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InHealthNW September-October, 2012


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InHealthNW September-October, 2012


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September-October, 2012

T H E I N L A N D N O R T H W E S T ’ S H E A LT H M A G A Z I N E

in this issue GUEST COLUMN Finding gender health equity


PA R E N T I N G Caring for preemies


NEWS Workplace safety; PAML plans


55-PLUS Battling back pain


I N N OVAT I O N Teaching girls about relationships


EXERCISE Train to prevent injury


W O M E N ’ S H E A LT H Why are women so tired?


CALENDAR Health events through October


FOOD A healthy fall dessert


PEOPLE Giving blood — a lot of blood


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But there’s a limit to what coffee can accomplish. Lately it seems more and more otherwise healthy women — often juggling a career and kids — have been telling me how utterly tired they are. In our special section this issue, Dawn Picken takes an in-depth look into what may be causing all that fatigue — and finds ways to energize your life. One place where coffee is indispensable is on the worksite, where America’s construction workers build new buildings and renovate old ones. These (mostly) guys need to be alert, as it can be dangerous work. On-the-job injuries and deaths are down in Washington state over the past decade, and Joe O’Sullivan has a report on a new program we can thank. No, it’s not free coffee; it’s an innovative new workplace safety program happening right here. Still, you better have another cup of coffee — just to be safe. To your health!

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Health statistics show Spokane — like most places — has health inequities holding many back B y k i m pa p i c h Public Information Officer, Spokane Regional Health District


e’ve all heard the old adage: The of the job market altogether. Thus, in Spokane Spokane area is a great place to County, 50 percent of children with a single mom raise a family. Central to this are living in poverty. statement is a belief about our Poverty often cuts off access to the resources that residents’ health as a resource improve health while limiting treatment options that enables our community to achieve its fullwhen women and their families become sick. To est potential. But the Spokane Regional Health translate that locally, in Spokane County, lowDistrict’s recent report, Health Inequities in Spoincome parents are 17.4 times more likely to rate kane County, paints a different picture of the town their child’s health as “fair” or “poor” than parents where I was born. In reality, health inequities are earning an average income. Our data also show affecting the lives and futures of people all over that babies born to mothers who do not finish high the world. Spokane is no different. school are 2.5 times more likely to die before their So what is health inequity? We define it in our first birthday than babies born to mothers with a report as “differences in a population’s health that bachelor’s or advanced degree. It becomes clear can be traced to unequal economic and social conthat these imbalances between men and women ditions that are systemic can prevent women from and avoidable — and thus exercising control over sound off inherently unjust and untheir own health. The first of five community dialogues fair.” It’s a pretty complex These circumstances on the findings of the Spokane concept. forever affect the health For me, I think of it as of their children. Regional Health District’s new study particular groups of people So here I am, a mother will be Wed., Oct. 10, at 6 pm at the having poorer health than telling my children it’s up East Central Community Center, 500 the rest of us. to them to reach their full S. Stone St., Spokane. Subsequent Maybe you’re like me potential. But in reality, dialogues will be conveniently located and made a mistake right their potential is affected throughout Spokane County. For more out of the gate by assumby my education, my ininformation, visit You ing health inequity had to come, my race, my sociodo with limited access to economic status. In turn, can access Health Inequities by going quality health care or inmine was affected by the to: Although that’s social, economic and enData/HealthInequities-2012.pdf. a contributor to health invironmental conditions I equity, it’s only one. There was raised in. are many factors — we call them determinants — that It’s actually a common misconception about affect health. Things like place of residence, race, well-being — that health is a matter of making good religion, education, socio-economic status and choices. If there is one thing I hope you take from social capital. For this special Women’s Health this editorial and the Health District’s report, it’s issue of InHealthNW, I’ll focus on one of the more that you begin to see how health outcomes are pervasive: gender. inextricably linked — for better and worse — to Women are more likely to face health inequities the social conditions that surround and shape simply because our biological make-up demands our lives. more care. Pregnancy and childbirth are life events Now, bolstered by data from Health Inequities in that expose women to greater risks. Spokane County, Spokane has a unique opportunity Women also tend to earn less than men regardto join in a nationwide effort toward health equity. less of occupation. In Spokane County, average The health district and its partners will begin hostearnings for men in 2010 equaled $46,707; for ing a series of community dialogues starting in women the figure was just $30,926. October to engage the community in our efforts Single moms are especially at high risk of enterto develop, implement and evaluate intervening poverty because of these generally lower wages tions. The views and voices of local women, of — and because the difficulty in finding affordable all residents, will be critical to our efforts. Please and high-quality day care can force women out plan on attending. n

InHealthNW September-October, 2012

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InHealthNW 9 S. Washington St. / Spokane, WA 99201 PHONE: 509-325-0634 EDITOR Anne McGregor MANAGING EDITOR Jacob H. Fries ART DIRECTOR Chris Bovey CALENDAR EDITOR Chey Scott PHOTOGRAPHER Young Kwak CONTRIBUTORS Luke Baumgarten, Kevin Blocker, Lisa Fairbanks-Rossi, Heidi Groover, Scott A. Leadingham, Joe O’Sullivan, Kim Papich, Dawn Picken, Stephen Schlange, Patty Seebeck, Chris Stein, Daniel Walters PRODUCTION MANAGER Wayne Hunt ADVERTISING SALES MANAGER Tami Booey DIRECTOR OF MARKETING Kristina Elverum ADVERTISING SALES Jann Harris, Kristin Wagner, Carolyn Padgham-Walker, Bruce Deming, Emily Walden, Jamie Albertini, Jean Russell, Kevin Kunz, Michael Daubel SALES COORDINATION Alanna Spencer, Rebecca Rison, Angela Rendall DESIGN AND PRODUCTION Tom Stover, Derrick King, Alissia Blackwood DISTRIBUTION MANAGER Trevor Rendall

collaboration innovation collaboration drives innovative health care

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


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

InHealthNW is published every other month and is available free at more than 500 locations throughout the Inland Northwest. Subscriptions are available and cost $2.50 per issue. Call x213. InHealthNW welcomes guest columns, either by mail or e-mail ( Include name and daytime phone number. REACHING US BY PHONE: EDITORIAL: x261; CIRCULATION: x226; ADVERTISING: x223. COPYRIGHT All contents copyrighted © Inland Publications, Inc. 2012. InHealthNW is locally owned and published by Inland Publications, Inc. Inland Northwest Health Services (INHS) is a non-profit corporation in Spokane, Washington providing collaboration in health care services on behalf of the community and its member organizations Providence Health Care and Empire Health Foundation.


September-October, 2012

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A New Lifeline


ou can tell a lot from an ECG. Those up-and-down lines — waves, intervals and segments — reveal the secrets of your heart. The electrocardiogram can detect the effect of a pacemaker or highlight the impact of drugs. It can show the rhythm and the rate, detecting irregularities and abnormalities. It can even indicate the size of your heart. And, perhaps most importantly, it can show a heart attack. During a heart attack, time is everything. With each passing moment of restricted blood supply, the heart muscle is damaged. That’s why the sooner treatment starts, the better. “You can recover faster. You can have a more meaningful life and a more normal life,”



says Adam Richards, director of emergency services at the Deaconess ER. “Every minute counts.” Fortunately, Richards says, new technology allows ECG readings to be beamed directly from the ambulance to the emergency room. As technicians on-board use a defibrillator, the device records six seconds of ECG readings. All they need to do is press a button and the information travels the same way a texted picture

Lo-Cal, Not Lo-Alcohol

ast those few years of reckless college experimentation, the savvy drinker knows her limits. She knows precisely how much she can drink without overindulging. She knows how long after a beer she’ll have to wait before it’s safe to drive. But occasionally, no matter how experienced the drinker, certain drinks can turn everything topsyturvy. That was the problem with caffeinated alcoholic drinks like Four Loko — the stimulating effects of the caffeine overwhelmed the drinker’s ability to judge precisely how drunk they really were.

Now studies have pointed to dangers of a more subtle kind: diet alcoholic drinks, for example a rum and Diet Coke. Most people know that it’s a good idea to eat while drinking: The digestion of the food helps decrease the impact of the alcohol. But people forget that a beer has calories, too — drinking a single dark beer can be like eating three pieces of bread. Artificially sweetened diet alcoholic drinks, however, don’t have those calories. A study from the department of medicine at the University of Adelaide in Australia tested eight men

Big Whoop


he coughing continues. Back in 2009, there were warnings of a whooping cough problem. Washington state had an upswing in the numbers of cases — and the malady tends to come in cycles. But they didn’t expect an epidemic this bad. “This particular epidemic is the worst we’ve had for over 40 years,” says Spokane Regional Health District Health Officer Joel McCullough. By April, whooping cough — or “pertussis” — cases in the state of Washington had risen to epidemic levels. By June, according to the 10

on an iPhone does. At Deaconess, the ECG reading arrives simultaneously on five different computers — including an overhead monitor waiting doctors can see. It also arrives in Adam Richards’ email inbox. So as the ambulance speeds to the hospital, the team at Deaconess can begin preparing. They can ready medication and set up the catheter lab to target and treat a blockage. Emergency rooms are always looking for new efficiencies, ways to improve their door-to-cath lab time, Richards says. “It’s really made big impact in just six weeks,” Richards says of having those ECGs beamed over. He estimates door-to-cath lab time was “probably reduced by about 10 to 15 minutes.” n

Centers for Disease Control, the year’s total had reached 2,520 confirmed cases, more than a 13,000 percent increase from the same period the year before. In Spokane County, fortunately, it hasn’t been as bad as on the west side of the state. Yet in mid-August, rates were climbing, with 164 cases, including 18 new cases in one week. Nine had been hospitalized. Though vaccination rates have improved to 81 percent for kids 0-6 years old, thanks to new legislation changing the “opt-out” process, low vaccination rates continue to plague Spokane —

with a regular orange-flavored vodka and a nearly identical but artificially sweetened orange-flavored vodka. The artificially sweetened drink got the men drunker, and did it more quickly. “If there’s no other calorie source in the drink… it could possibly cause them to be intoxicated faster. It would be like drinking alcohol straight,” says Jen Ropp, a dietician for Rockwood Clinic. “It’s not enough for your tummy to work on.” Fortunately, she says there’s a simple solution to this problem. “Just don’t drink on an empty stomach.” n

just 20 percent of adults have been vaccinated, and 30 percent of 7-18 year olds. “We haven’t even distributed the vaccine we have,” McCullough says. Yet roughly half of those infected had fully up-to-date vaccinations. In 2006, the vaccine changed, McCullough explains. It went from being composed of “whole-cell” viruses ground up, to an “acellular” version that just has parts of the viruses. The acellular version had an advantage of carrying fewer side effects. But it may also be somewhat less effective. In the meantime, if your child won’t stop coughing, seek out your health care provider. And let them take a few days off from school, he says. Before the pertussis vaccine, approximately 4,000 people died in the U.S. from the disease each year. n

InHealthNW September-October, 2012

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PAML’s Next Step New CEO Francisco Velazquez has big plans BY CHRIS STEIN


rancisco Velazquez insists on symmetry. Even sitting at a huge table flanked by leather-backed chairs and a jumble of expensive video equipment, he makes sure his Blackberry and iPhone (the former for business, the latter for pleasure) are situated in neat symmetry with each other. It makes sense, in a way: As the new CEO of Pathology Associates Medical Lab (PAML), ensuring that the supply chain for his labs remains orderly and on-time will be key to growing the business. And growth is what he’s here for. “Our goal is to build the portfolio and the expertise that we need to become high-tier,” Velazquez, 55, says. “The way I like to call it is to become the premium product, premium service provider. We will have the best. We may not have the best in everything, but certainly we’re going to try.” A pathologist by training but a health care execu-

tive by choice, as he puts it, Velazquez’s path has taken him from Madrid, Spain, his birthplace, to Puerto Rico, where he was raised, to Dallas, Southern California and other places in between. He came to PAML from Quest Diagnostics, where he served as managing director and vice president of two different institutes owned by the company. PAML recruited him from there. “PAML has a lot of potential for growth,” Velazquez says. He cited its proximity to hospitals like Providence Sacred Heart Medical Center and Deaconess Medical Center as assets to the lab. “PAML is more close to where care is being provided.” Quest was a good gig, but PAML appealed to him for the chance to truly lead the company, and for the fact that it was privately owned. “In the publicly traded arena, there is a certain amount of focus on product performance and

bottom line. I’d like to take more of a longitudinal view,” Velazquez says. From their headquarters in a Spokane office park just off of Trent Avenue near the growing University District, Velazquez wants to expand PAML from a regional entity to a national one. Though they already have labs in Kentucky, New Jersey and Pennsylvania, Velazquez wants to expand and bring PAML on par with Quest and the Mayo Clinic in Minnesota. “Mayo Clinic has a brand identity, and one of our goals is to make sure PAML has the same kind of recognition,” Velazquez says. “Our goal is to propagate our model throughout the country.” Part of this is centralizing services. Under the program “Powered by PAML,” the company partners with hospitals to draw blood and test it on the premises. If a hospital doesn’t have expertise for a particular test, it can be sent to PAML’s lab in Spokane. They also offer direct-to-consumer testing called “Results Direct,” which allows a customer to bypass

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a doctor and order a test themselves for, say, cholesterol or hormone levels. Velazquez says they plan to expand that service nationwide. “That’s what a high-tier provider does. It doesn’t compete with the hospitals locally. It brings to the hospital access to services they cannot afford,” Velazquez says. Velazquez believes in a culture of excellence, not as a word but as a business virtue. “Excellence means, if you’re given gifts and talents, you have a responsibility to use those for the benefit of all. That’s excellence,” he says. “I think health care is probably the best example of the pursuit of excellence that you can find.” There are different ways that philosophy is manifest. One is urban renewal. Velazquez says the company plans to remodel adjoining buildings to “Mayo Clinic has a brand identity, and one of our goals is to make sure PAML has expand their office space, which will take the same kind of recognition,” says PAML’s Francisco Velazquez. MIKE McCALL PHOTO another piece of empty real estate off to be part of the urban renewal of this whole lazquez, who started his job in January, is hoping the market. neighborhood. It’s very important that we do that to sell it. He may not be moving again. “We’re going to rehabilitate that building by the because health care… and higher education are “For the next many years,” he replies, when fall, and we’re going to inaugurate that as PAML’s economic engines in many communities.” asked how long he plans to stay. “I have a lot national corporate headquarters,” Velazquez says. Though he still owns a home in Dallas, Veto do.” n “We’ve made a commitment to this area. We want


September-October, 2012

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When Work Hurts Some jobs can kill you, which is where safety management can save the day BY JOE O’SULLIVAN

Gregorio Rodriguez helps make sure construction sites in Spokane are safe. YOUNG KWAK PHOTO


hen Gregorio Rodriguez worked in construction more than 20 years ago, safety was something workers and employers hid from. When government safety inspectors dropped by the Boise area job sites where he

worked, no one wanted to give the inspectors a reason to cause trouble or issue citations. So no one worked. “You didn’t continue working until they were gone,” he says. “That’s what we were instructed to do.”

Safety regulations weren’t taken seriously. “For us it was like you didn’t really follow them,” Rodriguez says. “You just hoped you didn’t caught.” Now Rodriguez is working to see that attitude change. He’s safety manager for the Inland Pacific Chapter of the Associated Builders and Contrac-

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tors, Inc. It’s his job to help train workers and make them think about being safe on construction worksites. It’s work that matters: In the state of Washington, construction work has been causing the second-highest number of fatalities (after vehicle accidents). The idea behind consultations is that safety audits can be performed on job sites to determine what could be done to make work safer. And since Rodriguez isn’t a state inspector, employers aren’t getting fined when he finds something wrong. “There may be a hazard that they don’t see,” he says. When on a job site, Rodriguez looks for a number of things. But he has two priorities. “The first thing when I’m walking in is: Are there any fall hazards?” Rodriguez says. Then, “What is the electrical looking like?” Both of those worries are present on messy construction sites — areas with garbage and electrical cords strewn everywhere. “That all becomes a hazard when people are walking through… carrying materials,” he says. In the safety classes, Rodriguez teaches employers and workers how and why to comply with federal and state safety regulations. He enjoys getting his students to think. “I had a guy that took [a safety] class, saying too much regulation, too much regulation, too much regulation,” Rodriguez says. “A couple weeks later he calls me back and says, ‘You know, I hate you, I cannot walk onto a job site [without] finding more and more potential hazards.’ And he said, ‘I thank you for that.’”


he safety work Rodriguez and others do may just be paying off. In Washington and around the country, workplace deaths in construction and other industries have been declining. In 2002, 81 Washingtonians died on the job; in 2011, 51 died, the lowest in the past decade. (Those numbers only take into account people who died at a worksite, not people who die later in life from a condition contracted during their work.) In spite of the lingering effects of the Great Recession, which put the brakes on some of the most dangerous jobs like construction, transportation and manufacturing, there are reasons to believe


workplaces are really becoming safer. “If you were really to take a straight statistical approach, the decline in [workplace] hours doesn’t correlate with reduced deaths,” says Mandi Kime, safety director for Associated General Contractors. Though she notes her perspective as a safety director is likely skewed, Kime says she really believes the industry is making itself safer. Like Rodriguez, Kime conducts safety training sessions and workplace audits. Those tasks not only make workers safer but also serve as a mark of validation that contractors are reputable. That’s why Kime worries about informal contractors that operate outside both inspection programs and the law. Renegade contractors may be unlicensed and less likely to pay attention to the standard safety practices. And since they’re often performing jobs for cash, they’re not paying into the worker’s compensation fund, according to Kime. “Those are people who are really scary to us in the industry,” she says.


nspecting every single job is simply beyond the reach of the department’s 114 state inspectors, according to the state’s Labor and Industries spokesman Hector Castro. “We don’t have the manpower to literally inspect every workplace in the state,” says Castro. “The last stat I saw was that it would take 35 years to get to all of them.” So it is mostly up to employers to pay attention to safety. And as it turns out, safer worker places

work, including the steps needed to complete the tasks, and what possible hazards could crop up along the way. “It’s starting to become a requirement to a lot of contractors,” Kime says. Still, things can and do go wrong on job-sites. Todd Schoonover manages a federally funded accident inspection program for L&I. A portion of his work is to investigate accidents and create reports that are then sent to contractors to educate them on how to avoid a similar mishap. “It’s really developed into a broader public health program,” he says. Schoonover cites a case where a residential carpet installer died after falling out a window. The contractor doing the work “just never really thought about fall protection. [They] thought about knives and knees,” Schoonover says. L&I, however, isn’t just worried about fatalities. The department also has its sights set on reducing workplace injuries. In January it launched Stay at Work, a program to encourage employers to retrain their employees for light-duty tasks so they don’t have to take time off due to injury. The idea is to keep workers earning their full pay, saving the department from cutting costly worker’s compensation checks. As of June, 63 businesses in Spokane County have used the Stay at Work program with more than a hundred injured workers, according to Castro. As part of the program, L&I reimburses employers up to $10,000 per claim to cover part of the injured worker’s pay and help cover any retraining costs. It’s cheaper for the state because it

In 2002, 81 Washingtonians died on the job; in 2011, 51 died, the lowest in the past decade. are not just better for the employees — they’re better for business, too. Kime says a trend at construction sites toward pre-planning work helps improve worker safety, and at the same time, makes jobs more efficient. Pre-planning includes using computer modeling to analyze blueprints, creating a detailed list what needs to be done during a day’s

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doesn’t have to pay out a full worker’s compensation claim, and the state sees it as a benefit for the employee, who stays on the job and, hopefully, recovers more quickly. Says Castro: “One of the things we found is that when someone’s injured on the job, if they stay at home, it takes them longer to get better.” n

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Red Flags

Teaching young girls the warning signs of unhealthy relationships BY HEIDI GROOVER


he can’t forget the body bag. Jenny Moeller was driving home in rural Montana and passed a restaurant surrounded by yellow caution tape. That night, she heard on the news that a man had killed his girlfriend. “I was just like, ‘Oh my gosh. That’s going to be me,’” she says. Moeller’s then-boyfriend would choke and kick her when they got in arguments. He’d insult her and intentionally clean his gun in front of her. She kept thinking she could “fix him,” but gradually realized that was impossible. Then came the struggle to leave. Moeller says she went back four times before she was finally able to get away. Today she’s living in Spokane, happily married and raising two kids. Though she says her own struggles with domestic violence now seem like a part of her distant past, she is determined to do something to keep other young girls from ending up where she did. While schools routinely teach about bullying, drugs, alcohol and safe sex, Moeller says there’s no comprehensive curriculum about unhealthy relationships and dating abuse. That’s a problem because the Centers for Disease Control report that about 10 percent of high school students say they’ve been physically hurt on purpose by their boyfriend or girlfriend. Young women are especially vulnerable — the rate of violence against women ages 16-24 is nearly triple the national average for all age groups, according to the Clothesline Project, a nonprofit focused on violence against women. Meanwhile, the same group reports that about 54 percent of parents say they’ve never spoken to

their children about dating violence. That’s why Moeller has developed a one-of-akind curriculum, called REDFLAG, to educate young women from junior high to college age about the warning signs of unhealthy relationships. While the program includes discussion of the risk factors for dating abuse, it emphasizes self-respect and leadership. The hope is that if young women learn to value themselves, they’ll be more willing to stand up to physical, verbal or emotional abuse. Moeller already teaches classes to victims of domestic violence at the Spokane office of the regional group Abuse Recovery Ministry and Services, but she says there’s a gulf in understanding between adults who’ve been victims of domestic violence and young people who could be the next generation’s victims.


oeller has taught the REDFLAG class to focus groups at local churches, but now she’s removed references to religion so it can be taught in schools as well. Mead High School has agreed to start this fall with a focus group of about 12 girls and, if it goes well, to consider teaching it in classes. Moeller has trained a few women in Seattle to teach the class and has a contact in Idaho who’s interested, too. She hopes this is just the beginning. “The goal for me would be in health class they have a binder they take off wall and they say, ‘OK, this is our safe sex week, this is our no drugs and alcohol week.’ I would love [for REDFLAG] to have that healthy relationship piece,” she says.

The program could be many junior high students’ only chance to learn about dating violence. Twelve-year-old Kyla of Spokane says her parents didn’t talk to her much about what dating would be like (she’s not allowed to date until she’s 16). She didn’t hear about unhealthy relationships in health class, and her friends didn’t talk about it in a serious way.

For more information about the REDFLAG program, visit If you or someone you know needs help, call the Alternatives to Domestic Violence 24-hour hotline at (509) 326-2255, the North Idaho Violence Prevention Center at (208) 664-9303 or the National Domestic Violence Hotline at (800) 799-7233. “A lot of people just joke about it,” she says. “I used to because it’s what everyone else does, but it’s not a joke. It’s a real thing.” Since taking the class at Life Center Church, Kyla says she spotted a friend who was dating a boy who wanted too much of her time. That’s one of the signs of an unhealthy relationship, she remembered. So the next day she took her REDFLAG folder to school and told her friend, “He needs to let you go be by yourself.” “My other friends said, ‘I think you’re just being ridiculous,’ but she listened,” Kyla says.

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InHealthNW September-October, 2012


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Jenny Moeller’s own past relationship drives her to keep girls from the same mistakes. STEPHEN SCHLANGE PHOTO


alah Pratt, 21, is Kyla’s youth group leader at the church and has sat in on some of Moeller’s classes. But it’s not her first exposure to the warning signs. Pratt remembers the fights she had with her ex-husband. “He’d say things like, ‘Oh, you’re so lazy. Why don’t you go work out every now and then?’ “You feel crazy,” she says of the arguments they’d have. “In the beginning it makes sense, but by the middle you’re so confused.” Pratt says she couldn’t understand at first how she’d ended up in a relationship like that. When she started to look back, though, she realized if she’d had more self-awareness and respect, she might never have married someone who was always putting her down. “That is exactly what this program teaches, in a sense,” she says. Pratt says she’s been surprised at how much the girls retain what they learn in REDFLAG. “It’s new information. It’s not like, ‘I’ve heard this 100 times,’” Pratt says. “We say, ‘Listen up.

This is really important and it could someday save your life.’ They’re able to grasp that.” To fund and run the classes, Moeller established a non-profit called Statement. In her own life, she’s hoping to start fostering an understanding of healthy relationships even earlier than junior

high. Each night when she tucks her 3-year-old daughter into bed, Moeller asks her, “All right, girlfriend, who are you?” “She’s like, ‘I know, mom… I’m valuable.’” Moeller says. “I’m like, ‘Yes you are. Yes you are. Don’t you ever forget it.’” n

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FATIGUED Juggling a job and a family will wear out any woman. Leslie Hebert found her diet was making her tired. Now she’s back in balance with her husband Matt and her daughter Reese.


InHealthNW September-October, 2012

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Why are women so tired and what can be done about it? STORY BY DAWN PICKEN PHOTOS BY YOUNG KWAK


indy Davis-Huffman has endured more than moments of fatigue. She nursed for 23 years in intensive care, among the high-stress, high-stakes environment of patients perched on death’s door. Between the ICU and her most recent second job as an organ donor nurse, she felt depleted, like a slow-leaking rubber life raft. With one child in grade school and the other in high school, the 44-year-old worked up to 50 hours per week in ICU and spent another 48 hours on call for her second job. “I never thought of me, whether to sit down and read, take a nap or spend time with the kids or my husband,” she says. “I wasn’t ever doing that. How did I do all this stuff that happens — the carpooling, the driving to soccer games, laundry, dishes? You sleep when you can, get up exhausted, and do it all again the next day.” Davis-Huffman says she would, on rare occasions, sleep all day. Her schedule seldom permitted a doctor visit — or cooking. She relied on fast food. Cindy’s

much like Greeks classify different kinds of love and Eskimos identify variations of snow. There’s newbaby-tired; overworked-tired; poordiet-tired; caregiver-tired; chronic-illness-tired; difficult-relationship-tired; late-night-Facebook-tired… Dr. Monica Blykowski-May, a family doctor at Rockwood Northpointe in Spokane, estimates 70 percent of women over age 30 complain of fatigue. She says most “textbook” diseases share fatigue as a symptom, making it tough to pinpoint a specific cause. She recommends a medical evaluation if you notice a significant change in what you used to be able to do lasting more than a couple weeks: If you’re suddenly short of breath when exercising; if you’ve lost 10 pounds without trying. Though actual chronic fatigue syndrome is rare, Blykowski-May says some fatigue-inducing conditions are fairly common — low thyroid hormone levels, diabetes and vitamin D deficiency — and can be discovered through lab tests and managed with diet, exercise, medication and vitamins.

“You sleep when you can, get up exhausted, and do it all again the next day.” five-foot, 10-inch frame carried 425 pounds. Gastric bypass surgery allowed her to shed 180 pounds and whittle her take-out budget. “I didn’t realize how much we were spending on food,” she says, “probably $600 to $700 each month for garbage.” You may know someone like Cindy. Or maybe you’re caught on fatigue’s molasses-coated treadmill. Surveys have shown women are three times more likely than men to report fatigue. Why are we so tired? And how do we fix it?


There are so many kinds of fatigue, you wonder if we shouldn’t have more words to describe exhaustion,

“Thyroid abnormalities are a common cause for fatigue,” says Spokane endocrinologist Lynn Kohlmeier, noting that almost 10 percent of the population has thyroid dysfunction. “Thyroid treatment, when needed, should be carefully regulated by your primary care provider.” All symptoms related to thyroid dysfunction, including fatigue, usually resolve when thyroid levels are normalized. “When people feel tired, they sometimes consider supplements before having tests to try and explain their symptoms. If a supplement claims to provide ‘thyroid support’, it should be avoided,” Kohlmeier stresses. “These supple...continued on next page

September-October, 2012

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“PERPETUALLY FATIGUED,” CONTINUED... ments can contain iodine, which has unpredictable effects on thyroid function.” Anemia, a condition in which there are not enough healthy red blood cells to provide oxygen to the body, also causes fatigue. Often it is related to iron-deficiency. Recent studies have shown one in five women to be anemic; half of pregnant women also have low stores of iron. Anemia can also be caused by other nutritional deficiencies

or poor absorption of nutrients, or by diseases affecting the production and maintenance of red blood cells. Vitamin D deficiency is another energy-killer, and for most people supplements are necessary to maintain optimal levels. Kohlmeier recommends at least 800IU of vitamin D3 daily. “Vitamin D deficiency might not directly cause fatigue,” she says, “but it is very common and results in muscle weakness and arthritis-like symptoms, which contribute to feeling tired.”


drenal function often gets blamed for low energy levels. If you start investigating causes for fatigue, it won’t be long before you’ll come across “adrenal fatigue.” Google that term and you’ll get 2.5 million results, many of them links to websites urging consultations, diet modifications and a slew of supplements. So what are the adrenals and can they really get tired? The adrenals are a pair of organs located on top of the kidneys that secrete cortisol and several other hormones in response to 20

stress. A condition called adrenal insufficiency, or Addison’s disease, does exist, but it “should be diagnosed with a specialized stimulation test in a medical office,” says Dr. Lynn Kohlmeier, a Spokane endocrinologist. “Because only a rare number of people truly have adrenal dysfunction, it is important to confirm the diagnosis before starting treatment. Adrenal insufficiency should not cause fatigue, however, once treated.” So why does the term “adrenal fatigue” appear so frequently? The symptoms of


What if your lab work seems just fine? Sometimes fatigue is the result of a sleep problem, which can be diagnosed in a sleep study, but it may simply be a result of not getting enough sleep. “That means nothing’s going to show up on a test,” says Blykowski-May, “and there’s no true sleep disorder. It’s a frustrating thing for women. It’s normal, but there’s no easy answer. You come home from the office and want to roll into a ball… sick child, financial pressures, maybe you’re fat,

“adrenal fatigue” are vague enough to make anyone think they may have the disorder on some days — from mood swings and tiredness to trouble sleeping and cravings for sugar, salt or caffeine. But according to the Hormone Foundation and Endocrine Society, “No scientific proof exists to support adrenal fatigue as a true medical condition.” The Society even went so far as to publish a “Myth vs. Fact” paper on the topic. Kohlmeier and other providers are concerned that people who attempt treatment for adrenal fatigue may in fact miss the real cause of their symptoms and not get effective therapy. In addition, supplements designed to treat “adrenal fatigue”

InHealthNW September-October, 2012

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Cindy Davis-Huffman fought exhaustion with big changes. She got a new, less stressful job, lost weight and even has time for family dinners again.



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tired, overwhelmed. That can’t be fixed with medication.” Sometimes even when exhausted women make time to sleep, it can be elusive. “It’s difficult to get a good sleep rhythm going. Lots of people are overworked, overstressed, oversaturated,” says Ellin Ethington, a clinical psychologist with Spokane’s Northwest Neurobehavioral Institute. “If that’s a chronic situation, eventually people’s ability to sustain that level of intensity diminishes. It compromises their energy.” Ethington says overstimulation is one of our greatest stressors. We stare at screens — computers, cell phones, TV — seven days a week. We never

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We never unplug. When’s the last time you just stared up at the clouds? unplug. When’s the last time you just stared up at the clouds? Switched off your mental to-do list? Ethington calls medication a last resort when someone can’t function and they’ve already tried other stress relievers. She suggests devising ways to manage stressors. That’s key for women spinning at the center of life’s carousel. We work, nurture children and aging parents, tend homes and communities. Like Marge Simpson of cartoon fame, we scrub one last dish before fleeing a burning house. Ethington advises moving your body long before the figurative fire fries your brain. “One of best things is exercise,” says Ethington. “That’s counterintuitive: ‘If I’m so tired, how do I get the energy to walk around the block?’” But she says the effort will pay off. In addition, “Turn off the computer at 8 o’clock instead of 9 o’clock, turn down the lights at that time, ...continued on next page

are, for the most part, unregulated by the FDA and may contain “extracts of human adrenal, hypothalamus and pituitary glands that could be harmful,” according to the Endocrine Society. Taking these supplements when you don’t need them may actually cause the adrenal glands to stop working; even after the supplements are discontinued, the adrenal glands may not rebound, potentially leading to a life-threatening condition called adrenal crisis. Instead of turning to supplements to deal with fatigue, Kohlmeier stresses, “Try to sleep better, eat well and exercise more. And, of course, recheck your thyroid hormone levels with your next blood test.” — ANNE McGREGOR

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TOP FIVE CAUSES OF FATIGUE THYROID DYSFUNCTION Levels of thyroid hormone that are too high or too low can cause fatigue. SLEEP Sleep apnea and other conditions may mean you are not sleeping as well as you think you are; a sleep study can diagnose these conditions.

“PERPETUALLY FATIGUED,” CONTINUED... instead of turning them off at 10:30 and thinking, ‘Okay, I’m gonna sleep now.’” Be patient. Ethington says it takes weeks or months to make new habits stick, so don’t give up if you fail to see results after a week of unplugging early and going to bed.


Diet makes a difference, too. Leslie Hebert, a 30year-old marketing director with Gonzaga University, says changing her diet has changed her life. Hebert’s energy level had been flagging for years. She sought answers after tests at her doctor’s office proved inconclusive. “They weren’t really concerned about it,” she says, “but I was miserable and would have spells where I was throwing up. I got sick and tired of being tired. I was talking about it with someone at work and he said, ‘Have you ever thought about allergy testing?’” Hebert learned she had a soy allergy, then found out nearly everything she was eating contained soy by-products (used as a thickener), like salad dressing, chocolate, chewing gum and tea. The married mom of a 14-month-old says she was able to work, finish graduate school and have her daughter all at once, thanks to banning soy four years ago. “I feel a lot better. I’ve made almost a 100 percent recovery. I never would’ve thought the food you eat would make you feel this way.” Even for people without a food allergy or sensitivity, though, diet can make the difference between feeling pooped and feeling invigorated. Dietitian Linette Giesa, a certified diabetes educator based at Sacred Heart Medical Center in Spokane, says three common causes of fatigue are skipped meals, dehydration and alcohol. For women, Giesa says anything more than one drink a day can make you tired. So can thirst. “Often we’re fatigued because we’re dehydrated, especially in the afternoon. When that afternoon slump hits, drinking a big glass of water will help that fatigue. Thirst is often masked as hunger. We think we’re hungry when we’re actually thirsty.” In spite of the almost overwhelming urge to grab a candy bar to boost energy, Giesa says sugar in general promotes lethargy. Instead, try eating complex carbohydrates like whole grains, legumes, fruits and vegetables to feel energized.

ANEMIA Too few healthy red blood cells mean your body isn’t getting enough oxygen. ASTHMA Impaired lung function can impair sleep and cause tiredness. MENTAL HEALTH AND LIFESTYLE STRESS Depression and anxiety can cause fatigue. — COMPILED BY ANNE McGREGOR

“They have nutrients that fuel our muscles and our brain,” she says. But she notes chronic, overwhelming fatigue may also arise from a medical condition: high blood sugar in diabetics causes fatigue, as does gluten for people with Celiac disease.


For some, fatigue is just a fact of life. Sixty-threeyear-old Carol Schmauder has multiple medical conditions, including Parkinson’s, an autoimmune disorder called Behcets Syndrome (pronounced buh-SHETS) and fibromyalgia. She also has a heart condition. “I get out of bed tired, and go to bed exhausted,” says Schmauder. “But I go about my business.” While she limits sugar and manages her illnesses with immunosuppressive drugs, Prednisone and doses of compassion from her husband and friends, she says fatigue is hard for others to understand. “I think there’s definitely a perception it’s not serious among those who don’t suffer from fatigue. Often people tend to think you could do something to make that better. Frankly, I don’t find a lot of things that make it better.” Schmauder gets limited relief with pool exercise, careful attention to her diet and from something a little unexpected: exercising her creativity by making jewelry. She offers advice for others suffering extreme fatigue. “Find something that brings you joy in life, and at least do some of that every day.” Blykowski-May suggests that when there doesn’t seem to be a fix for fatigue, finding someone to talk to can help. “Chronic fatigue has an effect on health and well-being, and counseling can be a significant support… it may not fix the underlying cause, but it helps people in what they can do.” What works for Cindy Davis-Huffman is working less: After 23 years holding two nursing positions, she quit her second job and left intensive care. She now works at Sacred Heart Medical Center as a clinical documentation specialist. It’s a 40-hour-per-week gig. (“No more, no less,” she says of her new job.) Davis-Huffman can help her kids with homework, attend soccer games and prepare meals. She says extra money would be nice, but she won’t trade cash for quality of life. “I’m a totally different person,” she says. “The kids will say, ‘You’re a lot less stressed; there are fewer wrinkles on your head.’ Life is way too short… I can’t get back those years when I was going so fast. I don’t know what I missed.” 

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Dr. Angela Lotrario understands overeating; today she carefully weighs out 1200 calories a day. JEFF FERGUSON PHOTO

here may be nothing wrong with devouring a bucket of French fries with a group of friends. There may not even be anything wrong with devouring a bucket of fries alone in your car. But how often do you do it? Do you have to be going through a break-up, have PMS or just be bored? We all have different triggers, and in spite of the fact that more than 37 percent of Americans are obese (and swear we’re addicted to certain foods), it’s tough to find any doctor who will agree.

“Food Addiction” is not recognized in the most current Diagnostic and Statistical Manual of Mental Disorders (DSM, 4th edition). While there is anecdotal evidence that overweight people crave grease, salt and sugar, scientists have failed to prove that these yummy ingredients are psychoactive substances (that, like drugs or alcohol, alter a person’s mental state by affecting the brain and nervous system). Forty-seven-year-old professional photographer Tia Wooley says she consistently uses highly caloric food as catharsis — asserting ...continued on next page September-October, 2012

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that she has been a food addict since age 14. “Food makes me feel better immediately. An hour later, not so much, but the immediate gratification is off-the-charts-good.” That “off-the-charts” feeling is what authors of a recent article in the American Journal of Physiology must have been referring to, albeit far more scientifically: During eating, immediate, direct pleasure is derived from mainly gustatory and olfactory sensations, driving consumption throughout the meal until satiation signals dominate… The question here is whether repeated exposure to palatable food can lead to similar neuroadaptive changes in the food-reward system and behavioral dependence (craving for palatable foods and withdrawal symptoms). It takes less time to finish a full bag of buttery microwave popcorn than to decipher the rest of the article’s content, but the authors do clearly assert that the most defendable addictive food ingredient is sugar: “As with drug and alcohol addiction,” they write, “abstinence from sucrose can cause craving and withdrawal symptoms, eventually leading to relapse behavior.”


dvocacy groups like the Rudd Center for Food Policy and Obesity are working to legitimize food addiction. They designed the 2009 Yale Food Addiction Scale questionnaire for use by practitioners to pinpoint sources of food dependence. Spokane registered dietitian and nutritionist Craig T. Hunt says the Yale Food Addiction Scale makes an excellent tool for physicians. “Most providers don’t have the time to get into a patient’s psychological or emotional ties to food,” he says. “Doctors have maybe two minutes to talk about nutrition.” He says the information gleaned from the questionnaire, even in the absence of a diagnosis, would be a helpful starting point in talking about compulsive eating. “I had a woman referred to me who is 347 pounds and diabetic… I’m thinking there probably is some food addiction with a psychological component.” Hunt says food addiction is more often referred to as “compulsive overeating,” but even that isn’t included in the current DSM. “Anytime there’s a diagnosis, it gives it leverage for referrals to a specialist, and it would make people who struggle with these issues have more strength,” in finding specific help, says Hunt. Not waiting for validation from the medical community, Food Addicts Anonymous calls

food addiction a “biochemical disease,” having adapted the “12 Steps and Traditions” of Alcoholics Anonymous as its format. Instead of focusing on abstinence from alcohol, they advise abstinence from sugar, flour and wheat. Kacey Hamilton, a mother to four young children, spent her own childhood watching her father struggle with eating and obesity — what she is certain was an “addiction” to fat and sugar. “[My dad] would consume half a cake after everyone was in bed like it was nothing,” she remembers. “In my opinion, the most difficult part about an addiction to food is that you can’t quit cold turkey like you can with smoking or drinking… you have to eat to live.” “My body is built just like my dad’s,” Hamilton adds. “I have a very similar personality, and I have some of the unhealthy cravings he does. Watching him all these years is what has helped me to keep my eating and weight somewhat in check.” Nearly all providers believe there is an emotional trigger for overconsumption, whether it’s cigarettes, martinis or chocolate frosting. “All addictions have some component of controlling emotions, or coping… a way to self-soothe pain or sadness,” explains family and marriage counselor Melanie Morlan. “We struggle with our parents as children or our spouses or partners as adults,” says Morlan. “When our sense of attachment is threatened, we feel afraid, stressed, anxious. This leads to looking for something to numb the pain, or fix the way we look, thinking this will help us find more love or prevent loss of it.”

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Morlan says that’s why she spends time with many of her clients helping them work through their own dynamics with eating and body image. “Food obsession, over-consumption or restriction, as with drugs and alcohol, often become problematic when one is coping with stress, anxiety, emotional or physical pain.” Wooley agrees that her most serious struggles with eating began during the most stressful time of her life. “I was really fine until my kids graduated from

Pepsi, whole Totino’s pizzas, and boxes of mac and cheese,” Lotrario says she has gone up and down in weight through adulthood, and finally struck a winning formula in the past year, using a nutritionist and meticulously keeping her daily intake at 1200 calories. “I carried measuring spoons, measuring cups and a little scale with me everywhere,” she laughs. “I had many people saying, ‘Great,’ ‘Way to go!’ and then all of a sudden: ‘You’re not anorexic,

“…the most difficult part about an addiction to food is that you can’t quit cold turkey like you can with smoking or drinking…” high school and went away to college,” she says. “I had empty nest syndrome. Then my mom was diagnosed with cancer, and I drove five hours one way each week to help care for her.”


n examination of eating patterns takes most people back to their childhoods. “Growing up, all the adults I knew were heavy, and it never occurred to me that grownups could be thin. I always thought that that’s what happened when you grew up,” says Dr. Angela Lotrario, an oncologist in Spokane. “I wasn’t concerned about gaining 25 pounds in college and medical school drinking cases of

are you?’ It seems to me that there is a fine line between obesity and eating disorder, and that there’s almost no one at a ‘normal’ weight,” Lotrario concludes. Still, whether “food addiction” is included in the next edition of the DSM, thereby setting clearer guidelines for diagnosis, Hunt says he foresees a more concentrated effort to work with patients toward their respective “normal” weights. “The new crop of young doctors are much more tuned into how food affects the body,” says Hunt. “If something’s going to change, like identifying food addiction, I think it’s way more likely to happen now than it was five to 10 years ago.” 

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Cinnamon and Turmeric Braised Apples with Pistachio Frozen Yogurt

Aside from the fact that cinnamon and turmeric just taste good together, Chef Ryan Stoy likes these spices for other reasons. “Turmeric is a strong cancer-fighting food ingredient. What I really like about cinnamon is it offers a sweet element without having to overdo it with sugar. If we have good apples, we can even omit the sugar all together.” 8 apples, peeled and cut into wedges 2 Tablespoons ground cinnamon 1 Tablespoon ground turmeric 2 Tablespoons butter 4 Tablespoons sugar 1 vanilla bean, split and seeded 2 Tablespoons lemon juice 2 Tablespoons simple syrup (made by heating up 2 Tbs of water and 4 Tbs of sugar until sugar dissolves) Over medium heat, toast the cinnamon and turmeric until they begin to slightly color and become aromatic (approximately one minute). Add the butter and allow it to melt. Add the apples, sugar and vanilla bean. Sauté the apples until they are well-coated and the sugar melts and starts to become sticky. Add lemon juice and simple syrup and continue to cook over medium heat until apples are fully cooked and soft to the touch. Yield: 6 servings.

Pistachio-Infused House Yogurt 2 cups water 1-1/2 Tablespoons yogurt with active cultures (Greek style) 2 Tablespoons local honey, slightly warmed 1-3/4 cup dry milk powder 1/2 cup roasted pistachio dust 2 cups water Pour 2 cups of water into a sealable one quart container and stir in the yogurt and honey until dissolved. Whisk in the powdered milk and pistachio dust until completely blended. Fill with remaining water and stir. Once everything is mixed together, close the lid and let it sit for 12-15 hours at a warm temperature. (The process is similar to how you would proof bread at 95-100 degrees. A pilot-lit oven or other warm place works fine.) The yogurt will thicken as it sits. Serve chilled or freeze in ice cream freezer. To make pistachio dust at home, grind roasted pistachios till they are light and creamy in a food processor.


InHealthNW September-October, 2012

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Dessert doesn’t have to be a nutrition nightmare



or Chef Ryan Stoy, a meal’s last course is sort of like the passing of the Olympic torch. “Dessert offers an opportunity to remember the last bite — and look forward to the next,” says the Downriver Grill chef. While dessert fills many health-conscious eaters with apprehension, Stoy says it doesn’t have to be a diet disaster. Instead, desserts can offer the perfect opportunity to enjoy seasonal ingredients and experiment with unique flavor combinations that don’t rely on fat and sugar to wow the tastebuds. “I honed my love for food in a succession of kitchens in the United States and Europe,” says Stoy, who started out in the food industry as a dishwasher at Marie Callender’s. He liked the trade, and enrolled first at Spokane Skills Center and continued on at the Inland Northwest Culinary Academy (INCA) before traveling the world. In Barcelona, he embraced the country’s culinary staples, especially the meat and seafood. “In Pamplona, I found myself closing my eyes and enjoying a slow-cooked meat from just a few miles away,” he recalls. Those lessons in locality, seasonality and sustainability have influenced how he works with food to this day. The world of the professional kitchen is demanding, and Stoy works to make relationships with his team as important as the meals they produce. “Restaurant work is shrouded with difficulties and intense atmospheres. We work long hours and in hot, dangerous and stressful environments,” says Stoy. “When you spend 40 to 80 hours a week with the same people, they become family. We golf together, go out after work together, share meals and all congratulate each other when our lives experience something great.” His deep appreciation for other people makes Stoy eager to work with diners who have special needs. “Gluten intolerances are becoming more prevalent,” says Stoy, who even prepares gluten-free desserts. “I always take all food sensitivities with grave seriousness. I try to understand the different diseases, conditions and intolerances so I offer safe choices to my guests. I train my servers to communicate very clearly so we can understand what the guest can and cannot have. “What is challenging for these dishes,” he says, “is making sure the customer clearly identifies themselves and the severity of their allergy.” n

Downriver Grill’s Chef Ryan Stoy has loved local ingredients from Spain to Spokane, including the apples he uses in this braised apple dessert. YOUNG KWAK PHOTO


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September-October, 2012

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Meet the Next

Superfood A pair of recent studies show we digest up to 32 percent less fat from almonds and pistachios than researchers previously thought.

Don’t call nuts and seeds “fatty” — call them “nutritionally dense” BY LUKE BAUMGARTEN


et’s see: Seeds. Seeds. Seeds and nuts. Nuts. Nuts. Seeds.” Allison Collins paces the cold case at the front of her new Spokane cafe, Boots, pointing out the items that contain a pistachio or a pumpkin seed, a flax seed egg replacement or some cashew butter. She points to almost every item in the case. “When people tell me they have a nut allergy,” Collins says, her face stretching into a wry smile, “I say, ‘You may not eat here!’” Above the register is a chalkboard with a quote that changes daily. Some days the board carries a piece of timeless wisdom. Today it reads, “Blah blah bla bla blah,” which the board attributes to “Yadda Yadda.” Boots is not a place that has a lot of rules, in other words, but it does have a couple guiding principles. Collins has taken pains to make the food here almost entirely vegan. Much of what they offer is also gluten free. (They do an egg frittata to satisfy ovo-vegetarians and have milk for people who need a little cow in their coffee.)

says, “but at some point you have to have flavor. And texture.”


uts are delicious, but they’ve been suspect in popular culture since the first low-fat diet. Seeds have, too, though to a lesser extent. Craig Hunt, a Spokane nutritionist and dietitian, says as a culture we decided to cut out all fats without understanding the nuances. In some cases, he says, cutting fats makes people fatter. “When people eat excess carbohydrates, their bodies produce excess insulin,” Hunt says, If you produce more insulin than you use breaking down carbs, you crave more carbs to get rid of the insulin. That’s one reason for the low-carb craze. But that, too, has its drawbacks. “We played this game to eat just low-fat or low-carb without concern for, ‘Are these foods nutrient dense? Are they high in fiber?’” Hunt says. “I think, for a long time, people wanted only one message.” That has begun to change, but it’s a slow process

…in general, plant fats like nuts and seeds have more benefits and fewer downsides than animal fats… And because Boots does not do any meat, almost no dairy or eggs, and very little gluten, Collins has learned to lean on nuts and seeds. Because of their high fat and protein content compared with other plants, she says flax makes a good substitute for the binding ability of eggs, and cashews are a good replacement for the creaminess of dairy. (They also taste good.) “People feel like we should cater to the nut-free because we cater to vegan and gluten free,” Collins 28

that fights conventional wisdom and our own evolving understanding of how different foods function to fuel our bodies. Hunt says that, in general, plant fats like nuts and seeds have more benefits and fewer downsides than animal fats, but our understanding of all this stuff is still embryonic. “We’re just beginning to understand how the nutrients in plants keep them healthy and vital,” Hunt says, “and how, when we eat them, we become more healthy and vital.”

He sees the ship of public perception slowly turning, though, guided by emerging science. He calls a holistic approach to nutrients — not just fat and carbs and protein, but vitamins and minerals and, vitally, water — “the next mass awarenesses we’re going [toward].” That mass awareness may be sped along by a pair of recent studies, one on pistachios and one on almonds, that found we digest up to 32 percent less fat from nuts than we previously thought. David Baer, a senior research physiologist at the USDA, who participated in the almond study, says this has to do with the way plants are built at the cellular level. “[Plant] cells are surrounded by a cell wall,” Baer says, “that’s where the fiber is. All the nutrients and the fats are in there.” Humans don’t have the right gut enzymes to digest the cell wall, so we have to “break down that wall by chewing or grinding it.” We tend to chew incompletely and hastily, though, and Baer’s study found that people who ate almonds were actually absorbing 32 percent less calories and fat than scientists previously thought. In pistachios, we absorb about 5 percent less. Baer says that incompletely digesting fats also means that we’re missing parts of all the other nutrients, but that the study showed nuts still had a positive effect on vitamin E and LDL cholesterol levels. “So we’re not getting 100 percent [of nutrients],” he says, “but we’re getting enough to see increases.” Baer says nuts have an interesting and unique nutritional profile that other foods don’t. “[Nuts are] all a little bit different, but they’re all a very good source of nutrients.” he says. “For people who may be reluctant to consume nuts because of the calories, I think [the almond study] is good news.” Craig Hunt thinks we pay too much attention to calories in general. We can’t overlook them completely, he says, but we need to begin paying a lot more attention to nutrient density. For nutrient density, it’s literally impossible to beat nuts and seeds. He’s particularly bullish on flax seeds. “They’re extremely nutrient dense and a great source of soluble fiber,” Hunt says. “I could go on and on about flax seeds.”

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ick Murto could go on about flax, too. And about good fats. “Flax has a lot,” he says, “Hemp seeds. Sachi inchi seeds. Chia seeds. They all have a ton of omega 3s” — fatty acids that are said to aid brain function and reduce the risk of heart disease, cancer and arthritis. Murto is a vegan “97 percent of the time,” so he needs the fat and protein nuts and seeds have in abundance. He’s a principal with Seven2 Interactive, a Spokane web-design and media company, so he is always looking for something to aid brain function. And he’s also the owner of the new West Riverside juice bar Method Organic Juice Cafe, so he’s banking that, among other things, Spokane is ready to take a second look at nuts and seeds as part of a business model that is vegan and mostly raw.

Murto says he never planned to open a juice bar, but he felt so good after cutting gluten, caffeine, meat, processed sugars and alcohol during a 30-day juice fast (he eventually brought back some of the alcohol), he started thinking about opening a place that would take a holistic approach to nutrition. It’s still too soon to tell, but after good early buzz from juicing demonstrations at the Lulu Lemon grand opening and internet hype that spread as far as Spokie expats living in Cologne, Germany, Method soft-opened in early August and, by the end of its first week, sales had tripled. “I think there’s a shift about how people think about their health,” Murto says. “People are caring a lot more.” And although he lost a bunch of weight when he went vegan, Murto agrees with Hunt that being healthy needs to be about a lot more than counting calories. “It’s not just low-fat or low-sugar or no-carb,” he says. “It’s balance and moderation in everything.” Method offers a dense and filling Chia-seed pudding (Hunt considers Chia the next superfood), and a protein smoothie that’s packed with peanut butter. Neither of these is a low-calorie option. The smoothie, Murto says, “gets up there — almost 600 calories. You can’t do four of those a day.” There’s room for one, though, as part of a balanced, nutrient-rich diet. Except: don’t say “diet.” “I don’t like the word diet,” Murto says, laughing a little. “It’s more like a ‘lifestyle,’ right?” n


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September-October, 2012

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Born Too Soon Premature babies are a challenge for health care providers — and for the families they’re born into B Y L I S A FA I R B A N K S - R O S S I


ristina Elverum was in a daze during the one-week post-partum follow-up at her obstetrician’s office. The friendly receptionist asked, “How far along are you?” Elverum, standing alone in the waiting room, taking in the bevy of late-term pregnant women and new mommies cradling their newborns, quietly responded. “I told her I’d already had a baby, then she was looking around for her, so I asked, ‘Can you get me straight into a room, please?’” At that moment, Elverum’s newborn, Kathryn, born nearly two months too soon, was hooked up to fetal heart monitors, pulse oximeters and IVs in her plastic isolette, inside a nearby neonatal intensive care unit (NICU). Like all mothers of “preemies,” being confronted with actual new mothers and babies, as well as magazine covers bearing happy, full-cheeked infants, is at best, surreal, and at worst, suffocating. “I couldn’t be around it,” Elverum recalls. “I’d see the full-term women or full-term babies and think, ‘That’s what should have happened.’ It was really hard.” In Elverum’s case, very little about the pregnancy and birth had been easy. “I had a pinched nerve and pregnancy-induced carpel tunnel, then at six months I was diagnosed with gestational diabetes, so I gave myself insulin injections three times a day, and I was testing blood sugar four times a day. It was a lot of poking myself,” Elverum recalls, wincing slightly. “But you do it because you have to. You have to keep the baby safe.”

Kathryn Elverum was born two months early when her mom, Kristina, got dangerously high blood pressure. lampsia, things happened quickly. “They hooked me up to an IV of magnesium sulfate [to prevent seizures], and they told me, ‘The only way to cure you is to have the baby now,’ and everything was a blur, but Kathryn was born at 6:27 pm. She weighed three pounds, five ounces, and other than being really small, she was perfectly healthy.”

“If a baby weighs 500 grams, then their entire blood volume is 50 milliliters… So a teaspoon is a typical blood transfusion.” By the seventh month, Elverum was receiving weekly fetal monitoring and ultrasounds. “Then my stomach started hurting; it felt like a gall bladder attack.” The severe abdominal pain was caused by elevated liver enzymes, a symptom of preeclampsia. “Kathryn was fine, but my blood pressure was high.” Once doctors diagnosed Elverum with preec30


Ten percent of all pregnant women get preeclampsia, also known as toxemia. While it presents with different symptoms (high blood pressure, protein in urine, blurred vision, swelling), all of them are dangerous to the mother and unborn baby. estimates that 15 percent of all premature births are caused by preeclampsia, and that it costs $3 billion a year.

Shannon Abernathy’s first sign of preeclampsia was blurred vision. “I wasn’t reading the pregnancy books because I had already had a full-term baby,” she says. Abernathy’s firstborn, Natalie, was four-and-a-half years old at that time. “I knew this pregnancy felt really different, but you always hear each pregnancy is really different, right? Yet I always had a sense something was wrong.” By the time doctors found protein in her urine and noticed Abernathy’s usually low blood pressure had elevated, she was only 24 weeks along. The kindergarten teacher was ordered away from her classroom and into bed. But nothing improved in those few days of bed rest. In fact, it got worse. Once she was admitted, doctors realized Abernathy’s baby was nearly out of amniotic fluid and had stopped growing. “They put me on an IV to try to build up the amniotic fluid level overnight, but she was so small they couldn’t read anything on her fetal monitor, so they told me we needed to do a C-section. And as we prepped for surgery, the surgeon started giving us statistics,” Abernathy recalls, still incredulous.

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“I want to say it was like a 40 percent survival rate at 24 weeks, and a 70 percent chance of ‘mental retardation,’ and I was wondering, ‘What exactly is the benefit of this? I’m still having the C-section!’” When her second child, Violet, was born, she was just 426 grams, or 15 ounces — not quite a pound. “I didn’t know what a 24-week baby looked like. But I was thinking, ‘If she’s alive, she must be okay.’ I was naïve.”

A recipe f or healthy babies


Compared to a standard newborn nursery, “okay” looks incredibly different in the NICU. And while the conditions of the mother can greatly affect the state of their tiny patients, neonatologists do follow a set of standard procedures. “With micro-preemies, if you make it through first 24 to 72 hours, it sets the tone for how the rest of life is going to go,” says Dr. Jami K. Lewis of the Sacred Heart Children’s Hospital. “We have a three-page admission order that sets the diagnoses. The babies are going from an environment where they’re living in fluid to one with air. The more premature, the less adaptable their skin is for outside environment,” Lewis continues. “Normally, a full-termer will lose 10 to 15 percent of their intracellular fluid, but the more premature you are, the more rapidly it is lost,” Lewis explains. “So we know we have to carefully manage electrolytes, and preemies are prone to a set of bacterial infections, so we hook them up with antibiotics.” What’s most jarring, especially to new parents, is the mind-bogglingly small amounts of medicine, fluids and blood the caregivers are working with. A standard unit of blood is 250 milliliters, or 8.5 ounces. “If a baby weighs 500 grams, for instance, then their entire blood volume is 50 milliliters of blood (just 1.69 ounces, in their whole body). When we give a blood transfusion for a 25-weeker, that would be five milliliters of blood. So a teaspoon is a typical blood transfusion,” Lewis says. Caring for preemies means dealing with one or more simultaneous health issues, most of them carrying three letter acronyms. RDS, or respiratory distress syndrome, is related to underdeveloped lungs; necrotizing enterocolitis (NEC) refers to the necrosis, or death, of portions of the intestine. ROP, retinopathy of prematurity, may result in poor vision or even blindness. IVH, or intraventricular hemorrhage is bleeding in the brain that can cause a drop in blood pressure or seizures. All of these, and other “terrible threes” make taking care of preemies a balancing act. “We try to guess which is the more serious problem. If we treat one, it could make the other problem worse. So we try a few techniques. Often we treat and then ask questions later,” says Lewis. But while the size and scope of care is routine for doctors and nurses, it takes a few days for moms and dads to become accustomed. When Abernathy first saw Violet, her diminutive, shiny frame (preemies are covered in a layer of petroleum to decrease the rapid loss of fluids) was suspended on a cloud-like puff of hospital-grade batting. Over her tiny head was a minute breathing …continues on next page

Saturday, October 13, 2012 The March of Dimes annual Signature Chefs Auction returns with delectable tastings from Spokane’s finest chefs and the opportunity to bid on unique and desirable auction packages. All proceeds benefit the March of Dimes mission of improving the health of babies by preventing birth defects, premature birth and infant mortality. To purchase tickets contact

509-328-1920 or

working together for stronger, healthier babies © 2012 March of Dimes Foundation

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All proceeds benefit the American Cancer Society and other local cancer-fighting organizations. September-October, 2012


InHealthNW 31 8/27/12 4:03:44 PM


Born Too Soon… machine; her eyes covered with strips of soft fabric to shield her from light treatment. “It finally hit me, ‘I have a micro-preemie. I have a baby who probably will not survive,” Abernathy recalls.


But like every parent, Abernathy, Elverum and their partners adjusted their old lives around this new reality: Visiting their newborn baby as she rests and grows inside a climate-controlled, artificial Plexiglas womb. Elverum was at the hospital full-time, holding and feeding Kathryn at every opportunity until she went back to work (she is the marketing director at The Inlander). Each baby is on a schedule that allows for solid periods of sleep. Barring medical

ask the nurse or doctor, ‘What’s the next step toward going home?’ and I’d tell Kathryn, ‘You need to do this,’ and she would. I’d never had a baby before, I didn’t know what I was doing. I just went by what they said. You’re told when you can hold her, and when you can’t, and when to go home,” Elverum recalls. “Putting her back in the isolette and leaving; you know it’s in the baby’s best interest, but it’s really hard to do.” For the Abernathys, it was like living a double life. “It was hard to have a child at home that we couldn’t bring in [to the hospital room]. How do I find a babysitter to go visit my other baby? I’d feel guilty when I couldn’t see Violet, and I felt guilty pawning my older daughter off,” she says. “And coming home from the NICU, especially after a

“Putting her back in the isolette [in the NICU] and leaving… it’s really hard to do.” emergencies, there are allotted slots of time for doctor and nurse exams, fluid management and parent visits, called “care times.” “I would go to the 11 am care time, and I would

really hard day, I’d be pretending to be happy; that ‘life is fine,’ because we didn’t want to worry Natalie. You can’t have two depressed parents when you’re four-and-half years old.”


While her stay in the NICU was extended — 87 days — Violet shocked her doctors and nurses by escaping the gravest procedures, considered almost routine with babies born under 500 grams. With the exception of a bout with necrotizing enterocolitis (NEC) and the resulting complications with her liver after intravenous feeding, Violet was dubbed the “smallest surviving, healthy baby ever born at Deaconess.”


Elverum’s baby Kathryn wasn’t so lucky. Not after the first month in the hospital, anyway. “They can never promise you anything, but someone in the NICU said, ‘I bet you’ll be out of here in the next two weeks,’ because Kathryn was eating well and gaining weight. That was before she got sick.” During one of their routine care times, Elverum and her partner Shane noticed their baby’s otherwise mellow attitude and demeanor had changed; she was writhing in her blankets and crying. Then Kathryn’s typically mellow dad’s attitude starting changing, too. “Shane was watching the [heart and breathing] monitors, and he was saying, ‘There’s something wrong. Her rates are off. The nurse needs to do something!’” At this time, the family was in the intermediate nursery, where babies go when they are no longer critical. Dr. Lewis refers to them as “growers and feeders.” When Elverum called from home at midnight, the overnight nurse told her Kathryn had had a

heart attack treatment 10 years in a row. 2012



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Kristina and Kathryn today: Trying to “live in and enjoy the moment.” MIKE McCALL PHOTO fever, but that it had gone down. Yet by the time she arrived for her 11 am care time the next day, “They had drawn labs because her temperature was high and her irritability was increasing,” Elverum says. “I could feel the tension rising in the room as we waited for the results and Kathryn’s breathing began to be labored. “That ended up being the last time I got to hold her for a week.” Kathryn was admitted back into the main NICU, hooked up to IV antibiotics and a ventilator. Right now, as Elverum cradles her strawberry blonde baby, she tears up recalling the pain and uncertainty of that time. “They told me she had late-onset Strep B, but by the next morning, they were pretty sure it was meningitis. I think they didn’t think she was going to make it.”

Worth the Wait


new effort in Washington state to reduce elective delivery before 39 weeks has resulted in 650 fewer optional early births statewide in a year, according to the March of Dimes. In the past, for various reasons, women have opted for delivering their babies a week or two early even though there was no real medical need. But new research shows the last week or two of pregnancy is an important period, allowing the baby to add body fat and finish up important lung, liver, ear and eye development. Though the last few weeks of pregnancy are generally not that much fun for mom, the “Healthy Babies are Worth the Wait” campaign aims to educate women, doctors and hospital staff about the risks of even slightly early delivery. Learn more at — Anne McGregor

It’s still unclear where the string of medical symptoms began, but Kathryn was now also dealing with hydrocephalus, a buildup of fluid in the skull that eventually causes pressure on the brain. “She had sensitivity to sound, and she was tremoring and shaking. They called it ‘neurological disturbances.’ It was around that time we met with the neurosurgeon. He diagnosed her with moderate to severe cerebral palsy, which was caused by the meningitis. That was the hardest week of my life. There were no glimmers of hope. I just wanted somebody to say, ‘It’s going to be okay,’ and they couldn’t.” But Shane could. Already a father to four children, Elverum says he was able to offer wisdom and assurance that she couldn’t grasp. “He was the eternal optimist through it all, which is something I desperately needed. Every time we got news, he would say he didn’t think it would be as bad as they predicted and reminded me that they didn’t know anything for sure. When I would cry and ask, ‘Why is this happening to us?’ he would tell me that, ‘God had chosen us to take care of her and that we will love her and take care of her no matter what.’ He has helped me to stop stressing out about what might happen and to just live in and enjoy the moment.”


And so Elverum does. The only apparent difference between Kathryn and other newborn babies is the two-and-a-half inch lump on the upper right side of her forehead, where a shunt was placed to relieve the pressure from the hydrocephalus. Their play and interaction is careful and focused. Elverum is humbled by the “awesome” team of specialists at the Guild School working to help Kathryn reach her physical and cognitive baby milestones. “Every obstacle that she overcomes and milestone she hits is cause for celebration,” Elverum says. “I can’t believe how far she has come in the short three months that she’s been home.” Violet, now seven-and-a-half years old, also received occupational, speech and cognitive therapy in her first two years of life. At her last physical a few months ago, she was in the 13th percentile for weight, and the 24th percentile for height. “And you know what?” says Abernathy. “I’m just thrilled we’re on the chart at all.” At 45 pounds, Violet is more than 45 times her birth weight. “Going through something like this really shows you what’s important,” says Elverum, nuzzling her baby. “Nothing can give you that perspective — that shift in life. The only thought that matters is that she is okay, and I am okay, and we’re a family.” 

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Back to Good Health Aging puts your spine at risk, but you can work to avoid surgery BY SCOTT A. LEADINGHAM

Dr. Daniel Dibble administers an epidural steroid injection. STEPHEN SCHLANGE PHOTO


t’s an almost universal sign: chest pain suggests something going on with your heart. So if it’s not a heart attack that requires immediate attention, you make an appointment with a cardiologist. But what if the pain is much lower — radiating down your leg or even causing tingling and numbness in your big toe? Who do you see then? What kind of doctor specializes in… tingly toe pain? Dr. T. Daniel Dibble, who founded Spine Team Spokane, would suggest you see someone like him. And, no, he doesn’t specialize in toes. Rather, he is board certified in pain medicine and specializes in the spine and back. It’s possible that pain or tingling you feel in your toe or foot stems from nerves in your lower back. Not all back problems and pain are created equal, and it is sometimes difficult to tell whether radiating pain is coming from a back problem or a crimp in a nerve somewhere else along its trajectory. There are, however, three general conditions treated by


Dibble and his fellow practitioners: STENOSIS Narrowing of the spinal canal, causing pressure on major nerves in the lower back that affect functions in the legs and feet. FACET JOINT DISEASE Also known as back arthritis, this is caused by inflammation of the facet joints that jut out from the vertebra surrounding your spinal column. When they rub together and become inflamed — and new bone starts to grow — they hurt, causing what most people would think of as back arthritis. DEGENERATIVE DISC DISEASE Mostly a catch-all to describe several conditions, but largely the reduction in “padding” of the discs that act as cushions or shock absorbers between vertebra. Dibble focuses on non-surgical treatment of back and neck pain, using a combination of injecting non-steroidal anti-inflammatory medicine and physical therapy. “Our clinic is full of people who have had surgery, and it’s not worked out well for them,” Dibble

says. “If you do a major surgery, it may solve one problem that you’re after. But it may lead to several other problems down the road.” Another option for treating some types of back pain is acupuncture. Rebecca Kemnitz, who has operated South Hill Acupuncture in Spokane since 2004, is a Washington state licensed acupuncturist, as well as a former back-pain sufferer from sports injuries. Acupuncture gave her relief and healing. Kemnitz recognizes that acupuncture isn’t a miracle cure for everything that ails you, but in some cases of back pain, it can help ease symptoms. “Different bodies have different reactions to acupuncture. It works at several levels. It’s antiinflammatory, reduces pain, reduces substances in the brain that recognize pain,” she says. And there’s little downside. “If it’s just not working, we can say we’re wasting time.” Sometimes, however, conservative approaches …continued on page 36

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Back to Good Health… just won’t work. “There are things for which surgery is absolutely necessary,” says Dibble. “And we connect our patients for the best possible surgeon for that type of problem.” Still, Dr. Benjamin Ling, a neurosurgeon with Inland Neurosurgery and Spine Associates, says he and his colleagues are conservative in recommending a trip to the OR for people with back pain. “Maybe 15 to 20 percent of back-pain patients are actual candidates for surgery,” he says. n


There are a number of factors that cause common back and spine problems, some of which are completely unavoidable. Family history and genetics play a role. But the chief culprit? Age. Every person will experience some form of degenerative disc disease, says Dr. Daniel Dibble. Not everyone will experience pain. Good posture and careful body mechanics are obviously key to preventing back pain. But there are other, less obvious ways to keep your back healthy.

Healthy Eating

“As always, having a good, healthy diet is helpful,” Dibble says.

Avoid Smoking

As if you needed another reason not to smoke. Smoking reduces the amount of oxygen that gets to your back’s discs. In fact, Dibble notes, “There are many surgeons who won’t do a surgery if the person is a smoker.” Why? Because oxygen may not flow in sufficient quantity to the area that’s been worked on. Dr. Benjamin Ling, a surgeon, agrees. “There’s clear evidence that smoker’s bones heal slower than non-smokers,” he says, meaning smoking can both exacerbate back problems and impede surgical recovery.

Low-Impact Exercise

Think of the discs in your back like shocks in a car. They absorb vibrations and stress as part of their job, and low-impact exercise helps oxygen flow more freely. However, lots of high-impact exercise, such as running, is like constantly taking your car offroading on bumpy, rocky roads: The shocks will likely wear out quicker.

Lose Weight

It’s pretty simple: More weight, in any part of the body, puts more stress on the lower back. Back stress only get worse when you bend or reach for heavy objects on overhead shelves. But not only can excess weight cause back problems, it can also complicate recovery from procedures meant to treat the problems. Quite simply, “Obesity makes things difficult,” says Ling. — SCOTT A. LEADINGHAM 36

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gility is what keeps an off-balance football player from going head-first into the turf. It’s what keeps an errant diver from belly-flopping into an Olympicsize swimming pool. It can be trained in many ways, but Chris Sarquillo prefers gymnastics. As a coach at Spokane Gymnastics, he’s seen his students start as gymnasts and go on to be stars in soccer and other sports where quick movement is key. “Kids who start in gymnastics end up being the top performers in any sport,” Sarquilla says. “If you started in gymnastics and went to something like [soccer], it just makes you more agile.” Or, as a poster on the gym’s wall puts it: “Life needs agility.” Porter, a 5-year-old who lives in Spokane, still has a long time to decide what direction he wants to take his athleticism. But as he bounds up and down on a trampoline and swing effortlessly from the gym’s exercise bars on a Friday morning, Sarquilla has no doubts about his dedication to gymnastics. “I want to be an Olympian,” says an

For Anything Developing agility may help prevent injury BY CHRIS STEIN

excited Porter. There are three components to gymnastics, says Sarquilla: balance, strength and flexibility. The kids who come to him often turned from jumping on the bed or cartwheeling down store aisles to gymnastics. The gym has recently expanded its offerings to include the growing sport of Parkour. But not everyone is a natural gymnast — or five years old. No matter. Agility can be improved at any age. And working on your agility may just keep you safe no matter what exercise you choose. n

ABOVE: Chris Sarquilla helps 5-year-old Porter demonstrate a dive roll at Spokane Gymnastics. RIGHT: Porter shows his hops. YOUNG KWAK PHOTOS


This one’s simple: Do a standing hop from a raised platform and back onto the ground. In the gym, Porter jumps on a special cushion, but you could use a platform of two-by-fours or a street curb. If you feel really confident, you can do it as you’re going up stairs, Sarquilla says. “[This exercise] trains your muscles to work on the weight transfer when you’re going up and down,” Sarquilla says. The key is to keep your weight on the balls of your feet as you jump, Sarquilla says. Train-

ing your body to land safely is important for athletes in any sport that involves running and jumping. “If they’re no good on their feet, they’re going to have a hard time,” Sarquilla says. “They’re going to roll an ankle, they’re going to break an ankle.”


A dive roll is a common bail-out move for athletes who are going down. “Any time you’re going to fall, any time you’re going to bail on something” a roll will

save you, says Sarquilla. “It takes your weight, [and] rather than going into the floor, you go into a roll.” Start with your arms up and your chin tucked in, then pitch forward, looking at your belly button as your roll on your back. Mid-way through you should be lying on your back and have your toes upwards and your arms at an angle. Use your momentum to get you back on your feet as you finish. — CHRIS STEIN

September-October, 2012

10.5-EXERCISE_INHEALTH_SEPT_2012.indd 37

InHealthNW 37 8/27/12 4:08:26 PM


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



TOBACCO CESSATION PROGRAM Students will learn to quit smoking during the four-week program starting on Sept. 5 and on Oct. 3 from 6-7 pm. Holy Family Health Education Center, 5633 N. Lidgerwood St. Visit: Call: 474-5490

FARM GIRL FIT Personalized circuit and strength training classes for women offered in a group setting MondaySaturday from 5:30 am-6:30 pm. Prices vary. Farmgirlfit, 128 S. Sherman St. Visit: Call: 747-2330 YARROW YOGA Hot yoga classes offered seven days a week from 6 am-6 pm. Prices vary. Yarrow Yoga, 412 W. Boone Ave. Visit: Call: 413-2215 FALUN GONG Chinese meditation exercises on Saturdays at 9 am. Free. Gonzaga College Hall Room 203, 502 E. Boone Ave. Visit: Call: 252-0433 SPIN CLASSES Spin classes on bikes. Mondays and Wednesdays at 6 pm. Free, bring your own equipment. The Bike Hub, 12505 E. Sprague Ave. Visit: Call: 443-4005 DANCE CLASSES Learn tribal fusion belly dancing, classical belly dancing, choreography, corps classes and more. Times and days vary, call for details. Mystik Dream Dance Academy, 5515 N. Oak St. Call: 481-1533 HATHA YOGA Classes are appropriate for all skill levels and held on Thursdays from 5:30-6:45 pm. $30 per fourweek series, $10 drop-in. St. Joseph Family Center, 1016 N. Superior St. Visit: Call: 483-6495 QI-GONG Classes focus on slow movements and breath to increase energy and overall health on Fridays from 3-4 pm. $50 per six-week class, $10 drop-in. St. Joseph Family Center, 1016 N. Superior St. Call: 483-6495

MENTAL ILLNESS PROGRAM A series of classes for family members of those living with mental illness on Saturdays through Nov. 17 from 9:30 am-12 pm. Free. Providence Sacred Heart Medical Center, 101 W. Eighth Ave. Visit: Call: 838-5515

PRE-DIABETES CLASS Students will receive a testing meter and preventative information during a two-part class on Sept. 10 and Sept. 17, or on Oct. 8 and Oct. 15 from 5:307:30 pm. $30. CHER Diabetes Center, 501 N. Riverpoint Blvd. Visit: Call: 474-5490 CULINARY HERBALISM Learn to cook using herbs with instructors from Medicine Circle Eco-Retreat on Oct. 6 from 10:30-2:30 pm. $30, preregistration required. Sun People Dry Goods, 32 W. Second Ave. Visit: Call: 368-9378 CPR CLASSSES Students will learn adult, child, and infant CPR and choking on Sept. 11 and on Oct. 9 from 6-8 pm. $10. St. Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 232-8138 HEALTHY COOKING CLASS Students will learn how to prepare a new healthy meal each class session on Sept. 20 and on Oct. 18 from 6:30-8 pm. Free. Holy Family Health and Education Center, 5633 N. Lidgerwood St. Visit: Call: 232-8138 WHOLE FOODS PRESENTATION Students will learn the health benefits of eating diets rich in whole and unrefined foods on Sept. 24 from 5:30-7 pm. CHER Diabetes Center, 501 N. Riverpoint Blvd. Call: 232-8138 CANCER SURVIVAL CLASS A 10-week open class to help cancer patients, families and care-givers, starting on Oct. 1 and on Nov. 1 Sacred Heart Medical Center, 101 W. Eighth Ave. Free. Call: 474-5490 LUNG CANCER PRESENTATION Attendees will learn how to identify early signs of lung cancer on Oct. 9 from 6:30-8 pm. Free. Providence Sacred Hearth Auditorium, 101 W. Eighth Ave. Visit: Call: 232-8138

FUNDRAISER Keeping It Free

For nearly 25 years, the Women and Children’s Free Restaurant and Community Kitchen has been helping to fight hunger and ensure access to proper nutrition. Recent unemployment means some families are using their services for the first time. “Certainly for women on fixed incomes, it’s gotten so much harder for them to make ends meet every month,” says Development Director Jennifer Priest. “They end up sacrificing their food budget — that’s really the only place they have flexibility.” Several days a week, the organization serves free 38

meals and also holds a free produce market so clients have access to fresh, healthy ingredients to cook with at home during the weekends. A lot has changed since the nonprofit’s inception in 1988, and recently the WCFR announced that it’s looking to move to a new location, since the building it’s currently housed in has come under new ownership. On Saturday, Oct. 13, WCFR will host its biggest fundraiser of the year, the 7th annual A Little Night Music — an event at the Lincoln Center featuring wine, food, live music and an auction. Although bidders will have a chance to score use of a private suite for a Chief’s game and lake cabin stays, Priest says the “dessert of the month” made by the restaurant’s staff is always a hot auction item. — CHEY SCOTT A Little Night Music • Oct. 13, 6-10 pm • $60 • The Lincoln Center • 1316 N. Lincoln St. • 324-1995 •

MEN AND ANGER Men will learn alternatives to aggression, develop coping skills and learn to identify anger triggers on Wednesdays from 5-6:30 pm. $15 per session or $90 for six classes. St. Joseph Family Center, 1016 N. Superior St. Visit: Call: 483-6495 WOMEN AND ANGER Women will learn to express anger constructively, learn to deal with angry outbursts, strained relationships and more on Wednesdays from 4-6 pm. $100 for three classes. St. Joseph Family Center, 1016 N. Superior St. Visit: Call: 483-6495 MEDITATION Students will learn to calm the mind with 30-minute meditation classes on Tuesdays from 6-7:30 pm. $10-$12. St. Joseph Family Center, 1016 N. Superior St. Visit: Call: 483-6495 MENDED HEARTS Attendees will learn about cardiac or pulmonary disease on the third Thursday of each month at 3:30 pm. Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 208-666-2897 HEARING HEALTH SEMINAR Attendees will learn about affordable treatments for hearing loss and communication strategies on Thursdays from 1-2 pm. Free. HealthInnovations, 1212 N. Washington, Ste. 307. Call: 324-7173 Visit:

PARENTING PREPARED CHILDBIRTH The class for mothers-to-be will discuss labor and breathing techniques, pain management, fetal monitoring, and more on Tuesdays from Sept. 4 to Sept. 25, from Oct. 9 to Oct. 30, and from Nov. 6 to Nov. 27, from 6:30-8:30 pm. A special class session will be held on Oct. 22 and 26 from 12-4 pm. $15-$65. Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 208-666-2030 CHILDBIRTH CLASSES Expecting parents will learn about prenatal care, nutrition, stages of labor, pain management, breathing, post-delivery care, infant CPR, and more in a six-week session from Sept. 10-Oct. 15 on Mondays from 7-9 pm. $60 per couple. Valley Hospital Health Education Center, 12606 E. Mission Ave. Spokane Valley Visit: Call: 473-5446 SAFE KIDS CAR INSPECTIONS Experts help parents select an appropriate child restraint system and explain how to install it on Sept. 13, 20, and 27, on Oct. 4, 11, 18 and 25, and on Nov. 1 and 8 from 1-4 pm. Free. Kootenai Medical Center, 2003 Kootenai Way. Call: 208-666-2233 BRINGING BABY HOME New parents will learn about postpartum stay and care of mothers and children on Sept. 15 and on Oct. 13 from 9-11:30 am. $15. Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 208-666-2030 BABYSITTING BASICS Students ages 10-15 will learn about childcare, safety, and behavioral techniques and more on Sept. 22 or on Oct. 20 from 9 am-2 pm. $40. St Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 232-8138 SAFETY SATURDAY Free fingerprinting, child safety information, and safety tips from the Spokane Police and Spokane Fire departments on Sept. 22 from 10 am-2 pm. AAG Insurance, 10408 W. Hwy. 2. Call: 891-1800 CHILDHOOD OBESITY PRESENTATION Attendees will learn about the risks and treatment of childhood obesity on Sept. 25 from 6:30-8 pm. Free. Providence Holy Family Education Center, 5633 N. Lidgerwood St. Visit: Call: 232-8138 MATERNITY TOURS Expecting parents will meet nurses, staff, and tour the birthing facilities on Oct. 1 and on Nov. 1. Call to schedule appointment. Sacred Heart Medical Center, 101 W. Eight Ave., Call: 474-2400 Holy Family Hospital, 5633 N. Lidgerwood St. Call: 482-2229

InHealthNW September-October, 2012


8/28/12 11:02:49 AM

BREASTFEEDING BASICS Mothers will learn to initiate and continue breastfeeding on Oct. 15 from 6:30-8:30 pm. $15. Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 208666-2030

CANCER SUPPORT GROUP Patients and family members are invited to meet on the first, third, and fifth Tuesday of every month from 5:30-7 pm. Providence Holy Family Health Education Center, 5633 N. Lidgerwood St. Visit: Call: 474-5490

PARKINSON’S SUPPORT GROUP Those living with Parkinson’s will meet on the third Monday of each month from 2-4 pm. Parkinson’s Resource Center of Spokane, 910 W. Fifth Ave. Visit: spokaneparkinsons. org Call: 473-2490

NEW MOTHER SUPPORT GROUP Attendees can seek advice from other new mothers and a lactation consultant will be on hand to answer questions. Group meets every Wednesday at 10 am. Free. Providence Sacred Heart Women’s Health Center, 801 W. 8th Ave. Visit: shmc. org Call: 474-2400

WOMEN’S CANCER GROUP Open group for women dealing with cancer, on Mondays from noon-1 pm. Kootenai Cancer Center, 1440 E. Mullan Ave, Post Falls. Visit: Call: 208-666-2000

HIV SUPPORT GROUP Individuals with HIV/AIDS and their friends and family are invited to meet for dinner and supportive conversation on the second Monday of each month from 5:15-7:15 pm. Free. Spokane AIDS Network, 905 S. Monroe St. Visit: Call: 455-8993

PARENTING CHILDREN OF DIVORCE Parents will learn to communicate with their children, create a supportive environment, learn about separation affects and more on the first and third Tuesday of every month from 6-9 pm. $25. St. Joseph Family Center, 1016 N. Superior St. Visit: Call: 483-6495

SENIORS COUNTRY DANCING Try a variety of dances including the 10-step, two-step, line dancing, and the waltz on Mondays from Sept. 10-Oct. 29 from 6:30-8 pm. $26. Sons of Norway, 6710 N. Country Homes Blvd. Call: 279-6027 TOTAL BODY FUSION Gentle exercises to improve the ease of daily activities and increase bone density on Mondays and Fridays from Sept. 10 to Nov. 9 from 11 am-noon. $36. Sons of Norway, 6710 N. County Homes Blvd. Call: 279-6027 LINE DANCING Students can stay energized and fit while learning basic steps and rhythms of line dancing from Sept. 10 through Nov. 19 on Mondays from 9:3010:30 am. $26. Corbin Senior Activity Center, 827 W. Cleveland Ave. Call: 279-6027 ZUMBA Classes combine Latin, salsa, and cha-cha rhythms to get participants energized and in shape on Mondays, Wednesdays, and Fridays from Sept. 10 to Nov. 30 from 4-5 pm. $58. Hillyard Senior Center, 4001 N. Cook St. Call: 279-6027 AEROBICS Students can boost metabolism, strengthen muscles, and improve flexibility and balance in fitness classes on Mondays, Wednesdays, and Fridays from Sept. 10-Nov. 30 from 8-9 am. $58. Touchmark on South Hill, 2929 S. Waterford Drive. Episcopal Church of the Resurrection, 15319 E. Eighth Ave. Sinto Senior Activity Center, 1124 W. Sinto Ave. Call: 279-6027 DANCE AEROBICS Combination class of ballet, salsa, tap and belly dance in a standing or seated position on Mondays and Fridays from Sept. 10-Dec. 3 from 12-1 pm. $42. CenterPlace, 2426 N. Discovery Pl. Call: 279-6027 STRETCH AND FLEX Reduce stress, increase range of motion, balance and flexibility on Mondays and Fridays from Sept. 10-Dec. 3 from 1:15-2:15 pm. $42. CenterPlace, 2426 N. Discovery Pl. Other locations available, call for more information. Call: 279-6027

AMPUTEE SUPPORT GROUP Amputees will share experiences on the third Tuesday of each month from 11 am-12 pm. St. Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 473-6681 SPINAL CORD INJURY GROUP Individuals will share experiences, learn about medical advances and therapies, and socialize on the fourth Wednesday of each month from 1-2 pm. St. Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 473-6681 STROKE SUPPORT GROUP The group will provide education, support, and social networking for stroke survivors, friends, and caregivers on the third Thursday of each month from 3-4 pm. St. Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 473-6681 ALCOHOLICS ANONYMOUS SUPPORT Those living with alcoholics will meet on Fridays from 5:30-6:30 pm. St. Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 230-0231

BREAST CANCER SUPPORT GROUP Women with cancer are invited to share their experiences and issues encountered, on the second and fourth Wednesday of each month from 6-8 pm. Providence Holy Family Hospital, 5633 N. Lidgerwood St. Visit: Call: 475-5490 HOSPICE SUPPORT GROUPS Grief support for spouses, children, families, survivors of suicide, and more meet regularly throughout the greater Spokane area. Times and locations vary. Visit: Call: 456-0438 CANCER SUPPORT GROUP People who are living with cancer are invited to meet on Wednesdays from 1-2 pm. Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 208-666-3800


AUTISM SUPPORT GROUP Family members and loved ones living with autism will meet on the third Wednesday of each month from 6:30-8:30 pm. St. Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 624-3323

TRIATHLON FOR KIDS An event to promote health and fitness to kids ages 4-11 on Sept. 8 at 9 am. $20. Kootenai Health Center for Rehabilitation, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 208-666-2950

BRAIN INJURY SUPPORT GROUP Those living with brain injuries, and their loved ones, will meet on the second Wednesday of each month from 7-9 pm. St. Luke’s Rehabilitation Institute, 711 S. Cowley St. Visit: Call: 340-0786

…continues on next page

COLOR VIBE Join others on a 5K fun run and get splattered with paint on Sept. 8 at 9 am. $40-$50. Spokane Falls Community College, 3410 W. Fort George Wright Dr. Visit: Call: 435-227-5809

The Art of Window Dressing

SUPPORT GROUPS GRIEFSHARE Those experiencing the loss of a loved one are invited to meet for support on Thursdays, starting on Sept. 6 at 1 pm. Free. ONE Church, 15601 E. 24th Ave. Visit: Call: 993-8276 FOOD ADDICTS IN RECOVERY Attend an informational meeting to learn about ways to better control the way you eat on Sept. 8 at 3 pm. Free. Sandpoint Events Center, 102 Euclid Ave. Sandpoint, Idaho. Visit: TOBACCO SUPPORT GROUP Learn to successfully quit smoking on Sept. 10, Sept. 24, Oct. 8, and Oct. 22 from 6-7 pm. Providence Holy Family Health Education Center, 5633 N. Lidgerwood St. Visit: Call: 482-0111 CAREGIVER SUPPORT GROUP Caregivers and the people they look after are invited to attend for socialization and activities on Sept. 11 and on Oct. 9 from 1-3:30 pm. Providence Adult Day Health, 6018 N. Astor St. Visit: Call: 482-2475

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September-October, 2012


InHealthNW 39 8/28/12 3:14:27 PM



BIKE MS An annual, two-day, 150-mile ride along the Trail of the Coeur d’Alenes between Mullan and Plummer, Idaho to benefit the National Multiple Sclerosis Society on Sept 8-9. $50. Visit: Call: 800-344-4867 SPOKEFEST Join in on a 2.5-mile family ride, a 9-mile Spokane Falls loop, a 21-mile river loop, or 47-mile Four Mounds loop, Saturday, Sept. 9 at 8 am. COBRA POLO CLASSIC The annual event benefits the Ronald McDonald House Charities of Spokane on Sept. 9 at 4 pm. $175+. Spokane Polo Club, 7500 U.S. Hwy. 2 Visit: BOCCE BALL TOURNAMENT Event includes a raffle and dinner to benefit local, underprivileged youth on Sept. 9 from 12:30-7 pm. $75+. Bozarth Mansion, 12415 N. Fairwood Dr. Visit: TREE OF HEALING Two-day educational conference with workshops on hearing loss, medications, addictions, mental illnesses and disorders, grief healing, and more Sept. 13-14 from 8 am-5 pm. $50-$200. Northern Quest Resort & Casino, 100 N. Hayford Rd. Call: 789-7630 HEART WALK Cardiovascular disease awareness walk and fundraiser to support heart disease medical care, research, and education on Sept. 15, start time TBA. Riverfront Park, 507 N. Howard St. Visit: Call: 536-1500 SCENIC HALF Choose from a half marathon, 10K, or 5K scenic route around Sandpoint on Sept. 16 at 8:30 am. $24-$54. Downtown Sandpoint, Idaho. Visit: scenichalf. com Call: 208-263-2161

DINE OUT FOR AIDS Eat breakfast, lunch, or dinner at Maggie’s South Hill Grill to benefit the Spokane AIDS Network on Sept. 17 between 8 am-9 pm. Maggie’s, 2808 East 29th Ave. Visit: Call: 455-8993 CARING FOR KIDS LUNCHEON 16th annual event to benefit St. Anne’s Children & Family Center and the Morning Star Boys’ Ranch on Sept. 20 at 11:30 am. $100. Doubletree Hotel, 322 N. Spokane Falls Court. Visit: Call: 358-4254 RACE FOR THE CURE Join others and Susan G. Komen for the Cure of Idaho in a 1-mile or 5K walk to raise money and awareness for breast cancer on Sept. 23 at 8 am. Starts at North Idaho College, 1000 W. Garden Ave. Visit: Call: 208-665-9088 DIABETES WALK Three-mile benefit walk for the Juvenile Diabetes Foundation on Sept. 23 at 10 am. Riverfront Park. Visit: Call: 459-6307 WELLNESS AND BEAUTY EXPO Three-day event featuring 100+ vendors, activities, demonstrations, fresh food market, and mini spa and beauty treatments, Sept. 28-30 from 10 am-7 pm. $5-$7. North Pines and East Sprague. Visit: Call: 434-1033 STOMP OUT ABUSE WALK Join others in a 5-K run or walk to benefit local victims of domestic abuse on Sept. 29 at 9 am. $35. Riverfront Park, downtown Spokane. Visit: Call: 484-0600 AIDS WALK Join the Spokane AIDS Network for its annual fundraiser and AIDS awareness event on Saturday, Sept. 29 at 11 am. Riverfront Park, downtown Spokane. Visit: Call: 455-8993

DUCK RACE Annual event hosted by the El Katif Shrine to benefit the Shriners Hospitals for Children-Spokane on Sept. 30 at 11:30 am. $5 per duck. Riverfront Park, downtown Spokane. Visit: Call: 624-2762 SISTER PETER CLAVER AWARD DINNER Annual award presentation to a nominee who exemplifies Sister Claver’s commitment to serve others on Oct. 9 at 5:30 pm. $40. Nominations due by Sept. 14. Spokane Club, 1102 W. Sprague Ave. Visit: Call: 474-3081 SIGNATURE CHEFS AUCTION Annual event to benefit The March of Dimes on Oct. 13 at 6 pm. $100+. Red Lion at the Park, 303 W. North River Dr. Visit: marchofdimes. com Call: 328-1920 THE PUMPKIN BALL Black-tie gala featuring dinner, auctions, and entertainment to benefit children serviced by Sacred Heart Children’s Hospital and the Vanessa Behan Crisis Nursery on Oct. 20 at 5:30 pm. $150+. Spokane Convention Center, 334 W. Spokane Falls Blvd. Visit: Call: 474-2819 GUARDIANS OF HOPE Attend the annual benefit breakfast for Cancer Patient Care on Wednesday, Oct. 17 at 7:30 am. Davenport Hotel, 10 S. Post St. Visit: Call: 456-0446 PEOPLE WHO CARE Transition for Women will host its annual fundraiser breakfast and luncheon and its 10th anniversary celebration on Oct. 23 from 7:30 am-1 pm. Red Lion Hotel, 303 W. North River Dr. Visit: Call: 328-6702 BLOOD DRIVE Walk-ins and registered donors will be accepted on Oct. 26 from 7:30 am-4 pm. Kootenai Medical Center, 2003 Kootenai Health Way, Coeur d’Alene. Visit: Call: 800-423-0151 FASHION SHOW AND LUNCHEON Models from the media, law enforcement, and civic agencies will model fashions to benefit for the Hope House on Oct. 26 from 12-2 pm. $45+. Doubletree Hotel, 322 N. Spokane Falls Ct. Visit: Call: 624-2378 n


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The 40-Gallon Man Eldo Androes has helped as many as 1,000 people BY KEVIN BLOCKER


Eldo Androes has been giving blood for six decades now.

f one has spent the majority of his life donating blood — nearly 40 gallons worth — you’d suspect he’d say he’s done it out of a profound sense of community or some other altruistic motive. At 83, Eldo Androes wouldn’t fess up to any of those motivations, at least publicly. He did admit that after donating blood he tends to “feel better” physically. Could it be there’s such a thing as a donor’s endorphin rush? This much is certain: Whether Androes is deliberately downplaying his contributions in an aw-shucks-it’s-no-big-deal manner, his actions speak more profoundly than anything he could ever articulate. Elizabeth Giles, the marketing and communications officer for the Inland Northwest Blood Center, quantified his almost 60 years of blood donations this way: “Every one donation has the potential to save three lives,” Giles says. “What that means is that as many as 939 people could have used blood from him through the years.” The mathematical breakdown looks like this:



One unit of donated blood per visit equals a pint. (Eight pints equal a gallon.) Androes has made 313 donations and needs to make six more to reach the 40-gallon mark. The INBC is not aware of any 40-gallon donors actively contributing. “I don’t know,” Androes says. “The Lord pointed me [in the direction of donating.]” He is one of a half-dozen regional donors have who have eclipsed the 35-gallon mark, according to INBC records. Residents of the Inland Northwest have historically recognized the significance of an ample blood supply, something many other parts of the country cannot claim. Older donors like Androes tend to be among the most consistent blood contributors, according to Giles. Blood donations as a routine habit for older Americans started around World War II when the country faced a massive blood shortage. Today, however, blood centers like the INBC cannot regularly rely on older donors. In the case of Androes, his blood donation pace has slowed this year because he had to start taking medication to boost his pulse rate.

At present, 35 percent of the INBC’s blood supply comes from high school and college students, extraordinarily higher than the national average, Giles says, adding that the INBC needs more consistent donors in the 35 to 54 age range. “It isn’t that they no longer want to donate,” Giles says of the age group. “It’s that medically they can’t due to surgeries, health issues or medications. It’s hard when we lose those donors who have spent all of their lives contributing.” As for Androes, he’s eager to begin donating and hopes to soon get clearance from his doctor to do so. He recalls he began donating blood at age 24 or 25, after he got out of the Air Force and returned to Spokane. “There’s so much more awareness now about blood donation than there was back then,” Androes says. “Personally for me though, I don’t think I ever thought about it.”  To join Eldo Androes and become a blood donor at the Inland Northwest Blood Center, visit

InHealthNW September-October, 2012


8/27/12 4:09:40 PM

Molly Pepper, Associate Professor of Management and Peggy Sue Loroz, Associate Professor of Marketing

Gonzaga professors help women reduce work-related stress It’s no secret that working women today are facing everincreasing demands in both their personal and professional lives. That often leads to unhealthy levels of stress. Research by Gonzaga University management and marketing professors Molly Pepper and Peggy Sue Loroz has revealed key contributors to the problem as well as a few practical tools to help women reduce stress and prevent workplace burnout. They found that some of the biggest stress factors involve trying to attain work-life balance, overcoming career advancement hurdles and coping with workplace bullying. Over time, dealing with these issues can lead to emotional exhaustion, detachment and reduced physical and emotional energy. Consistent with Gonzaga’s mission, Pepper and Loroz focused on cura personalis – or care for the whole person – when developing their techniques for handling these issues. They identified three main ways to improve workplace stress levels:

Time Management: Find the time of day that you are most productive and the setting that is the most conducive to getting things done. Use those factors to your advantage. Identify the tasks that are most important and focus energy on those before addressing other things. Affinity Groups: Join a group of colleagues who share similar interests and needs. If one doesn’t exist, start your own. Relationships formed within these groups provide a support system that can help you cope with and lessen your workplace stress. Mighty Purpose: Define the purpose of your job and focus on fulfilling it. Keep this purpose in the forefront of your mind and avoid distractions that can pull you away from achieving it. Once you find your mighty purpose, you will feel freer to be your true self and accomplish your goals.

Professors Molly Pepper and Peggy Sue Loroz present workshops based on their findings that can help women reduce stress and prevent workplace burnout. To learn more about current research done by Gonzaga faculty, visit the School of Business Administration’s online Knowledge Center at

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InHealthNW 43 8/27/12 4:09:44 PM

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Inhealth September 2012