine. My research and clinical duties allow me Why do you make the Inland Northwest home? to interact with people and do what I was born and raised in Spokane and love the I can to help them understand their Inland Northwest. I am a graduate of North Central disease and take better control of their High School in Spokane and Washington State health. My role as editor of Diabetes University. Not only is the Inland Northwest my Spectrum, which has an international family’s home — I am married with three children readership, allows me to meet this goal in — I am very fortunate to be able to work with a a different way — by working with the ADA number of national and international experts in and my editorial team colleagues to deliver diabetes on a daily basis who also call the Inland timely education to diabetes educators and other Northwest home, such as Dr. Carol Wysham, Dr. health care providers across the country and beKatherine Tuttle and pharmacist and diabetes educator Keith Campbell. n

Mission

Heal

WSU-SPOKANE PHOTO

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Becky Doughty Becky Doughty is the founder and program coordinator of Catholic Charities’ Inland Northwest Transitional Respite Program, a unique and innovative program that provides transitional care for homeless people after they are discharged from the hospital. In 2013, she was a recipient of the Association of Community Health Nursing Educators’ outstanding graduate student award. Tell us about your work. In the Transitional Respite Program, homeless men and women who are hospitalized can be discharged to our shelter-based medical beds. Respite provides them a safe, warm place to recuperate after illness or injury. These are patients who are well enough to be discharged to home, but still too sick to be back on the streets. As respite guests, they receive nursing care and are connected to needed resources such as mental health, drug and alcohol treatment, and housing. In addition to healing their bodies, we seek to encourage and empower them to begin rebuilding their lives. What’s the most important aspect of your work — in the short term and further down the road? The most important aspect of my work is connecting with people who are marginalized, and treating them with dignity, compassion, and respect. Long-term, it is critically important to continue building Respite with community to partners. Homelessness and its connection to health outcomes is a community issue, and must be addressed as such.

What do you enjoy most about your work? The most enjoyable thing about working with the Respite Program is listening to the guests — really listening to them respectfully and without passing judgment. It is something that all health care providers should do more of, and it is so rewarding. Every person has a rich, complex history that is worth hearing. Why do you make the Inland Northwest home? I grew up north of town, and most of my family still lives in the area. My kids go to school in Spokane, and so this has remained home for me. I am connected to the community through Respite, and the wonderful people I work with at Providence, Catholic Charities, Volunteers of America and the WSU College of Nursing.

Mission

Heal

What early life experiences made a difference in getting you to where you are now? I grew up watching my parents selflessly give their time and resources to anyone in need. I was encouraged to not look away from human suffering, but to reach out and do something about it. And from them I learned that wealth has nothing to do with money — that fulfillment comes from acting on compassion. These are messages that I pass down to my own children on a daily basis.

Any favorite books you’ve recently read? I am in my last semester of class for my Ph.D. in nursing, so I haven’t had much time to read for pleasure! Any spare time I have is spent with my kids and my French bulldog — they are my favorite people in the world. Anything else you’d like to add about your work? I encourage every person reading this to make an effort to volunteer at a local homeless shelter. It will absolutely change your life. n

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Health 19 5/27/14 5:37 PM

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r. Rayme Geidl can pinpoint the exact moment she knew she wanted to tackle obesity. In 2008 she was working at the student health clinic at the University of Idaho and remembers coming out of a room after working with a patient who was young, yet facing a new regimen of diabetes and cholesterol medications. The student knew that if she lost some weight, she wouldn’t have to take that route, so she asked what she could do. Geidl wasn’t satisfied with her own answer. “I walked out of that appointment saying to myself that I have to do better, that there has to be something else I can do for patients,” Geidl says. Five years later, she became the only physician certified by the American Board of Obesity, offering a nonsurgical bariatrics clinic on the Palouse. The certification offers doctors an opportunity to gain in-depth understanding of the complex web of genetic, biologic, environmental, social and behavioral factors that contribute to obesity. Patients and their doctors need a variety of options for combating weight problems, since there’s no one-size-fits-all treatment approach that will work for everyone. Geidl’s practice at Moscow Medical offers a comprehensive approach aimed at maximizing overall health and improving or reversing obesityrelated problems. Founded in 2012, the American Board

of Obesity Medicine is relatively new, but the number of doctors taking its certification exam is increasing, ABOM Executive Director Dana Brittan says. One problem is awareness. “There are lots of physicians who don’t know this certification exists, but we are growing,” she says. “Usually, a physician in a community will get the certification and others will hear about it and want to be certified, too.” Certification doesn’t come easy, though. Physicians have to complete 60 hours of education on obesity before applying for the exam. Geidl is one of only 158 physicians who successfully achieved certification in 2013, out of the more than 300 who tried. Historically, about 75 percent of exam takers receive a passing score. Geidl says the certification has helped her customize treatment for each client. Much of her work involves obesity-related health issues: diabetes, high blood pressure and liver problems. Non-surgical treatments range from changing a patient’s diet to recommending more exercise and altering sleep patterns. She devotes about half of her day-to-day practice to working with patients on these issues. “I’m not done learning,” she says. “I’ll continue to learn and will probably change things as I go along because I’m constantly trying to improve what I’m doing as I know more.” n

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NEWS

TOXINS

The Chemistry of Convenience Why BPA-free may not really fix anything BY LISA FAIRBANKS-ROSSI

M

eagan Norris was warming a plastic bottle of soy milk for her 3-year-old daughter as she read the online version of the March/April Mother Jones article entitled, “The Scary New Evidence on BPA-Free Plastics.”

“Oh, crap,” Norris says, “I was thinking either she will develop some horrible disease, or her offspring will be mutated.” Norris is mostly joking, but also partly resigned, and feeling guilty. Norris’s daughter was not yet born

when Washington state banned Bisphenol A (BPA) in children’s cups, bottles and dishware in 2010. But Norris knew about it; she’d been researching which products would be safest for her newborn. “We bought glass bottles for her initially,” trying to be extra safe, she recalls, “but they break so easily and they’re expensive. So we eventually said ‘Oh, to heck with it.’ We assumed [manufacturers] were telling the truth” about the safety of BPA-free plastics. The Mother Jones article asserts that any momentary peace of mind parents may have gotten from buying BPA-free is unfounded. The story digs deep into evidence from a private, independent study of BPA “free” plastic children’s cups that revealed more than 15 of the cups tested “leached synthetic estrogens — even when they weren’t exposed to conditions known to unlock potentially harmful chemicals, such as the heat of a microwave, the steam of a dishwasher, or the sun’s ultraviolet rays … some BPA-free products actually released synthetic estrogens that were more potent than BPA.” The Centers for Disease Control estimates that more than 90 percent of Americans have BPA in their bodies, and the “estrogenic effects” of BPA have been linked to breast and other cancers, reproductive problems, obesity, early puberty and heart disease. Pat Hunt, a WSU reproductive biologist and geneticist, has been campaigning to clarify and pinpoint the endocrine-disrupting effects of BPA for 15 years. She researches why older females have a harder time getting pregnant and maintaining pregnancies. While her test subjects — mice — test the effects on male and female fertility, she is driven to provide safety for children as well. “Chemicals can alter the growth pattern of cells,” Hunt explains. “Of most concern to us is exposure to the growing fetus or newborn, since their bodies are being reprogrammed and growing.”

B

ack in 2008, Hunt and her colleague Frederick vom Saal (a source in the MJ article) were called “alarmist” by critics. She laughs about that now, and notes that “hundreds of investigators have joined us” in a global Bisphenol awareness campaign. But taking on the $375 billion plastics industry is a tough gig for a group of committed scientists. “It’s definitely an uphill battle, and it’s frustrating,” she admits. Hunt hopes her advocacy impacted

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the development of the Washington Toxics required, according to the MJ research, Coalition and subsequent laws banning that “chemical makers share safety-testing BPA. But in retrospect, Hunt sees they data with federal regulators.” needed a more specific demand: “We were It hasn’t happened. asking for the removal of Bisphenol A, but “What parents ask for is what manufacturers produce,” Hunt asserts. “They have to the problem with alternatives to Bisphenol demand stricter standards.” A is that some are simply modifications of Bisphenol [which she also refers to as ut parents, particularly those who as‘sister molecules’] like BPS or BPT, which sume they are informed and conscihave the same harmful properties.” entious, can get bombarded learning The biggest roadblock to reform, Hunt about all the potential hazards. says, is at the top of the environmental “My daughter can’t drink milk, and and political action food chain: the federal rice milk allegedly has arsenic in it … so government. does tap water, for that matter,” says Nor“We need to update our Toxic Chemiris. Then there are phthalates and lead in cals Act, and we need chemical testing toys, pesticides in fruits to be overhauled,” she says. “They are no longer adequate and vegetables, and mer… There are so many chemicury in farmed fish. from the puzzle on page 13 cals that come into the market, “I will proceed with 15 = I; 9 = L; 10 = S and with our current guidecaution, and try to reduce her exposure to other lines, the onus falls on the government to test for harm, rather than on possible carcinogens. We try not to not eat the manufacturer to demonstrate safety.” prepacked, processed foods … and to keep The Environmental Protection Agency, as plastic-free and fresh and organic as for example, has been scheduled for years possible,” says Norris. “But I’ve been feeding her organic applesauce out of squeezy to screen nearly 80,000 chemicals for “encontainers that may be coated with BPA.” docrine disruption,” in the hope of creating Norris pauses. “It could be a full-time job a “chemicals of concern” list. It would have

B

CODEWORDS: HINT

investigating the optimal way to take care of all the eventualities and possibilities,” she concludes. Hunt admits that she often struggles with the same sense of helplessness and the overwhelming nature of the problem. “I don’t like to talk to parent support groups, because it’s not a happy story … There’s no escape from toxic chemicals,” which Hunt refers to as a cost of convenience. “But we can at least be safer,” she says. “I tell them, ‘No plastic in the microwave. Not ever.’ And if plastic is showing wear and tear, then it’s starting to leach chemicals.” Hunt isn’t hopeful about the prospect of alterations in product manufacturing without a consumer mandate. “The plastics industry isn’t going to touch” the data, media attention, or public response from the MJ piece, Hunt says. “They’ll let it die a peaceful death. Their job is to convince consumers there is still doubt about the harmful effects.” Still, Hunt continues to trust that eventually science will prevail. “The development of safer materials is coming over the long haul,” she says. “We are evolving; I have to keep telling myself that.” n

INHealth

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Amy Simmons says her work is about giving patients options. STEPHEN SCHLANGE PHOTO

INNOVATION

Empowering Patients A patient advocate offers help navigating the health care maze BY ANNE McGREGOR

A

health crisis can feel like a slowly unfolding nightmare. Health care providers can be frustrating to reach, formulating the right questions can be difficult and the answers can get lost in a haze of emotion and fear. “My family was falling apart,” says Osha Semple, now 31, from her home in New Orleans. “My mom’s crying, my dad’s cussing on the phone,” she recalls. Months earlier, Semple had been visiting her family in Coeur d’Alene when a flare-up of a chronic disease stranded her far from her own home. She endured a lengthy hospitalization, multiple surgeries and then a stint in a nursing home. When an infection

set in, she was headed back to the ICU and faced additional surgery. “We were all feeling really overwhelmed, like there was nobody in our corner,” she says. A family friend urged them to contact patient advocate Amy Simmons, who owns Wayfinders, the first independent patient advocate service in the Inland Northwest.

I

n 2010, patient advocacy was named a “career of the next decade” by Kiplinger’s Personal Finance magazine. “The goal of patient advocacy is to remove barriers to care by giving patients more choice and control in their health care decisions,” says Io Dolka, the executive director of Wash-

ington State Health Advocates Association. The profession has many facets — from helping educate patients and their families about a medical condition, to coordinating care and preventing unnecessary duplication of diagnostic procedures, to researching the options for therapies and second opinions, to dealing with financial concerns, perhaps through auditing itemized bills and comparing them with medical records. Whatever form advocacy takes, Simmons sees her role as empowering her clients to take charge of their own health care. Most of them have a chronic disease or are going through a major medical crisis. “They feel like they’re up against a wall.

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They’re so sick and so discouraged they don’t know what to do,” she says. After a consult with a potential client, Simmons helps figure out what the immediate goal is. “Then we gather information. If we need medical records gathered from different facilities, that would be something I would do. We can identify their support systems, figure out who they want in their process. If they have a sibling or a parent or a child across the country that they want involved, we can set that up. Then we plan for steps to get us toward the goal, whether preparing for a doctor visit, or researching a disease or therapies,” says Simmons. An advocate can help a client prepare for a doctor visit — prioritizing questions to make the best use of the allotted time, as well as accompanying the client to the visit and taking notes. Gathering peer-reviewed pertinent research, finding sources for second opinions, and deciphering the content of a patient’s medical records are all within an advocate’s purview. What advocates won’t do is tell a client what to do. “That is in our code of conduct. We do not make medical decisions,” says Simmons. “We give options. We give maybe

more options than what you knew were there. There is supposed to be an emphasis now on shared decision-making in patient care. We facilitate that,” she says, noting that she has yet to encounter resistance to her presence from a local provider. “I don’t have an affiliation with any facility or provider. I can go with you anywhere you want. I don’t work for anybody else except for the patient,” she adds.

R

ight now, there’s no official accreditation for advocates. Simmons has 16 years of experience as a radiology technician, as well as a bachelor’s degree in radiologic sciences. She also received a certificate from the Harold P. Freeman Patient Navigation Institute’s patient advocacy program. But researching an advocate’s background and credentials is currently a patient’s job. Another issue for patients is paying for the advocate. Insurance does not cover advocacy; Simmons negotiates a fee schedule with her clients. Dolka says that in addition to working toward national accreditation standards for advocates, the association is pushing for insurance reimbursement at some point in the future. “We strongly

believe advocacy services are a health care delivery innovation with potentially big returns for health care systems and health plans,” she says. As for Semple, she has mostly recovered from her illness. Ultimately, she asked Simmons to research getting a second opinion on her condition before she committed to another surgery. The second opinion led to new options and a relatively speedy recovery. But the extended time away came at the cost of her job working with troubled teenagers, and she is now trying to find a new one. Looking back on her illness, she says, “I have to advocate for my kids all the time. I’m a pretty strong person, but when you’re so sick, you are put in this position where you’re kind of an island unto yourself.” Hiring an advocate “was the first step in me finding my voice and my empowerment, and realizing I am paying them, and this is my life. She was the person that helped me organize that, and feel like ‘You can do this.’” n To learn more, read You Bet Your Life! The Ten Mistakes Every Patient Makes by Trisha Torrey. For a directory of health advocates: advoconnection.com

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LIVING BABIES

Labor Day and

Beyond The remarkable physical and emotional challenges of having a baby BY E.J. IANNELLI

Y

Baby Dane, at one week old. MEGAN KENNEDY PHOTO

ou have at least one thing in common with everyone alive today, and indeed with anyone who’s ever walked the earth: You were born. For the vast majority of us, the details of that universality are all but irrelevant. Occasionally our parents might recount the complicated deliveries that accompanied our arrival, but it’s not always easy to appreciate the intensity of those events in light of the seemingly more important outcome — that is, the simple fact of our existence. Yet that mind-set shifts when we find ourselves on the giving rather than the receiving end of the generational divide. Suddenly those protracted labors, emergency Caesareans and preterm births seem like imminent possibilities. And this despite hard figures from the National Vital Statistics System that, for example, America’s preterm birth rate has been falling steadily (as of 2010, it was under 12 percent), the need for vacuum or forceps during vaginal deliveries has plummeted (it now sits comfortably below 5 and 1 percent, respectively) and infant mortality rates are a fraction of what they were even 50 years ago (25 per 1,000 births in 1960-65, down to just five per 1,000 between 2005 and 2010). There are, however, less rosy figures to contend with. Between 1990 and 2013, the number of maternal ...continued on next page JUNE-JULY, 2014

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LIVING

“LABOR DAY AND BEYOND,” CONTINUED... deaths per 100,000 live births (called the maternal mortality ratio, or MMR) in the United States rose from 12.4 to 18.5, according to a just-published study in The Lancet. To group the countries that have seen an increase in the MMR in the past decade means putting the United States in the same company as El Salvador, Afghanistan and South Sudan. A 2011 article in Contraception magazine notes that critical childbirth situations in which the mother’s life was in jeopardy rose by 27 percent between 1998 and 2005 in the U.S. to affect 34,000 women per year.

A TOKOPHOBIC FOOTNOTE

All these statistics notwithstanding, apprehension toward childbirth is both understandable and natural. It is a major life change for women as well as men, one that brings new responsibilities, new routines, and reevaluations of our selves and our relationships. “There’s all these unknowns,” says Tine Reese, who founded the popular childbirth resource network Bloom Spokane. “Can I do it? How do I make these decisions for myself, for my spouse, for this new being? What if a home birth needs to transition to a hospital? What if an otherwise routine pregnancy turns into a Caesarean?” Some of these doubts and concerns

Clair Bennett counsels Amy Evans and Brian Rickey during a Childbirth Education Class. YOUNG KWAK PHOTO have existed for millennia. “[T]he act of birth is the first experience of anxiety,” Sigmund Freud theorized in a tokophobic footnote to The Interpretation of Dreams, “and thus the source and prototype of the affect of anxiety.” (Yes, there’s a word for fear of childbirth and pregnancy: tokophobia.) Others, somewhat paradoxically, have arisen despite — or because of — the increasing sophistication of health care. In the 25 years she’s been providing childbirth instruction in England and the U.S., Clair Bennett reckons she has never seen a level of anxiety regarding childbirth greater than the current one. “I’m stunned how fearful women are,” she says. “I have never come across such a generation of women who seem to lack such confidence in their bodies at being able to birth their child. I would have thought that over the decades, with the enlightenment and education, that women would be less scared.” The basis for those fears isn’t easy to pinpoint, given what a charged event childbirth inherently is, but Bennett has her suspicions. “I put a lot of it down to Hollywood, because when you watch the depiction of birth in TV and the movies, it would scare me,” she says. The lifethreatening rush to surgery isn’t the only depiction that the visual media offer, but the alternative nevertheless tends toward

another extreme: a stylized, sanitized version of birth, such as the impossibly glamorous arrival of Prince George last year. Certified doula Xylina Weaver agrees, citing Laboring Under an Illusion, a 2009 documentary by Vicki Elson that explored the disparity between on-screen births and the reality: “Today our only experience and awareness of birth, especially if you’re among the first of your group to have kids, is media birth. It’s an engaging, interesting, exciting, maybe funny birth, but it’s not real birth.” For Weaver and Reese, the widespread distortions of media birth are an important but tiny part of why parents, especially first-timers, might be more apprehensive regarding childbirth than in the past. This larger issue is also cultural in origin, but is more institutional than representational in its manifestation. Childbirth is “a process of … letting go, and in that vulnerable state you want to be able to wholeheartedly trust your care provider,” says Reese. “That [trust] doesn’t exist, because people know that doctors and hospitals are doing interventions because they can make money. And this is across the whole health care system, not just in maternity care. “A labor and delivery nurse I talked to this morning said almost every time a

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doctor makes a recommendation to one of her patients in labor for an intervention of some sort, the second that doctor leaves the room, they turn to her and say, ‘What do you think?’ They want a second opinion from the nurse or from their doula.” “Your average face time with most doctors is only five, six minutes,” Weaver adds. “How can you have a relationship with this person? There isn’t a lot of time for confidence-building and for having a rapport.”

SOCIAL MEDIA ANXIETIES

If basic interpersonal trust seems like a bygone, so too are the days that pregnancy preparation consisted of a well-thumbed, secondhand copy of What to Expect When You’re Expecting. Not only is a glut of information on childbirth out there, it’s instantly accessible through our TVs, magazines, and any device capable of connecting to the web. In theory, this ubiquitous, unlimited access to firsthand experiences and unfiltered advice should do more to assuage our fears than stoke them, but that’s not often the case. At the mention of the Internet, Bennett rolls her eyes and groans. “If you have an issue, don’t Google it!” She recalls one participant raising her hand to confirm a blogosphere account of an epidural that “went the wrong way,” causing the patient’s head to go numb instead. If there’s an upside to be found there, it’s that it provided a good starting point to address the many misconceptions that are passed off online as fact. “On the Internet,” Reese says, “stories

right thing to choose so that nobody will judge you. But that means you are the one who gets to decide what you want to do for your family. “We have to move away from looking outwardly. We have to be confident in our own decisions. It’s not for Facebook to decide.”

“LEARNING AS WE GO”

For their first and second pregnancies, Dave Musser and his wife Bri did consult the Internet. They even followed some advice that makes them laugh in retrospect. They took classes, too, and spoke with their large circle of friends and family. And still he admits to being “very ill-prepared and just scared to death” when it came to their firstborn. “You have no idea how a birth’s going to go, even though they tell you in the classes. We knew that it was going to be life-changing, that all our routines were going to be ruined,” he says. But as far as the birth itself was concerned, they were pleasantly surprised. “Our first was amazing. We got to the hospital at 10:30 and the baby was born by 12:45.” It was almost too easy. “When we left the hospital it was like: ‘What? We just walk out with this?’ It was harder for us to get a car than a baby,” he laughs. “For the car we had to sign all this paperwork and we were there forever. The hospital just signed us out and said, ‘See ya!’” With their second child, born this April, both the birth and the postpartum period have proven unexpectedly challenging, despite the old (and clearly erroneous)

“Information is good, but you want it in the right doses and from the right sources. Otherwise it’s turning a little nervousness into an over­-the­-top fear.”

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— TINE REESE either tend to be horrible outcomes or, ‘I had no pain, it was beautiful, in a candlelit setting.’ Guess what? For 99 percent of us, our births are somewhere in the middle.” Social media, adds Weaver, merely compounds the issue by adding oldfashioned gossip to urban myths. “With our access to personal information, you know who’s cloth-diapering and who’s using disposables, who vaccinates and who doesn’t, who’s formula-feeding and who’s breastfeeding. I tell my classes: ‘You will be judged.’ By in-laws, by friends. There’s no

chestnut that everything comes easier after the first. The baby was stubbornly breech, which required a scheduled Caesarean. In the weeks that have followed, he’s had difficulty feeding and has struggled to regain his birthweight. “My wife does have this picture in her head: how giving birth, how breastfeeding, is going to look. She wants it to be a certain way, because that’s how it’s supposed to work, right? “I think Bri feels like she’s failed,” he ...continued on next page

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LIVING “LABOR DAY AND BEYOND,” CONTINUED... says, “because she’s trying really hard, and she’s doing everything, and then he’s just not eating. And it’s kind of the same with the C-section, too. She was very scared, and it was a hard pill to swallow. She didn’t want to have to go through a surgery. Maybe it’s just me being insecure, but it feels like we’re being judged by people: ‘You’re doing it wrong.’” Musser, however, is resolutely upbeat. True to his calling as a part-time pastor and “spiritual architect,” a job title he proffers with a cheeky grin, he says they’ve come to regard the challenge as an opportunity for growth: “One thing Bri and I are going to take from this is that we’re not going to give advice to people unless asked. And we’re not going to show judgment towards people who have different ways of parenting. We’re all experimenting and learning as we go.” That same open-minded, inclusive philosophy is one stressed by Bloom Spokane, as well as Bennett and her colleagues at Providence Health & Services. “It’s not my job to tell anyone how to give birth,” Bennett says. “It’s my job to

Doula Xylina Weaver (left) admires Tiffany Long’s 12-day-old daughter Olivia at Spokane Midwives. YOUNG KWAK PHOTO give them all the choices so they can make an informed choice. Because even if everything doesn’t go according to plan, at least they’re familiar with the options they’re being given.” Her phrasing — according to plan — is

worth highlighting. When discussing childbirth eventualities, it’s easy to fall into the trap of saying, “When things go wrong.” Yet that not only exacerbates fears, but also implies there’s a right way to give birth. What’s more, this idea of deviating from a plan also

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speaks to the very contemporary notion of being able to manage and arrange every milestone in our lives.

EVEN THE BEST-LAID PLANS…

Megan Kennedy and her husband Rob are unabashed planners. They have to be. In operating Rogue Heart Media — a video production and photography company that specializes, coincidentally, in documenting life milestones — out of their home, they have to schedule assiduously to maintain a suitable work/life balance. “I feel like I did everything I could to not be fearful, whether it was the books I was reading or the people I was confiding in,” Megan says, describing her pregnancy with Dane, their first child, born this past February. “I actually took a Tibetan meditation course, trying to gain some additional skills on mental strength and focus. That made a huge difference in my pain management.” She and Rob opted for a home birth for several reasons. One was the “pragmatic” concern over cost. “Because [the hospital] billed in three different sections — at the beginning, the middle and the end — it would have meant meeting our deductible

twice in full.” Another was her mother’s disconcerting experience with Caesarean section, which had been necessary to birth Megan and her twin sister. Another was the “impactful” 2008 documentary The Business of Being Born. Finally, “the whole hospital environment seemed very uncomfortable. I was worried that [my labor] would be drawn out if I were in a stressed state of mind.” Despite her best-laid plans, Kennedy’s labor proved to be anything but quick. Contractions began early on a Monday morning and continued without progress until Wednesday evening. By the time they hit the 60-hour mark, the attending midwife, doula and family members calmly informed her that they’d decided to transfer her to a hospital. Roughly eight hours and one epidural later, their baby finally was born. Throughout it all, despite her physical exhaustion, Kennedy says she generally felt at ease with things, if not exactly wholly in control of the situation, thanks to her close-knit support group and her advance preparation. “All in all, the part that I was most nervous about, more than the labor, was

what it would be like to have a newborn in the house. I’d never been around babies that much. They always looked so fragile, and I hardly had any exposure to holding them. But everyone says it’s different when you have your own, and it’s true. I couldn’t believe how easily Dane assimilated. It’s two months and we’re like, how did we ever live without you?” Kennedy admits that the adjustment, though smoother than anticipated, has prompted them to rethink their plans for a large family. “It’s mostly just how big of an impact it is on life. We already have our hands full with one, and are having a hard time imagining what two would be like,” she says, while acknowledging that they felt an added personal and professional obligation to resume work quickly. As an instructor, Bennett says it’s important for her to give people, even those as tenacious as the Kennedys, “permission” to fall short of their own expectations during the postpartum period: “It doesn’t matter that the floor needs vacuuming. You’ve got the rest of your life to split an atom, the rest of your life to run a marathon. You will have a beautiful baby. You don’t have anything else to prove.” 

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LIVING

Hay J’s Chef Patrick Fechser lets top-notch ingredients shine in his culinary creations. YOUNG KWAK PHOTOS COOKING

Family Man in the Kitchen BY CARRIE SCOZZARO

F

amily is rarely far from Chef Patrick Fechser. Hay J’s, the wildly popular Liberty Lake restaurant he opened with his mother Rhonda Entner in 2006, is named after Fechser’s two children. Brother Jeramie Entner is sous-chef there, while sister Natasha Nixon works the front of the house with Rhonda. Yet another family member — Fechser’s uncle, Martin Dean (Rhonda Entner’s brother) — is involved on the business side in management. As busy as he is, Fechser still likes to keep things simple. “Simple and fresh cooking, if done with perfection in mind,” says Fechser, “can be accomplished by anyone if they put their mind, heart and soul into a dish.” It’s a kitchen philosophy he’s honed for more than 20 years, most of them learning

on the job at the former Percy’s Cafe Americana in Spokane Valley. What excites the 39-year-old chef is creating “an atmosphere and dialogue about great food, great wine and great experiences through dining.” It’s that kind of approach that has made Hay J’s Bistro a hit with cuisine often described as New American, featuring dishes like goat cheese and fig crostini, a seafood Cobb with langoustine, blackened ahi and Gorgonzola, and a chicken Marsala risotto. Besides seasonal, fresh ingredients, Fechser gets inspiration from the rare, precious mini-vacations he takes with family. A recent trip to San Francisco’s famed Scala’s Bistro has him thinking about risotto. Located in an not-exactly-picturesque spot adjacent to a gas station just off Interstate 90, Hay J’s is nonetheless foster-

ing spin-off business ventures. In addition to their nearby Eau de Vie wine shoppe (opened in 2011), Fechser, his mother and cousin Eddy Rogers recently added yet another new venue — Butcher Block — which Fechser says will allow them to enhance their reputation for fresh, seasonal cooking. Butcher Block, explains Dean, has the ability to bring in seafood from throughout the Northwest, and from Hawaii via nextday air. Don’t be surprised, says Dean, if Butcher Block items show up on Hay J’s menu. When Fechser isn’t in the kitchen, he’s likely to be found doing something physical: racquetball, softball, football, paddleboarding on Liberty Lake, or playing with his two Labradoodles. And of course he spends a lot of time with family. n

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RECIPE

Halibut with Rocket Salad High in vitamins A and K, arugula (also known as rocket) is bright and peppery. Chef Patrick Fechser’s recipe is a variation on Hay J’s Rocket Salad, and he chose the halibut because it’s simple to prepare — something he and his kids typically eat at home.

ROCKET SALAD 12 ounces arugula 6 ounces shredded Parmesan cheese 1 cup diced tomatoes, heirloom if possible 2 tablespoons capers, drained ½ cup Kalamata pitted olives, rough chop 6 anchovy filets, rough chop ¼ cup fresh-squeezed lemon juice ¼ cup + 2 tablespoons extra virgin olive oil Freshly cracked pepper and sea salt 2 tablespoons pine nuts, raw 1. Combine first six ingredients in a large mixing bowl. 2. Mix lemon juice and olive oil. Toss with salad mix just before serving. 3. Season with salt and pepper and top with pine nuts.

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LIVING

PARENTING

Mobile Generation With more and more kids using smartphones and tablets, how can parents make sure it’s a good thing? BY LISA WAANANEN

I

n the video that went viral, a toddler with a magazine happily taps its glossy pages with a pudgy index finger. She taps it again, perplexed, then tries swiping all her fingers across the page. Nothing happens. Is it her finger? She presses her finger into her leg to make sure it’s working. Yep, that works. She taps again and looks up at her parent, at a loss. Even before she’s learned to talk, this baby has spent enough time with a touch screen that she assumes a magazine is a broken iPad. When that video hit the Internet in 2011, only 10 percent of children under 2 had used a mobile device. Just two years later, that figure jumped to 38 percent. The percentage of kids 8 and younger who’ve used a mobile device nearly doubled from 38 percent to 72 percent in that same time,

according to a survey by Common Sense Media, a nonprofit that assesses the effect of media on children. “I’ve never seen a new medium take hold among little kids this fast,” project director Vicky Rideout said in a press release announcing the new numbers. “As many little babies and 1-year-olds have used smartphones or tablets today as all kids under 8 had done just two years ago.” The market has responded with a huge variety of apps geared toward kids of all ages, many of them educational and designed for developing minds. But pediatricians and child development specialists have long warned against too much screen time for children — for kids under 2, the American Academy of Pediatrics still recommends none at all. Most of the studies

linking screen time with attention problems and obesity have focused on television, however, and researchers are only beginning to examine the many ways we engage with our various smaller screens.

S

o how much should parents worry? Are mobile devices revolutionizing the way kids learn, or turning them into gadget addicts? Is using a device an essential skill in the modern world, or something parents should limit? Studies eventually will tell us more, but children today can’t just wait 20 years for the results to come in. So the Center on Media and Child Health at Children’s Hospital Boston offers recommendations on media from a pediatrician’s perspective, based on what’s available now. They say the important thing is not the

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specific device or amount of time, but how it’s being used. “What we like to focus on for any type of media use is mindfulness: What are you trying to accomplish?” says Lauren Rubenzahl, Center on Media and Child Health program administrative manager. The center encourages parents not to think in terms of limits, but about all the positive activities that a child needs in their day. Take a toddler’s day, for example: They already sleep through a lot of it, so their waking hours should be used to interact with caregivers and learn about the world through hands-on play. That doesn’t leave a lot of time for passively sitting in front of the TV. For older kids, it’s the same idea: Physical activity, schoolwork and socializing should take priority. Research shows that having the TV on while doing homework makes it take longer, Rubenzahl says, and even adults can benefit from the corresponding rule of thumb: If media use is getting in the way of what you’re trying to accomplish, it’s time to turn it off or put it away. That’s similar to how some Spokanearea classrooms are integrating tablets without letting them become a distraction.

“The strategy is: Get it out when you need it, put it away when you don’t,” says Kristin Whiteaker, director of Instructional Technology for Spokane Public Schools. The district is only beginning to use mobile devices in classrooms, but teachers have so far reported that students are more engaged when they’re used during lessons. In January, the district did a full analysis of nearly every device on the market, and found that Windows 8.1 devices worked best with their existing curriculum and network. And that’s the goal — the district already provides a lot of resources online and recommends some other free educational apps and sites. Making all of that easily available to students will empower them as they learn “As students are struggling or figuring out a problem, they can go to those resources for homework help,” Whiteaker says. In the latest survey from education and technology nonprofit Project Tomorrow, more than half of middle- and high-schoolers say they want to be allowed to use their own mobile devices at school to help with schoolwork, and a quarter of middle-schoolers say they’ve played a game

outside of school time specifically to learn something.

B

ut how’s a parent supposed to know whether their child is learning or just playing games? The Center on Media and Child Health recommends that parents sit down with their kids and ask them to show how they’re using the device. If a child is playing a game, a lot of times they’ll be better at it than a parent who tries it out — and that’s a good thing, Rubenzahl says, because it can be fun for kids to demonstrate mastery and teach their parents. But it’s also an opportunity for parents to see and discuss the content. If kids are drawn to shooting games, for example, parents can ask kids how it makes them feel and help them see how it relates to real life. Parents should stay involved and curious about how their kids are using devices, Rubenzahl says, and shouldn’t be afraid to set boundaries even if they don’t fully understand the device themselves. “We really encourage parenting in the digital space,” she says, “even when kids know the technology better than the parents.” 

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LIVING

Jan Love of Spice Traders Mercantile says there are unlimited combinations of tea to make you feel better. STEPHEN SCHLANGE PHOTOS ALT MED

Sip Away Concoct your own tea blends and enjoy health benefits while you’re at it BY LAURA JOHNSON

S

he’s attempting to conceal the bitter tang of the dandelion leaf. Dashes of powdered vanilla and honey are spooned into the bowl, nearly covering the dried green leaves. Mixing the herbal tea, Erin Heuvel explains that dandelion leaf is excellent for your liver; it’s just hard to swallow without masking agents. We’re at Spice Traders Mercantile in Spokane Valley, which provides an in-store station where anyone can mix their own tea and make their own essence. Every couple of months, the store offers a class to educate people about tea and tea blending. Jan Love, who co-owns the business with husband Bill Coyle, says those who attend these seminars are there to learn about flavors or the health benefits of tea. “We brew up highly concentrated herbs or components, so participants can taste

them and know what they’d like to put in their mix,” Love explains. “Who’s ever had hawthorn leaf? You wouldn’t put that in your tea unless you tried it first.”

A

fter water, tea is the most consumed beverage on the planet. Yet America is a coffee-soaked nation — 83 percent of adults in the country drink it, according to a 2013 online survey by the National Coffee Association, making the U.S. its largest consumer. “It’s because we threw it all in the Boston Harbor,” Love jokes about why Americans don’t drink as much tea as they do coffee. The steadfast packet of Lipton Orange Pekoe tea represents a bag of boring to many, but the beverage it creates is healthier than coffee.

“There’s more caffeine in coffee, and chemicals [are] used in processing the beans,” Love explains. “Where teas are oxidized using air, fermenting or drying, more natural tendencies than most coffee beans. The less processing the better, in my book.” The trick to further enjoying the health benefits of tea is exploring flavors that excite the palate while learning how to brew the beverage correctly. Black tea is more appetizing to many Westerners than green tea, but Love says that probably has to do with how green tea is steeped. (See “Steeping Guide.”) “You want to wait a minute after the pot has boiled for it to cool a little,” Love suggests. “Then only steep the leaves for one to three minutes. It’s not like black tea that gets darker when it’s done. Follow this, and your green tea will be smooth.” Six types of tea are made from the leaves of the tea bush (Camellia sinensis) mostly grown in Asia: black, green, white, yellow, oolong and Pu-erh. Herbal tea, often healthy in its own right, doesn’t use tea leaves, instead relying on aromatic plants, berries and spices. Tea leaves naturally contain more than 20 amino acids, the water-soluble vitamins B2 and C, and have been shown to stave off heart disease and some types of cancer. While all varieties

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TEA STEEPING GUIDE BLACK

1 tsp. 190-209 degrees 3-5 minutes

GREEN

1-2 tsp. 170-190 degrees 1-3 minutes

OOLONG

1-2 tsp. 160-180 degrees 1-3 minutes

from the tea plant offer antioxidants, which help cleanse the bloodstream of free radicals, green tea offers the highest concentration and also has been shown to improve bone density in older women, according to a study in the American Journal of Clinical Nutrition. Because of these benefits, Love says downing two to four cups of tea per day is just fine. She and Heuvel admittedly sip tea all day long from various brews while working. Love says loose-leaf tea is often the way to go for the freshest, most healthful results — not those pre-packaged bags you’d find in the tea and coffee aisle of the grocery

WHITE

2+ tsp. 150-170 degrees 1-2 minutes

YELLOW

1-2 tsp. 170-190 degrees 1-3 minutes

store. That means using an infuser of some kind to brew the tea, which may seem more cumbersome than pre-packaged envelopes but allows one to better dictate their desired flavor profile. Since Love opened her spice shop three years ago, she says people come from all around the area for high-quality tea ingredients; meanwhile, the Tea Association of the USA has found that more Americans are enjoying loose-leaf teas today than ever before. Even Oprah loves tea. She recently announced a partnership with Teavana that puts her name on a special blend of chai tea (a spiced black tea) that will be sold at Starbucks.

PU-ERH

1-2 tsp. 190-209 degrees 2-5 minutes

HERBAL

1-2 tsp. 190-209 degrees 3-5 minutes

E

rin Heuvel, who works at Spice Traders, names her blend “Garden Stroll.” Drinking the reddish-purple dandelion herbal tea blend, a symphony of flavors hits the tongue: sour, sweet, grassy and earthy. She stirs in balsamic vinegar to offer more of a zing. Love explains that additional flavorings, like balsamic or a squeeze of honey, don’t detract from tea’s health benefits like cream or sugar would. “Tea is not dehydrating at all,” Love says. “In fact, it’s the opposite. Everything should be consumed in moderation, of course, but tea is perfect for quenching thirst.” n

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LIVING to get dentures. Glenn, who’s in her 50s, remembers how her grandparents had dentures that they removed every night — but that’s not the expectation of youthful grandparents today. “Certainly people in my generation and younger expect to keep their teeth,” she says.

M

Twyla-Lea Jensen flashes her new smile alongside her daughter Landyn. STEPHEN SCHLANGE PHOTO ORAL HEALTH

Older Teeth, New Smile Adults have every intention of keeping their teeth, so braces aren’t just for adolescents anymore BY LISA WAANANEN

W

hen Twyla-Lea Jensen got her braces on, she decided to surprise her family. It turned out it took more than an hour before her husband and daughter noticed. And while it felt at first like everyone she met was noticing them, that faded after a week, she says. Sometimes strangers did notice — and told her they’d had braces as adults, too. “I’m just so pleased,” says Jensen, who now has them off. “It’s improved my confidence in my smile.” Long considered a rite of passage for adolescents, braces are becoming more popular and socially acceptable for older patients. Nationwide, one in five of all patients at orthodontic offices are older than 18. Many of them are young twentysomethings, but a growing number of older adults in their 40s, 50s and beyond also are opting to invest in their smiles. “We definitely have seen an increase in

adult patients who are seeking orthodontic care,” says Gayle Glenn, president of the American Association of Orthodontists. The increase has been spurred in part by improved technology that makes braces less cumbersome, but it’s also a generational shift in what we expect from our teeth as we age. These days, 50 or 60 doesn’t seem very old. Spending a year and a half with braces still leaves decades to enjoy the benefits, from eating more comfortably on a daily basis to smiling more widely in photos at the weddings of children and grandchildren. Adults who get braces are sometimes motivated by purely cosmetic reasons, but often it’s also about prolonging the life of their teeth. Over time, issues with jaw position and teeth alignment can cause headaches, gum disease and wear on tooth enamel. For most of modern history, people who outlived their teeth simply expected

any adults remember growing up when braces required a band around each tooth — “a lot of metal,” Glenn says — and the balance tips when they see how much orthodontic technology has improved. Adult patients’ most common concerns — How it is going to look? How long is it going to take? — are not so different from children’s concerns, but they’re asking from a more complex perspective that takes into account how braces and trips to the orthodontist may interfere with work, travel plans and working with clients. Jensen says the amount of time is what sold her on the idea of getting braces as an adult — she went to Curtis Orthodontics in Coeur d’Alene for a consultation along with her daughter, and was expecting it might take three years. Instead, she was told it would take just 15 to 21 months. “Being able to get that done quicker makes it more attractive,” says Dr. Erik Curtis of Curtis Orthodontics. He’s had adult patients across the spectrum from 20 to older than 70, he says, and adult patients feel a lot more comfortable when they realize they’re not alone. The process is largely the same for adults as it is for kids, the main difference being that adults frequently have a more complex dental history. They’re more likely to have cosmetic bonding, crowns, veneers and natural wear, and are more susceptible to receding gums or other periodontal disease. A lot of times, braces for older adults are planned with more of a teamwork approach, Glenn says, the orthodontist coordinating care with the patient’s periodontist and dentist. Orthodontists say there’s no reason to downplay the cosmetic benefits, either. People who’ve been reluctant to smile for years are transformed by their new confidence in their teeth in ways adolescents may be too young to fully appreciate. Curtis recalls the rewarding experience of treating one patient, a woman in her 70s whose teeth were repositioned to accommodate implants. “At the end she was hugging me,” he says, “and almost in tears about how much it changed her life.” n Read more from the American Association of Orthodontists or find a local orthodontist at mylifemysmile.org.

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LIVING JUNE - JULY EVENTS BLOOD DONATION Give blood at the Inland Northwest Blood Center, which requires up to 200 donors each day to ensure the blood bank is adequately stocked. Donors can schedule an appointment online or donate during walk-in hours. Spokane office: Mon, Fri, Sat from 7 am-3 pm; Tue-Thu, 11 am-6 pm. Coeur d’Alene office: Mon, Fri, 7 am-3 pm; Tue-Thu, 11 am-6 pm; Sat 10 am-3 pm. inbcsaves.org (423-0151) HEAL YOURSELF, HEAL THE WORLD A new review of the Gerson Therapy, intertwining Gerson Media films with new interviews, updated scientific information, modern graphics and media from Dr. Gerson’s time. Howard Straus, an author, scientist, son of Charlotte Gerson and grandson of Dr. Max Gerson, joins via Skype following the film for a discussion. Thur, June 5, from 6-8 pm. Free. Pilgrim’s Market, 1316 N. Fourth, CdA. pilgrimsmarket.com (208-676-9730)

JUNE BUG FUN RUN The annual fun run/walk offers 3- or 5-mile courses along the Spokane River. Proceeds benefit programs of Lutheran Community Services Northwest. Sat, June 7, at 9 am. $20-$25. Spokane Community College, 1810 N. Greene. lcsnw.org (343-5020) HEAR ME RUN! A timed 5K run/walk along the Spokane River, benefiting the Spokane HOPE School, the area’s only listening and spoken-language preschool for the deaf and hard of hearing. Sat, June 7, at 9:30 am. $15-$30. Riverfront Park. hearmerunspokane.com (863-7097) BABYSITTING BASICS Youth (ages 10-15) learn skills and techniques to care for children of all ages, including CPR and first aid, discipline, personal safety and business basics. Courses offered June 7, July 12, July 23 and Aug. 16, from 9 am-2 pm. $40, registration required. Providence Sacred Heart Hospital Auditorium, 20 W. Ninth.

FIRE ON THE RUNWAY Local firefighters and models take to the runway in an annual fundraiser for the Red Cross, including a live auction, hors d’oeuvres and champagne. Fri, June 6, from 7-10 pm; after show event from 10 pmmidnight. $50/person, (+$10 for aftershow.) Lincoln Center, 1316 N. Lincoln. redcross.org (326-3330)

11TH ANNUAL PARADE OF PAWS The Spokane Humane Society’s annual dog-walk fundraiser is open to groups and individuals, offering 2- or 4-mile walks, local vendors and info booths and a barbecue. Walkers who collect $100 or more receive an event T-shirt. Sat, June 14, at 10 am; day-of registration starts at 8 am. Entry by donation and/ or pledges. Spokane Humane Society, 6607 N. Havana. spokanehumanesociety.org (467-5235 x 211)

2014 FREE STATE PARK DAYS Washington State Parks and Rec allows visitors access to all state parks without needing a Discovery Pass. Includes access to Riverside State Park and Mt. Spokane State Park. Upcoming “free” days include June 7-8 and 14, Aug. 25 and Sept. 27. parks. wa.gov (800-833-6388)

TEEN CLOSET 50 RELAY A 10-leg, 50-mile relay race stopping at every high school in the Spokane area, with proceeds benefiting the local nonprofit Teen Closet. Sat, June 14, starting at 6 am. $200-$350/team of 5-10 members. Starts at Mt. Spokane High School. teencloset.org (993-5471)

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LIVING JUNE - JULY EVENTS ZOMBIE BOG JOG POKER RUN A spectator-friendly fun run on 70 acres of zombie-infested land, with proceeds benefiting the Inland Northwest LGBT Center. Also includes a shorter, kid-friendly course for ages 10 and under, and a beer garden. Sat, June 28, at noon. $55/person, $20/kids run ($5 spectators). Cowgirl Co-op, 20424 N. Dunn Rd., Colbert. thelgbtcenter.org (499-0999) PENNANT RUN The 3rd annual Spokane Indians Fourth of July Pennant Run benefits the Wounded Warrior Project. Distances include 1K, 5K and a Little Sluggers Dash for kids age 3 and under. Fri, July 4, at 10:30 am. $15-$35, kids under 3 free. Avista Stadium, 602 N. Havana. spokaneindianspennantrun.com (343-6807) NEGATIVE SPLIT The annual half-marathon and 5K starts in Riverfront Park; proceeds benefit Boys & Girls Clubs of Spokane County. All runners receive a tech T-shirt and a bottle-opener medal. Sun, July 6, half-marathon starts at 6:30 am, 5K at 7 am. $40-$45/5K, $85-$100/half-marathon. nsplit.com (208-806-1311) SUMMER FUN RUN SERIES U-District Foundation’s annual 5K fun run series is hosted by U-District PT, offering timed runs and David’s Pizza after the race. July 8, 15 and 22, at 6:30 pm. $5-$10/adults, kids 18 and under free. U-District PT, 730 N. Hamilton. udistrictpt.com (458-7686) THE BIG KAHUNA GOLF TOURNAMENT A double shotgun tourney, followed by a reception with prizes and a silent auction. All proceeds benefit the Breathe For Gina Fund, assisting with costs for a double lung transplant. Sat, July

12, from 8 am-10 pm. $100/person. Sundance Golf Course, 9725 N. Nine Mile Rd. (466-4040) LET’S CLIMB A MOUNTAIN Create a team or participate solo in the 34.3-mile race from the Clock Tower in Riverfront Park to the top of Mt. Spokane. Sat, July 12, starting at 6 am (solo) or 6:30 am (teams). $55-$70/solo; $23$28/team member. letsclimbamountain.com VALLEY GIRL TRIATHLON A women’s-only sprint distance triathlon, with a ⅓-mile swim, 12-mile bike ride and 3-mile run. Sun, July 13, starting at 7:45 am. [SOLD OUT] Race starts and ends in Liberty Lake. valleygirltri.com JACEY’S RACE A timed 5K race/walk and 1K kids fun run benefiting local families with children who are currently being treated for cancer or other life-threatening illness. A post-race festival includes food and kids’ activities. Sun, July 13, at 8:30 am. $15-$30. Sandpoint High School, 410 S. Division Ave. jaceys-race.com (208-610-8023) LUNCH & LEARN: THE NEED FOR SLEEP Lunchtime presentation covering types of sleeping disorders, how to get more quality sleep, and why getting a full eight hours per night is important. Thur, July 17, from noon-1 pm. Free; attendees should bring their own lunch. INHS Wellness Center, 501 N. Riverpoint Blvd., Ste. 245. SUMMER PARKWAYS STREET PARTY The first annual event is a joint effort between Summer Parkways and the Emerson-Garfield Neighborhood, offering festivities, booths and activities centered around Corbin Park, which are closed to vehicular traffic. Fri, July 18, from 6-9 pm. Free. 2914 N. West Oval St. summerparkways.com

THE DIRTY DASH The 4-mile mud-run obstacle course returns to Spokane. Sat, July 19. All starting waves sold out except for 8 am. $50-$60. Riverside State Park ORV Park, 9412 Inland Rd., Nine Mile Falls. thedirtydash.com SCHWEITZER MOUNTAIN TRAIL RUN The third annual trail run offers 3.5-mile and 10-mile distances, on mostly single-track trails. The Schweitzer Music Festival takes place after the race (2 pm). Sat, July 19, at 10 am. $15-$50. Schweitzer Mountain Resort, Sandpoint. smtrailrun.com MUDDY MILES Runners compete in teams or solo in this mud-filled, 2-mile obstacle course and race, during which spectators lob water balloons. Sat, July 19, at 3:30 pm. $15-$100. North Idaho Fairgrounds, 4056 N. Government Way, CdA. muddymiles.org (208-415-0292) SPOKENYA The fifth annual 7K run/walk benefits efforts to bring clean water to Adeido, Kenya. Sat, July 19, at 9 am. $20-$35. Starts at Life Center Church, 1202 N. Government Way. spokenyarun.org (290-1036) LILAC CITY TWILIGHT CRITERIUM The downtown bike race hosted by Spokane Rocket Velo features races for all levels of riders through the streets of downtown Spokane. Sat, July 26, starting at 5 pm. Kids race (9 and under) at 6:40 pm, Citizen’s Rag Tag Rally at 7:40 pm. $30. spokanesports.org/twilightcrit ZAK! CHARITY OPEN The annual dinner, auction and golf tournament benefits the Rypien Foundation and the Boys & Girls Clubs of Spokane County. July 27 at Northern Quest; July 28 at the Spokane Country Club or Manito Golf & Country Club. zakcharityopen.org (244-8656)

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depression, couples or divorce FULL FILEPATH: issues with compassionate Advertising:Accounts:G-I:Gaela Baker:06.03.14 8th H pg Dir:GaelaBaker_060314_8thHDir Psychotherapist, Kari Joys MS. URL LINK: http://www.inlander.com

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BARE BUNS FUN RUN The nudist ranch hosts its 30th annual clothing-optional 5K fun run/walk. Sun, July 27, at 9:30 am. $18-$28. Kaniksu Ranch Family Nudist Park, Loon Lake, Wash. kaniksufamily.com (327-6833) RACE THE RIVER The seventh annual sprint-distance triathlon includes a half-mile swim with the current of the Spokane River, a 10.7-mile bike ride and a 3.1-mile run. Also includes a kids race ($20). Sun, July 27. $60-$90/ individual, $150-$210/relay team of 2-3 members. Riverstone Park, Coeur d’Alene. racetheriver.com 8 LAKES LEG ACHES The 16th annual bike ride heads through West Spokane, Cheney and Medical Lake, offer-

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ing 15-, 30-, 45-, or 75-mile routes, with the longest route passing eight area lakes. Proceeds benefit the Sexual Assault Family Trauma Response Center of Lutheran Community Services. Sat, Aug. 2. $45-$300. Starts at Group Health, 5615 Sunset Hwy. lcsnw.org (343-5020) MIDNIGHT CENTURY An annual, informal and unsupported 100-mile nighttime bicycle ride on dirt roads through rural areas around Spokane. Sat, Aug. 2, at 11:59 pm. Free. Starts at the Elk, 1931 W. Pacific Ave. midnightcentury.com LONG BRIDGE SWIM Swim 1.76 miles across Lake Pend Oreille in Sandpoint in the 20th annual open-water event which helps fund swimming lessons for local children and

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LIVING

Runners during a dye throw at the post-race party at Run or Dye in Riverside State Park in May. STEPHEN SCHLANGE PHOTOS TRENDS

Colors That Run Non-traditional races add a playful element to exercise BY CHEY SCOTT

O

ff in the distance a haze of neon pink dust rises up like smoke into the ponderosa branches. Closer, a crowd wearing mostly white and combinations of Dayglo neon presses forward, waits for a countdown from five, and then bursts forth toward the pink cloud. Later, as those same runners begin to emerge from the treeline of Riverside State Park near Seven Mile, their faces, clothes, hair and skin are transformed into a tie-dyed rainbow palette. They’ve just finished the Run or

Dye 5K, a jubilant, untimed 3.1-mile run through the park’s wooded trails. Unlike more traditional road or trail races, participants were willingly dusted and sprayed along the course with biodegradable, foodgrade corn starch powder dyes in bright hues of blue, green, orange, pink, purple and yellow. Themed, non-traditional races like Run or Dye and similar 5K “color runs” are part of a growing national fitness trend that’s estimated to have attracted 4 million

participants just last year. That number had grown from the low six-figures in just the past five years, according to Running USA, a nonprofit, distance-running industry tracker. Popularity of alternative 5Ks has increased so much in that time, they’ve now surpassed the number of participants in traditional half-marathon and marathons, combined. Other types of alternative races in this non-traditional race boom combine color runs’ elements of fun and social interaction with outrageous tests of physical endurance and courage — jumping over fire or crawling under electrified wires — in obstacle and mud runs, like the Warrior Dash, Tough Mudder and the Spartan Race. Some of these more extreme races, which feature obstacles similar to military endurance training courses, have recently been criticized for a lack of safety, resulting in serious injuries and even death. Organizers of those races have responded to media by saying race participants are required to sign

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waivers of liability, and always have the option to bypass any obstacle on the course. The Inland Northwest, however, hasn’t yet hosted one of those extreme obstacle races. Here, the popular Dirty Dash, a toned-down version of these mud runs, is set for July 19, and has already sold out all but one of its start times. That same day, the Kootenai County Fairgrounds hosts the locally organized Muddy Miles, a family-friendly mud run that raises funds for the nonprofit health-care programs at Heritage Health and the Kroc Center.

R

unners who share pictures of themselves covered head to toe in dye or globs of mud on social media have helped ignite the trend, Running USA found. Other than the apparent social element, it’s largely the sense of achievement and physical challenge for many first-time 5K runners that’s made these non-traditional races so successful. About 1,500 people turned out for Run or Dye’s first event hosted in Spokane in early May, including first-time 5K runners Emily Frank and Monika Ide, both 24. The women saw people talking about the event on their Facebook feeds and decided to sign up. The night before the race, they decided to create colorful tutus after seeing some of other participants’ elaborate outfits, from furry leg warmers and neon tights to superhero costumes. Now that the friends have conquered their first 5K together, they say they’re already eager to try a 10K, and maybe even a half-marathon. “We find that a lot of people who participate are first-time runners,” says

Run or Dye’s communications director Katie Langston. “The experience of getting covered in color is so outside your normal, everyday life. People really love it, and they use [their experience] as a goal and inspiration to get fit and to be their best selves.” Fireplace Center • Heating & Cooling The Salt Lake City-based company Outdoor Living • Sales that organizes the • Service race, Viral Events, • Installation held its first color race back in March 2013, and has since hosted more than 150 events across the U.S. and Canada, says Langston. It recently announced a new color race series in the UK, and plans Turn to the Experts at to continue expandFalco’s for all your ing its events across Air Conditioning & the world. Furnace needs Run or Dye joins 4th Generation, Family Owned several other color Serving the Inland Northwest Communities run series in the growfor over 80 years! ing and highly-competitive fun run mar9310 E. Sprague Ave • 509.926.8911 ket, with each trying www.falcospokane.com to stake out its claim in being unique or the “happiest” event of its kind. There’s also the Color Run and Color Me Rad, both of which are hosting FILENAME: AD SIZE: PUB races in the Spokane area later this summer. FALCOS_060314_6THPG 6TH PG V INH Despite the originality claims, all three are PUBcornstarch DATE: AE: AA MODIFIED: similar in using the same powDS: JS DK FRIDAY, 5/23/2014 - 3:23PM dered dye, being 5Ks, 06/03/2014 and culminating with rave-esque festivals of FULL club music and blasts FILEPATH: Advertising:Accounts:D-F:Falco's Fireplace and Spa:06.03.14 6th pg:Falcos_060314_6thpg of more colored powder into the crowd. URLalso LINK: All three for-profit series partner with local charities in each http://www.inlander.com host city to donate a Restore Your Vitality portion of the race proceeds. Langston says the inspiration for Run offering... or Dye, as well as other color runs, comes Functional Medicine from the Holi Festival in India, a Hindu spring celebration dating back thousands of Hormone Balance years that’s recently been embraced in nonMetabolic Assessments Hindu cultures for its message of spreading love — and color. Nutrition Counseling “I think there is something profoundly moving about that,” she says. “You embrace Free 20 Minute Consults the present moment, and the color is a symbol to throw away bad feelings and ‘live life in full color.’” 

Aging Gracefully

UPCOMING NON-TRADITIONAL FUN RUNS COLOR ME RAD: June 14, Spokane County Raceway ZOMBIE BOG JOG: June 28, Cow Girl Co-Op DIRTY DASH: July 19, Riverside State Park MUDDY MILES: July 19, Kootenai Fairgrounds BARE BUNS FUN RUN: July 27, Kaniksu Ranch

THE COLOR RUN: Aug. 3, Downtown Spokane THE SLIME RUN: Aug. 23, Spokane County Raceway IN YOUR FACE MUD RUN: Sept. 13, Spokane County Raceway HAPPY GIRLS RUN: Sept. 27, Riverside State Park

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INHealth 6/2014