mvnews health & wellness

Health and Wellness 2010/11

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Contents

Methow Valley

Health&

Wellness2010/2011

Paul Butler publisher

Sue Misao editor

Robin Doggett ad sales

Callie Fink ad sales

Dana Sphar ad design/production

Linda Day ad design

Marilyn Bardin office manager

Janet Mehus office assistant

ContributorsJoyce Campbell

Sally GraciePatrick Hannigan

Ashley LodatoAnn McCreary

Bob SpiwakMarcy Stamper

Amy Stork

A publication of the

Methow Valley News

PO Box 97Twisp, WA 98856

509.997.7011Fax 509.997.3277

Coffee and other vicesThe secret to a long and prosperous life.........................p. 4

Emergency roomsWhere the buck stops after the breaks start...............p. 5 ToesFar from the brain but important to remember.....p. 6

We support youA network of help............................................................................................p. 8

Country lifeClean air but danger abounds.................................................p. 11

Medical marijuanaA gateway drug?..........................................................................................p. 12

Home birthA private and peaceful option..................................................p. 13

Hospital infectionsUnderstanding HAI’s................................................................................p. 14

Directory of AdvertisersSupporters of this guide......................................................................p. 15

[email protected]

As people, we are continually faced with health-related issues,

from the moment of our birth to our final resting day. In that finite window of time, we strive to achieve and maintain well-ness, while many others strive to help us in our pursuit of that

goal. The Methow Valley Health & Wellness guide probes into a few preconceived notions of what may or may not be

good for you; examines some often-ignored elements of our physiology; and offers links to genuine local support in times

of need. It also journeys into the medical institutions we take for granted and examines the pros and cons of life in the beautiful Methow, where, until now, may have seemed nothing short of a hearty and healthful paradise.

Turn the page to find out more.... Cover photo courtesy of Blue Bradley

To your health!

Est. 1983


The upside of vicesBy Amy Stork

ant to live a longer, healthier, smarter and happier life? Put away the supplements and pick up a cup of coffee, a glass of wine or a shot of whiskey. Mounting scientific evidence

points to the health benefits of all these traditional vices – when they’re consumed in moderation, of course.

Good news for the more than half of American adults who have a daily coffee hab-it: In addition to living a bit longer on average, you seem to be less likely to develop a host of common diseases than those who seldom or never drink coffee.

In an analysis of 17 stud-ies relating coffee consump-tion to diabetes, scientists at the George Institute for International Health in Sydney, Australia, reported that as coffee consumption rose, the risk of developing Type 2 diabetes fell sharply – with a 7-percent reduction in risk of diabetes for each daily cup.

Coffee’s tendency to stave off diabetes may come from its ability to make the body more sensitive to insulin and prevent the development of high blood sugar. The benefits seem to come not from the caffeine (decaf works just as well) but from other compounds found in coffee and some teas.

Meanwhile, at the Florida Alzheimer’s Disease Research Center, they’ve been feeding caffeine to mice with Alzheimer’s disease – and replicating the results of European studies show-ing that people who drink three-to-five cups of coffee a day are more likely to stay sharp in old age. (Mice who ingested caffeine equivalent to 10 cups of coffee a day fared even better.)

Researchers have also linked coffee con-sumption to decreased risk of cancers of the head, neck, prostrate and liver – perhaps because it contains high levels of antioxidants, the chemicals thought to protect cells from aging and toxins.

For women, coffee may have cardiovascular benefits, too. One study found that women who drank one-to-three cups of java a day reduced their risk of cardiovascular disease by 24 percent. Another showed a 19-percent lower risk of stroke among women who drank coffee.

Besides its preventative benefits, coffee is also used as medicine. It can ease the occasional headache, relieve constipation and reduce asthma symptoms. Some parents are even using caf-feine to address attention-deficit hyperactivity disorder (ADHD) in their children – it has the same paradoxical calming and focusing effect as Ritalin and other stimulants.

If you are now wondering if there’s such a thing as too much coffee, the answer is yes. Coffee can be abused, is associated with anxiety and other psychological disturbances, and can lead to chronic migraines.

Although caffeine addiction isn’t considered a clinical condition like alcoholism or other drug abuse, it is definitely habit-forming for some people – and stopping suddenly may lead to

headache and other unpleas-ant symptoms.

However, a casual sur-vey conducted recently in the Methow Valley found that coffee wakes people up when they are tired, and on average this makes them happier.

Drinking a pint of whis-key or a jug of wine a day isn’t good for anyone, and chronic alcohol abuse can lead to liver disease, car-diovascular problems, car accidents and family and social problems.

But dozens of studies now show a correlation between moderate drinking and healthier, longer lives.

Moderate drinking usu-ally translates into one-to-three drinks a day, depend-ing on your size and gender. To get any health benefits,

the drinks have to be consumed daily, not all at once on Friday night.

A passel of studies links those one or two drinks a day to decreased risk of heart disease, particularly for men, and for people over 55. Both teetotalers and heavy drinkers tend to fare worse.

According to the Mayo Clinic, such moderate alcohol use can also reduce your risk of heart at-tack, stroke, gallstones and possibly diabetes.

Of all the drinks, red wine appears to have the most benefit. Researchers think that’s thanks in part to antioxidants called flavonoids that occur in colorful vegetables and fruits as well as wine, and appear to protect the lining of blood vessels in the heart. Studies in mice show resveratrol, another antioxidant contained in wine, may help prevent arteries from becoming clogged with fatty blockages.

Scientific evidence for the benefits of drink-ing whiskey aren’t as forthcoming – except one study conducted by a consultant to the single malt scotch industry that showed a link between that particular beverage and cancer prevention. Hmmm.

Not so long ago, whiskey figured promi-nently in frontier medicine for its anesthetic and antiseptic properties. Folk medicine also calls for liquor in treatment of stomach ailments (brandy) and colds (rum), and as a dressing for everything from cracked nipples to snake bites.

W

Photo by Sue MisaoA glass or two of wine each day may benefit some people.


Emergency!By Marcy Stamper

The common image of an emergency room, inspired by television and movies, is one of high-pitched drama

and heroics, but, fortunately, the scene at local ERs is not quite like the one at Chicago’s County General.

“It can be either calm or hectic, depending on the day,” said an ER nurse at the Okanogan Douglas Hospital in Brewster.

Both the Brewster hospital and Mid-Valley Hospital in Omak are certified Level IV trauma centers and provide comparable emergency ser-vices. As Level IV facilities, they have critical- and inten-sive-care units and can arrange to transport a patient by air if necessary.

Okanogan Douglas has an emergency room nurse and a doctor, physician’s assistant or nurse practitioner, all with specialized ER training, on staff at all times. They call in other specialists as needed, said chief nursing officer Emily Canwell.

“We have everything needed for trauma, heart at-tacks – anything that comes in,” she said.

Mid-Valley is staffed ’round-the-clock by a physi-cian and nurses, all certified in trauma care, according to Rachel Weber, their critical care services manager. They care for more than 7,000 patients annually in the emergency room, although most cases fall within the non-urgent and ur-gent categories, she said. Still,

it is not uncommon to have six patients arrive by ambulance each day.

Okanogan Douglas has four private main rooms and an overflow room, but will use other areas when necessary to accommodate patients. They once had 13 trauma cases and had to use the dining room and hall, said Canwell.

Okanogan Douglas’s busi-est times are weekends, par-ticularly during the summer, when they treat more injuries and broken bones. During harvest season, the hospital sees many injuries associated with apple picking, such as falls from ladders, said Canwell.

Virtually all emergency cases are transported to one of the two hospitals (gener-ally the one that is closer), where people are assessed

and stabilized. Patients with a heart attack, stroke or serious trauma and those requiring complicated surgery are typi-cally transferred to hospital with a higher level of care after they are stabilized.

What can you expect when you arrive at the emergency room? A triage nurse will ask about symptoms and take vital signs – blood pressure, pulse, and temperature – and then decide if immediate attention is required, said Canwell.

While some people with-out health insurance or a primary-care physician rely on emergency rooms for their ba-sic medical care, because there are no clinics or urgent-care centers open after hours or on weekends, local ERs also treat people with conditions that

require attention but are not emergencies, said Canwell.

Mid-Valley has almost completed a renovation of its emergency room, tripling the space and providing eight private rooms, including two

trauma rooms, said Weber. The hospital is also remodel-ing its laboratory and mov-ing the respiratory-therapy department so it is closer to the ER. The new facility will have private areas for triage and blood draws, a designated ambulance entrance and a separate waiting room. The renovations are being funded by a voter-approved levy.

Okanogan Douglas also hopes to renovate its emergency room and is currently applying for a grant to fund the project. Plans call for a new layout to make things more efficient, al-lowing one nurse to monitor all rooms from a central location, and for modernizing equip-ment, said Canwell.

Patients can help health providers in the ER give them the best care by bringing their medical history, including a list of medications and allergies, and information about past surgeries and illnesses, said Canwell.

Photo by Marcy StamperLocal hospital emergency rooms in Okanogan and Brewster are fully staffed with highly qualified medical professionals.

HORSE OF A DIFFERENT COLOR


oes are kind of like fingers except they are not. Granted, there are five of each and they have what...for some reason...we call

“nails.” But fingers are to most people far more useful and this is correct. I could not type this with my toes, although my edi-tor might wonder if I did.

Anyhow, toes do play an important part in our physiol-ogy. It would be very hard to balance without them and we should take care of them. This is frequently overlooked because we only see them when remov-ing our socks or in the shower or tub. Dr. Del Schweitzer, the leading podiatrist in Edelweiss, advises that toe health, along with the attached feet, is a very important thing. Therefore, since they are out of sight, out of mind, further amplification of the toes is crucial to this publica-tion devoted to health.

Out of sight yes, but out of mind? Have you ever had athlete’s foot, or worse, an in-grown toenail? Ouch.

Athlete’s foot is a layperson name for fungus between the toes, on the toes and sometimes on the foot, which, as already mentioned, is attached to the toes. It can be itchy, annoying, and odoriferous and can require constant applications of anti-fungal creams, salves or sprays. At its worst, more draconian measures may be required, and the podiatrist is the person you will turn to.

Why are toes so prone to fungal disease? Because not only are they out of sight, they

are hidden beneath a layer of socks, which in turn is under a layer of shoe or boot. It gets quite warm and dank down there in the nether regions, and the warmth produces transpiration of liquid matter that lies in the dark recesses between the toes – an ideal breeding ground for icky stuff. Thus, toes should be washed daily or nightly – better yet, both.

Each foot contains five toes. From right to left, or left to right if you choose, there is the big toe, the one next to it, the one next to that and the one next to the little toe, also known in medical terminology as the “pinky” toe.

The big toe is so named because it is large and burly. Its job is to crash against obstruc-tions in a maneuver medically known as “stubbing.” Stub-bing can produce a mild ache or great pain, both of which are a warning to the rest of the body to back up, or if tripping,

to protect yourself as you fall. It has also been reputed to be protection for its fellows on the individual feet. My big toe on the right foot is named “Brutus” because he is a tough hombre, his mate on the other foot is called “Big Toe.”

There is some question about the use of all the other toes. Without them, at first glance (if you can see them), there probably would not be athletes’ foot. But they do serve a purpose, for what they do is bend upward while walking, enabling the body above to push off, as well as perform push-ups. There has long been contro-versy over the need to have a pinky toe, which, according to historians, has been shrinking for millennia and someday may be only a residual stub, if extant at all.

Toenails adorn the top of each toe. Their purpose is to protect the lower regions from harm. The problem with this

is they frequently enjoy harm-ing their hosts, frequently by becoming ingrown. This occurs when, through poor clippage or injury, a portion of the nail will enter the surrounding flesh somewhere and grow in that di-rection. Even normally growing toenails must be clipped prop-erly because, along with other maladies, horny fungal growths can breed under the nail, result-ing in a malodorous condition and just plain ugliness. It is a little known fact that nail polish was originally invented not for the fingernails, but for the toes. Once painted they were very at-tractive, especially when worn with open-toed sandals as in medieval times.

By now, you may have removed your shoes and socks or looked through the gap in your sandals at your feet. Good. Looking closely, you will note that the toes march away from the foot, big toe at the front (or back – your choice) of the line in a 45-degree angle, give or take

a few degrees. This is a marvel not only anatomically but how it came to be, which has been extensively studied by scholars of evolution. Toes, you see, used to face directly forward from the foot. It is a marvel of rapid evolutionary change, all begin-ning around 1400 AD. There were a lot of wars in those days and the soldiers, when lined up in formation at attention had to point their feet outward, not surprisingly at a 45-degree angle. This was very hard on the ankles, and nature recognized this anomaly and in her own way, albeit rapidly, began to change the configuration of the foot and its toes, thus making it easier not only to point outward, but to perform a snappy “about face,” pushing off as noted above with the rear toes.

Do remember to remember your toes. They need attention even if you are not cleansing the rest of your body in the shower or bath. Your feet will thank you for it. So will your mate.

TStay in balance with clean, healthy toes

By Bob Spiwak

Photo by Sue MisaoAs an important part of our anatomy, toes deserve and need to be treated with caring devotion.


We support youBy Ann McCreary

“People come to share experience, strength, and hope.”

–Local Alcoholics Anonymous member

“People need to be able to share those fragile moments and come away stronger.”

–Jocelyn Murray, Breast Cancer Support Group facilitator

“Support groups are a good means of creating a framework for life change.”

–Adrianne Moore, Domestic Violence Support Group facilitator

upport groups provide a place for sharing what’s difficult in our lives, learning from the experience of others and finding the strength to make changes to improve our lives.

In the Methow Valley, several groups meet regularly, providing local residents a

place to join with others to talk about common inter-ests and experiences. From Alcoholics Anonymous, which has held meetings here for about 30 years, to a Domestic Violence Support Group founded about one year ago, our small community is developing a growing network of support for its residents.

Several of the groups are sponsored or hosted by Room One in Twisp, the valley’s primary provider of social services. The Domestic Violence Support Group

and a Mothering Group are sponsored by Room One because they “speak specifically to some of our core goals,” which include decreasing domestic violence and increasing parent and child health, said Karissa McLane, Room One director. “We have an excellent facility and we want to make that as available as possible,” McLane said.

There is still a need for other types of support groups in the valley, McLane said. Two ideas suggested by community members include a grief support group and a co-parenting support group. She hopes that eventually facilitators will come forward to launch those groups.

Following are descriptions of several active sup-port groups in the Methow Valley.

Alcoholics AnonymousThe 75-year-old granddaddy of support groups,

with an estimated two million members worldwide, has been active in the Methow Valley “for as long as I can remember,” said one member. “Some members have been attending for 30 years.”

In its literature, AA doesn’t describe itself as a “support group,” but as a “fellowship” or “informal society” that is concerned solely with the personal recovery and sobriety of individuals who turn to the fellowship for help.

According to AA, “the relative success of the AA program seems to be due to the fact that an alcoholic

who no longer drinks has an exceptional faculty for reaching and helping an uncontrolled drinker.”

“The disease of alcoholism is very widespread, through all classes of people,” the local member said, adding, AA “supports those people trying to change their lives.”

AA’s strength, the member said, lies in its single-ness of purpose – helping members live without alcohol – and its enduring commitment to anonym-ity for its members. “Anonymity, like sobriety, is a treasured possession.”

AA meetings are held seven days a week at loca-tions throughout the valley. Attendance at the meetings ranges from 10 to 40 people, the local member said. On holiday weekends the numbers increase as visitors to the valley attend local meetings during their stay.

Meeting times and locations are listed each week in the “What’s Happening” section of the Methow Valley News.

Narcotics AnonymousNarcotics Anonymous grew out of the Alcoholics

Anonymous program in the late 1940s, and is modeled on the same recovery and peer support approaches pioneered by AA when it was founded in 1935.

The local NA groups meet three times a week, and attendance ranges from two to 12 people, a local member said. Participating in NA “helped me see I needed to change my life and it helped having people

S


Illustration by Tania Gonzalez Ortega

Sometimes a shared burden is less of a burden.

to talk to who knew what I was going through,” the member said. NA meeting times and locations are published each week in the “What’s Happening” section of the Methow Valley News.

Domestic Violence Support GroupEstablished about a year ago, the Domestic Vio-

lence Support Group offered by Room One provides a safe environment for women to meet with others who have experienced domestic violence in their lives.

“In dealing with any traumatic event…particu-larly longstanding events that have become part of your life, it’s extremely beneficial to process that in a group,” said Room One director Karissa McLane.

McLane said participants in the Domestic Vio-lence Support Group find strength in “realizing you’re not alone in that situation and hearing other people’s experiences, and how they’ve worked through them and made changes in their lives.”

The group is facilitated by Adrianne Moore, who studied public health with a focus on marginalized women, and who previously founded and managed shelters for women before moving to the Methow Valley. Moore said women who participate in the domestic violence group come from two different situations. “One is where a woman has come from a safe background and entered a domestic violence situation. The other is women who have been lifelong domestic violence survivors and have just started to come out of that darkness.”

In either case, the women’s personal beliefs about their world are shattered, Moore said. Women who saw the world as a safe place before experiencing domestic violence “will often have their beliefs traumatized,” and lose faith in their own perceptions. Women with long

histories of domestic violence “may never have created positive life beliefs.” They feel, says Moore, that “the people I love hurt me and I can’t trust people.”

“Both are left with the feeling that the world is unsafe, they can’t trust anybody, and lose faith in themselves,” Moore said.

In the support group, the women examine their beliefs about five basic needs – safety, trust, control, self-esteem and intimacy. “We look at the core belief that makes you feel angry, or uncared for, or unloved,” Moore said. Through this work, and with each others’ support, the women gain insight and strength to heal themselves and move forward in their lives.

Before joining the group, women contact Room One and are interviewed by Moore to make sure they will fit into the group and can uphold the rules of confidentiality that are a key part of the group. To join, they must sign an agreement to keep everything that is said in the group confidential. The group meets twice a month, and meeting times and location are

also confidential. For information, call 997-2050.

Non-violent CommunicationFormed about two years ago, the Non-violent

Communication Group focuses on learning to com-municate in a manner that is more direct, honest and empathetic.

“It’s not really a support group in the typical sense,” said facilitator Rocklynn Culp. “It’s a group where we discuss and practice these particular com-munication techniques.”

“Non-violent communication” is a technique developed by psychologist Marshall Rosenberg. It is also known as “compassionate communication,” a term Culp said may better express the goal. “It’s a technique that’s really simple but really challenging because it requires a person to change the way they think and communicate based on making observations, express-ing feelings and needs, and making requests.”

Culp began studying the non-violent communica-tion techniques about six years ago, and two years ago she and Dierdre Luvon of Twisp organized a local group and brought a trainer in to offer a workshop. The group has continued to work together to learn and practice the communication methods. The approach is about the way people communicate with others, and the way they communicate with themselves, Culp said. It teaches how to have empathy with people even when you don’t understand their actions, she said.

“It contributes to more feelings of compassion for ourselves and others. A lot of us go around blaming ourselves for what happens. Non-violent communication helps us create more gentleness with ourselves.”

Continued on Page 10

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The group allows participants to practice the communication techniques together. “It’s really like learning a new language. It feels really awkward at first,” Culp said. “The practice group is taking it from the level of a form to a practice you can embody.”

Because the current members have already done a lot of work to learn the technique, Culp encourages any potential new members to spend time working with someone who has been involved for a while to learn the concepts and read some of the materials about non-violent communication.

The group meets on the first and third Thursdays of each month at 7 p.m. at Room One. For more information contact Culp at 997-4480 or e-mail [email protected].

Breast Cancer Support GroupWomen in the Breast Cancer Support Group

give each other both emotional and practical support, said facilitator Jocelyn Murray.

Members may share information about ways to control nausea, what to do in Wenatchee while living there during treatment, or what medical specialists they really liked. Or they may simply listen quietly while a woman talks about the physical and emotional pain she is going through.

“Sometimes people share on a level that they feel vulnerable, and they just want to be heard. We’re not there to fix each other, but we’re there to share,” Murray said.

The group ranges from seven to 14 members, and includes people in all stages of breast cancer, from newly diagnosed to 15 years post-treatment. “People who are starting out (in cancer treatment) are so reassured to see people who are that far down their walk with cancer and whose lives are so rich and full,” Murray said.

Meetings include mild exercises and time for sharing. Occasionally a special meeting is scheduled to provide education with a guest speaker. Murray, a registered nurse for 30 years, has not had breast cancer herself but has a mother, grandmother and aunt who had breast cancer. When three of Murray’s friends were diagnosed with breast cancer about three years ago, she realized that they needed support and began facilitating the group.

“With my medical background, I make sure that privacy is respected and confidentiality is maintained, and our vulnerabilities are respect-ed,” Murray said. “All of us are fragile at times in our lives, and this is one of our times.”

The Breast Cancer Support Group meets on the third Sunday of every month from 3-5 p.m. at Room One. For information contact Murray at 997-2819 or e-mail [email protected].

Mothering GroupEspecially for new mothers with infants,

the job of mothering can be a lonely one. Nicole O’Driscoll, a facilitator of the Mothering Group, knows that from experience.

“I started going to the Mothering Group last winter when my daughter was five months old. I was getting kind of cooped-up in the house. In

the valley in the winter time, it’s hard to get around with an infant.”

The group provided her the camaraderie and shared experience that is so helpful for mothers of young children, O’Driscoll said. “They under-stand and they listen, and say ‘Oh yeah, I’m so there right now.’”

The Mothering Group meetings provide an informal, confidential place to share feelings and information. Participants may discuss a healthy diet for babies, bring a speaker in to talk about posi-tive discipline for toddlers, or simply talk about their kids’ latest exploits. The women develop a network of friends they can call to support them outside the meetings as well, O’Driscoll said. “I’ve met moms that I wouldn’t have gotten to know otherwise,” she said.

The group meets the first and third Wednesday of each month, from 10:30 a.m. to 12:30 p.m. in Room One. As an added benefit, a teenage girl attends to keep the young ones entertained so the moms can have some uninterrupted time.

Continued from Page 9


any folks who visit or live in the Methow do so because they want to live a healthy life. They value clean wa-

ter, fresh air, good food, physical exercise and mental relaxation. But do they really appreciate how country living can be hazardous to their health?

For a hypochondriac, life in the Methow is downright terrifying. The valley has a variety of dangerous wild animals, a potpourri of environmental hazards and a smorgasbord of stinging, biting or poisonous insects that carry several debilitating diseases.

Wolves are probably the most infa-mous predators roaming the Methow, but of all the big animals here, these warm, fuzzy creatures are probably the least dangerous. They don’t generally eat people, but they do have an annoy-ing habit of huffing and puffing and blowing houses down. Even so, nobody need be afraid of them except the three little pigs.

Cougars are a bit more of a concern. Many folks here have stories about hik-ing along and then turning around only to find cougar tracks on top of their own. The best thing to do if you encounter a cougar on the trail or at a local bar is to turn and run screaming in the opposite direction and hope you are faster than the slowest member of your group.

Black bear are common in the valley. If you are attacked by one, first take a mo-ment and try to determine why the bear is chewing on your leg. If it is protecting its cubs, play dead. If it is actually trying to eat you, first douse yourself with bear spray (bears generally don’t like spicy food) and fight back.

Moose are fairly uncommon here, but what they lack in numbers they make up in size and an irritable predisposition to stomping anything that threatens them into a bloody pulp.

Deer are by far the most dangerous large animal in the Methow. In an aver-age year, there are around 400 deer/car collisions in the valley that result in numerous injuries and deaths. The safest way to deal with deer is to run them over. Seriously. When faced with the choice of swerving into oncoming traffic or driving off the road, the best choice to preserve your health is to simply hit the brakes and hit the deer.

Smaller local carnivores like wol-verines, coyotes and badgers can be hazardous if cornered or hugged. But if you value your health, why would you go around cornering badgers or wolverines?

Rattlesnakes top the list of local creepy crawlies that pack a potent bite. Living as I do on Rattlesnake Way, I have lots of experience dealing with these critters. One tip: Don’t weed-whack in tall grass while wearing ear plugs and flip-flops.

Mice may not appear harmful, but they are known to have fleas that can carry bubonic plague. Stranger still, several people in North Central Wash-ington have actually died after inhaling mouse poop. Mouse droppings can carry a disease called hantavirus, and once the droppings are dry and dusty, breathing that dust while cleaning the shed out back can be fatal.

Packrats are common in the valley and their greatest threat is to your mental health because they will drive you insane as they chew their way through your life. They can make a mess of your car’s wiring and they love to move into attics or crawlspaces, where they will keep you up all night by making more noise than a troupe of intoxicated tap dancers.

We have two kinds of mosquitoes here in the Methow: Big Slow Blood-suckers and Small Fast Bloodsuckers. Sure, the bites are annoying, but with every bite one also has to wonder: Did

I just get West Nile Virus? (Yes, this mosquito-borne illness has now spread to our region.)

Black widows and brown recluse spiders lurk in every woodpile and outbuilding in the Methow. Recluses are actually the scarier spider: their bite causes a slowly expanding, flesh-rot-ting wound that can grow to alarming proportions.

As winters in the valley become milder, ticks have become more com-mon. Hello Rocky Mountain tick fever and Lyme disease! Any mention of troublesome insects would be incom-plete without a shout-out to the yellow jacket – our unofficial mascot here in the Methow. If you haven’t been stung yet, you will be. Health tip: Don’t drink out of soda cans or beer bottles without first

checking for swimmers with stingers.Another icky bug in the Methow is

schistosomatidae, which is a parasite that lives in goose poop and then burrows under human skin causing a rash known as “swimmers itch.” Swimmers itch is most commonly found in late summer in waterfowl-filled marshy lakes around the valley. Oh, and while you are swim-ming, fishing or playing along the lakes and rivers in the valley, don’t forget to keep and eye out for poison ivy, which thrives in this climate.

Speaking of climate, the Methow has a full menu of weather-related hazards. Temperatures here can swing between -30 in the winter and +105 degrees in the summer, which means that you can experience frostbite, hypothermia, sunburn and heat exhaustion all in a span of five months!

Lightning storms are a common occurrence in the valley and can quickly turn otherwise healthy outdoor recre-ational activities such a hiking, golfing, biking or boating into hair-rising, near-death experiences.

Wildfires are a frequent threat to health in the Methow. Not only are they dangerous because they can burn you up, but every summer or three wildfires blanket the valley with smoky smog so thick it makes the air of L.A. or Beijing look positively pristine.

Other local hazards to your health include avalanches, flash floods, fall-ing trees, crazed hunters, windstorms, blizzards, earthquakes, porcupines, icy roads, skunks and poisonous plants. On top of it all, the nearest hospital is an hour-long drive from the Methow.

The valley does, indeed, offer reprieve from the industrial pollution, violent crime, traffic and other sundry stresses and dangers of urban living. On the other hand, we have plenty of our own challenges to living a healthful life right here in the Methow.

Country living may include side effectsBy Patrick Hannigan

M

Photo by Sue Misao

Dive now, itch later.


Medical marijuana: Gateway to pain reliefBy Joyce Campbell

n increasing number of authorized medi-cal marijuana patients in the Methow Valley are discretely adding the cannabis plant to their indoor and outdoor gardens, harvesting the leaves and flowers that relieve their suffering.

One local patient who suffers chronic nausea from a rare illness is looking forward to his first marijuana crop grown indoors under lights.

“Pot is wonderful for nausea. It keeps me sane,” said the patient, who, like all the patients interviewed for this story, requested anonymity. “I’m looking forward to eating it for longer lasting relief.” He said smoking marijuana gives relief for an hour or more, but he expects to get up to six hours of relief by ingesting the herbal medicine.

Another patient takes a daily dose of homemade tincture to reduce symptoms of glaucoma. Another is experimenting with extracting the active ingredient in marijuana to use with butter in cooking, especially desserts, to relieve chronic pain. Still another patient resorts to taking pain pills at work, and smoking

marijuana at home. Smoking has adverse effects on

the lungs and heart, according to the National Institute of Drug Abuse

website. Scientific studies showed the active ingredient (THC) acts on parts of the brain that influence pleasure, memory, thoughts, concentration, sensory and time perception, and coordinated movement. Adverse effects included dis-torted perception, impaired

coordination, difficulty in thinking and problem solving, and problems

with learning and memory.

Patients said they were informed about the risks and satisfied with their choice to use medical marijuana. All said they were ingesting or planning to prepare edible medicine, and smokers had been advised to use a vaporizer to reduce respiratory ir-ritation. One said, “I don’t have to get pills with six pages of side effects.”

State law acknowledges that marijuana “appears to be beneficial” and provides for its medical use,

while federal law outlawed the substance in 1970 and only allows its use in federally ap-

proved research. The illegal federal status prevents doctors from prescribing it and pharmacies from dispensing it, according to a report on patient access to medical marijuana prepared by the state health department.

Washington voters approved the state law in 1998 that authorized the medical use of marijuana by patients with terminal or debilitating illnesses, including chemotherapy-related nau-sea and vomiting in cancer patients, AIDS, severe muscle spasms associ-ated with multiple sclerosis and other spasticity disorders, epilepsy, acute or chronic glaucoma, and some forms of intractable pain.

Local patients each told a similar story about how they acquired a writ-ten recommendation from medical marijuana clinics in the Puget Sound

area. They each provided supporting medical records from their primary health care providers in the valley.

One patient who said he has used marijuana illegally for pain followed a

Little Nickel ad to a clinic in Burlington, where he said people were professional, polite and informative. He paid $200 for

the visit and with his legal paperwork in place said he felt like a

first-class citizen for the first time.

“I had to hunt to get a doctor,” said one patient.

He contacted The Hemp and Cannabis Foundation

online and for $200 followed the foundation’s process and received the written doctor recommendation that is good for one year, along with a registration card and information packet on the laws and how to deal with the police.

He did deal with the police when a helicopter circled his yard recently. He called the drug task force and they asked how many plants he was growing and requested that he fax his paperwork.

“Make sure your paperwork is in place and stay within the guidelines. We have no problem with that,” said Okanogan County Sheriff Frank Rogers. He said it is a learning process for patients and some try to grow a few too many.

The only legally protected source of medical marijuana in Washington state is homegrown by patients or their designated providers, according to Donn Moyer, Department of Health spokesperson. Patients are allowed to possess15 plants and 24 ounces of dried marijuana, which lawmakers identified as a 60-day supply.

“The law doesn’t legalize marijuana or authorize transactions,” said Moyer. He said it allows people to grow their own supply and offers a legal defense to criminal charges. “It’s against the law to buy or sell it, and there are a lot of misconceptions about how to get it. There is no registration for patients and no tracking or reporting of patients in the state. There is no legal dispensary,” he said, advising people to educate themselves and read the department’s web-site (www.doh.wa.gov/hsqa/medical-marijuana).

Dispensaries are cooperative stores that may offer dried medicine by the ounce and candies, cookies, lotions and oils, according to a medical marijuana advocate in the Seattle area named Todd, who de-clined to give his last name. “Technically, it is illegal to sell. Like a true cooperative, you put something in and get something out,” he said. You must have a qualifying card to get in the door.

The lack of a legal source of usable marijuana or seeds to start homegrown plants remains a barrier for patient access to medical marijuana, according to the 2008 Health Department report on patient access. The disagreement between federal and state laws blocks the development of a legal distribution system and “legal ambiguity puts patients, caregiv-ers, law enforcement and the judicial system in the difficult position of figuring out which activities are protected.”

The law does not al-low smoking medical marijuana in any public

place or engaging in its use while

driving on pub-lic roads.

Work-places,

schools and correctional

facilities are not required to accommo-

date a patient’s medical use of marijuana.

A

Photo by Sue Misao


Home birth: the right choice for someBy Ashley Lodato

ntil the early 1900s, the term “home birth” was redun-dant; most births took place at home. By the 1950s, how-ever, most births took place

in a hospital – attended by physicians, accompanied by pharmacological pain relief, and frequently resulting in medi-cal interventions, including induced labor, episiotomies, and instrumental or Caesarean delivery. The creation of the insurance industry, coupled with aggressive promotion of hospital births, created a climate that effectively elimi-nated midwives and home births.

But in recent years, as the rate of Caesarean section births in this coun-try has skyrocketed (from about five percent in 1965 to about 30 percent in 2009), many more low-risk women are choosing midwife-assisted home birth in hopes of preventing the invasive or premature interventions that increas-ingly accompany hospital births.

The American Congress of Ob-stetricians and Gynecologists (ACOG) opposes home births, believing that women who deliver babies without physicians and hospital (or birth cen-ter) resources close at hand are taking unnecessary risks. Yet the American College of Nurse-Midwives (ACNM) supports home births for women with uncomplicated pregnancies. Both organizations use the same data to support their positions, but with different interpreta-tions. ACOG cites risk statistics that include all out-of-hospital births (including unplanned home/car/etc. births, unassisted births, and births assisted by unqualified attendants), while ACNM defines planned home birth as “the care of selected pregnant women by qualified providers within a system that provides for hospitaliza-tion when necessary.” Within this context, home births are statistically as safe as hospital births and result in far fewer interventions.

Some home birth mothers seek to avoid hospital interven-tions, but other women simply believe the birth experience will be more satisfying at home. Twisp mother Heidi Bard delivered her first child without complication at an area hospital attended by her then-practicing midwife. “The birth was routine,” she said, “but the post-partum experi-

ence was terrible.” Hospital staff came in every hour to check the vital signs of mom and baby, to bathe the baby, and to change diapers. “By the next morning,” says Heidi, “we hadn’t slept for more than 45 minutes. I said to my husband, ‘We’ve got to get out of here.’”

When Heidi was expecting her second child, she immediately opted for home birth. Like her first birth, Heidi’s second delivery was routine. But un-

like her first post-partum experience, Heidi’s second recovery was tranquil and unscheduled. “We didn’t even leave the house for two weeks,” laughs Heidi, “and my baby got a gradual, gentle introduction to the world.”

“Home births make sense for low-risk women,” says Blue Bradley, who is the Methow Valley’s only practicing Cer-tified Nurse Midwife (CNM), and only one of four CNMs in Washington state doing home births. “Women have more power and control in their own homes and they are less likely to experience interventions than in a hospital birth.

“As an out-of-hospital midwife, I continually evaluate all my clients for risk factors all through pregnancy and labor,” continues Bradley. “If at any point they develop a risk factor, they become ineligible for home birth.” Bradley closely follows standards that make a woman ineligible for home birth, such as cardiac disease, seizures, twins, or previous Caesarean delivery.

Mazama mom Katharine Bill planned to deliver her first child at a hospital, but as she learned more about the statistics for positive outcomes for home births and high intervention rates

at hospitals, she reconsidered. “We had a high level of trust in Blue, and knew that she had the experience and tools to address nearly any complication that might arise,” says Katharine. “I also felt that I would cope with the pain best in a familiar, private place.”

A late pregnancy ultrasound confirmed that all signs indicated a normal, healthy baby, which gave Katharine the confidence to proceed with a home birth. The birth was routine and Katharine felt lucky to have been able to welcome the baby “in a private, peaceful way.”

Home birth isn’t for everyone, however, Bradley acknowledges, par-ticularly in the Methow Valley, where hospital transport times can be as long as an hour. Most midwives use a 30- or 60-minute maximum transfer time as a guideline, but for the rare woman who requires a mid-labor transfer, those 30 or 60 minutes in the car can be grueling.

The most important thing, says Bradley as she echoes the position of midwives around the country, is that a woman experiences childbirth in a way that respects the safety and dignity of both mother and baby.

U

Photo courtesy of Sandy SzalayIf possible, at home with the family is a nice place to be born.


AHospitals target infections

By Sally Graciefter breaking her ankle in a car accident, my friend had emergency surgery. She was released from the hospital and went home to mend. Shortly after, when she was

diagnosed with Methicillin-resistant S. aureus (MRSA), she had to return to the hospital, where she was isolated until the staphylococcus rash on her ankle was treated successfully.

My friend may have been a MRSA carrier, or she may have acquired the infection in the community. In any case, she did have to return to the hospital, and the cost to her recovery and to her health insurance and the hospital were significant.

According to a 2009 Centers for Disease Control and Prevention study, the overall, direct annual medical costs of hospital-associated infections (HAIs) in the United States were as high as $45 billion annually for inpatient services during the years 2001 through 2007.

The good news is that our hospitals, locally and nationally, are on the job to eliminate HAIs for good – and the costs they add to our healthcare – and our family doctors are ready to answer our questions about infection before we are admitted to the hospital.

Washington state is a leader in adopting those “Best Practices” protocols in hospitals that will eliminate HAIs, according to Carol Wagner, vice president for patient safety at the Washington State Hospital Association (WSHA).

Member hospitals are targeting the most com-mon HAIs: surgical, central line infections, ventilator infections and urinary tract infections.

Washington hospitals were the first to adopt the Safe Surgery Checklist in 2008. According to Wagner, “The Surgical Checklist improves com-munication among members of the surgical team while insuring the key steps to keep patients safe are completed.” Studies have shown that where the surgical safety checklist has been introduced, marked improvements in surgical outcomes, reduc-tion of complications after surgery and lower death

rates have followed. “Millions [of dollars] have been saved”, says

Wagner, as concerted efforts have been made to reduce infections.

All member hospitals have adopted the Safe Surgery Checklist, including Mid-Valley Hospital in Omak, Okanogan-Douglas District Hospital in Brewster and Central Washington Hospital in Wenatchee.

In 2005, WSHA launched the first statewide effort in the nation to improve hand hygiene in member hospitals. One key strategy for this initiative was to “make it easy for the staff.” Hand sanitizer dispensers have been placed outside patient rooms and throughout all areas of the hospital. Your doctor, nurse or orderly, will not think you rude if you ask them if they have washed their hands before they enter your hospital room. According to Wagner, the simple task of hand washing has resulted in a 25-percent reduction in HAIs. The “Best Hands on Care” is awarded by WSHA to hospitals for exem-

plary rates of hand hygiene.“Hand washing and the use of hand

cleaner is the best way hospitals can decrease the risk of HAIs,” said Central Washington Hospital’s Tracey Kasnic, vice president of patient care services. The Wenatchee hospital also participates in the WSHA’s Safe Hands initiative and has implemented best practices to eliminate surgical site, ventilator and central line infections.

Progress has been made since 2005, when Washington hospitals began col-laboration to reduce HAIs. At a leader-ship meeting in Washington, D.C. in 2008, healthcare administration profes-sionals agreed that “Chasing Zero” HAIs must become reality. Today, WSHA has raised the bar by creating the Washing-ton Hospitals In Safe Hands Initiative to accelerate the effort by eliminating HAIs by 2012. The boards of member hospitals must approve the infection elimination goal and sign a pledge of participation. WSHA will evaluate their success or failure.

Our hospitals are working to adopt the best medical practices that will reduce and eliminate HAIs. When you prepare to go to the hospital for surgery, you must also take an active role in infection prevention. Ask your surgeon or contact WSHA about HAIs in the hospital where your surgery will be performed.

Methow Valley Family Practice’s Joe Jensen told me that he may or may not play a role in pre-op evaluations as those are generally done by the surgeon. When he does participate, he works with his patient “to examine risks and make sure they’re stable medically” before they go for surgery. He routinely would look for infections. If the surgery is elective, he would help the patient take care of problems ahead of time.

Chris Hogness is a family practice doctor and internist at The Country Clinic in Winthrop. Dr. Hogness told me that he “co-manages” his patients with surgeons before surgery and at the hospital. Like Dr. Jensen, he actively addresses such risk fac-tors as smoking, blood glucose control in diabetics,

and cardiovascular issues. He also advises patients to ask caregivers if they have washed their hands.

Our primary care doctors in the Methow Valley are well-informed about HAIs, and are ready to advise us when our specialist says we need surgery.

Our surgeons should expect to be asked about their “infection rates.” Hospitals in our region are actively work-ing to eliminate HAIs, but you may want to check your hospital’s record before you schedule your surgery.

Photo by Sue MisaoDon’t be afraid to ask your doctor if he washed his hands before handling you.


Directory of advertisers

AcupunctureMethow Valley Wellness Center ................6, 9

Adult CareHarmony House Health Care .........................14

Assisted Living CentersEmmanuel Rocking Chair Ranch .....................................9

Ayurvedic PractitionersMethow Valley Wellness Center ............... 6, 9Moksha Studio .........................10

BakeriesCinnamon Twisp .......................9

BodyworkCircle M Massage .................... 6Green Lotus Massage .............. 2Methow Valley Wellness Center ............... 6, 9North Glover Healing Center..................... 2Spirals .......................................13

CardiopulmonaryRehabilitation

Okanogan Douglas Hospital ... 7

CounselingJames Donaldson .....................13Ann Douglas ............................. 5

Dentistry/OrthodonticsMerlin Ekvall, DDS, MS ...........8Family Health Centers ............. 6Steven Harrop, DDS ................ 5Sawtooth Dental Care .............11

Emergency ServicesAero Methow Rescue ..............10

Fitness CentersWinthrop Physical Therapy .... 8

Health Food StoresGlover Street Market................ 2

Hearing Aids & ServicesEye & Ear Clinic ....................... 8Micron Audiology .................... 4

HerbalistsHorse of a Different Color ....... 6

Home Care SuppliersOkanogan Douglas Hospital ... 7Ulrich’s Valley Pharmacy ........ 5Webster Furniture .................... 2

HospitalsOkanogan Douglas Hospital ...7Mid-Valley Hospital ................ 3

Human ResourcesRoom One .................................. 2The Support Center .................10

Laundromats/ShowersThe Washworks ........................ 5

Medical ClinicsThe Country Clinic ................... 9Eye & Ear Clinic ....................... 8Family Health Centers ............. 6Main Street Health Associates ................ 9Omak Clinic .............................16

MidwiferyNorth Glover Healing Center..................... 2

NaturopathyMethow Valley Wellness Center ............... 6, 9

OptometristsEye & Ear Clinic ....................... 8Dr. Milt Herman ..................... 13

PharmaciesFamily Health Centers ............. 6Ulrich’s Valley Pharmacy ........ 5

PsychotherapyJames Donaldson .................... 13

Physical TherapistsWinthrop Physical Therapy .... 8

Pregnancy/Birth ControlOkanogan Family Planning ...10

Retail/GiftsSpirals .......................................13Ulrich’s Valley Pharmacy ........ 5

SchoolsLittle Star Montessori ............ 10

Teeth Whitening ServicesMerlin Ekvall, DDS, MS ...........8Kara’s Smile Lab ........................2Steven Harrop, DDS ................ 5Sawtooth Dental Care .............11

YogaMoksha Studio ........................ 10Winthrop Physical Therapy .... 8

[ c e l e b r a t i n g 2 5 Y E A R S t o g e t h e r ]

Ever since the beginning of Omak’s Family Medical Center in 1958, the clinic has experienced a lot of change, including the merge with Wenatchee Valley Medical Center (WVMC) in 1985. One thing that has not changed is the strong commitment we have to the communities of Okanogan County. You are our friends, family and neighbors and we want to make sure you are receiving quality health care in a friendly and caring atmosphere close to home.

With our association with WVMC, we have been able to host 33 dif ferent physicians and mid-levels representing 15 dif ferent specialty depar tments in Omak so that our patients do not have to travel to Wenatchee for their specialty visits. We’re proud of our association with WVMC and we’re honored to ser ve your medical needs together.

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