Health And Wellness 2013 - Fall Health And Wellness 2013

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W hen the weather starts cooling off in the fall and rain re-turns to the Pacific Northwest, it can be a struggle to find motivation for exercise. Although our temperatures rarely

preclude us from exercising outdoors, the rain can definitely put a damper on energy. However, it’s no excuse for not staying in shape because there are plenty of fun, physical activities that can be done indoors.

Gym memberships can run up a hefty bill and there is also the issue of actually wanting to zone out on a treadmill while watch-ing Judge Judy re-runs on silent — boring.

Bowling, on the other hand, is fun and competitive, and rela-tively inexpensive. There is no monthly membership fee or con-tract unless you choose to join a bowling league.

“There are very few indoor sports activities,” said Margie Wells, manager of Marysville’s Strawberry Lanes. “It’s a form of exercis-ing that is indoors and also fun.”

There are physical benefits to bowling and people of all ages can find something to love about it.

“It really improves your hand-eye coordination and it trains a lot of your muscles, because it requires stability,” said Wells. “A lot of the men who golf during the summer turn to bowling in the winter for something active to do. And we do have leagues for kids and seniors as well. That’s another great thing about bowling —

anyone can do it. We have little kids bowling with the bumpers on the lanes all the way up to our oldest bowler who is 98 years old.”

Wells noted that although bowling is traditionally inex-pensive, there are ways to take advantage of even deeper price cuts.

“There are good times to come in. Right now, between 9 a.m. and noon we have $2

games so it’s really affordable for everyone,” she said.For those who are looking for a more intense aerobic exercise,

while having a ton of fun, the Absolute Air Park in Arlington offers fitness classes on trampolines.

“We’ve been hosting aerobics since we opened in June of 2011,” said Katie Golder, manager of Absolute Air Park. “We wanted to be a place where people can come in and jump. The kids come in, but adults also have fun and we wanted something for them specifically.”

Fitness classes on trampolines offer several benefits over tradi-tional workouts.

“It’s so good to exercise on a trampoline,” said Golder. “It works more muscles than most aerobics classes because you have to stabilize yourself. It also burns more calories per hour than run-ning — and it’s fun.”

The Air Park offers a pay-per-class system, so it’s no big dent in the wallet to try it out.

“I don’t know how much gym memberships are these days, but here there is no contract to sign,” said Golder. “Individual classes are $8 each, or you can buy a month unlimited for $50.”

For parents with kids, bringing your kids to the gym can be pret-

ty boring for them, but with both bowling alleys and trampoline parks, kids are not only allowed but encouraged to participate.

“On Saturday mornings we have a class before we open, but if people bring their kids we have a Wild Child area where some-one is there to watch the kids while the adults are exercising,” said Golder. “And during regular hours, we block off a part of the facil-ity for aerobics, so kids can jump and enjoy the foam pit during their parent’s class.”

Bowling alleys, trampoline parks, skating rinks, indoor batting cages, boxing gyms and more are all examples of indoor athletic activities that can be enjoyed when it’s too cold or rainy for out-door exercise. l

Winter no excuse for not staying in shape

Adults enjoy jumping on trampolines, while getting in some cardiovascular exercise at Arlington’s Absolute Air Park.

Health & WellnessSEPTEMBER 2013 3

Indoor Workout Spots:

l Bowling Alleysl Trampoline Parksl Skating Rinksl Indoor Batting Cagesl Boxing Gyms

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One issue a� ecting people’s health and wellness regardless of the season is the level of their insurance coverage.

Dr. Steve Aguila, of the Community Health Center of Sno-homish County in Arlington, and Dr. Greg Sanders, family physi-cian and clinical director of the Sea Mar Community Health Center in Marysville, both serve signi� cant numbers of uninsured and underinsured patients in the area, and they agreed that concerns about how to pay for health care can lead their patients to wait too long to seek such care.

“One of the biggest obstacles in getting those patients proper care is that they delay getting any care, at least until small problems have grown big,” Aguila said. “By that time, an infection has spread to the whole leg, rather than just the foot, or we’re treating pneu-monia, rather than catching it early when it’s a relatively minor ill-ness. If it becomes serious enough, they can lose their jobs and lose their insurance, at which point the cost is passed onto society.”

“� e percentage of people who only come in when they’re really sick has gone up with the recession,” Sanders said. “Part of keep-ing people healthy is preventive medicine, whether it’s immuniza-tions, mammograms, cholesterol checks or shingles vaccine for the elderly. Diabetes is one of the more common diseases that we treat, and without regular treatment and checkups, you can su� er high blood pressure, ulcers in your feet, blindness, kidney failure and cardiac problems. People are saving money by being sicker.”

Both the Sea Mar Community Health Center and the Com-munity Health Center of Snohomish County are nonpro� t clinics that receive state and federal funds, and while both Sanders and Aguila see it as their mission to make health care as a� ordable and accessible to everyone as they can, both doctors acknowledged that patients do incur some costs for even cost-reduced medical treatments.

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“We’ve got a sliding fee scale, but I still have patients who tell me, ‘I’ve got just enough money for gas to get here,’” Sanders said. “Many of these people are the working poor. The cost of medica-tion can be prohibitive, so instead of prescription insulin which they can’t afford, diabetics might take cheaper oral insulin, which is not as effective, but between needles, syringes and the vials of insulin themselves, prescription insulin can run them between $100 to $200 a month.”

Walmart has helped out by providing discounts on generic medication, but medication such as in-sulin, at $23 a vial, is too expensive for them to cover. As such, Sanders hopes the Affordable Care Act will finally pro-vide medical coverage to some of the roughly 50 million uninsured people in America.

“These people go to the ER and get soaked, and even hospitals are realizing that they’re penalizing their poorest pa-tients,” Sanders said. “Community health centers and free clinics are their safety nets, thanks to govern-ment support, but even we can’t absorb them all. As more of them hopefully get insured, though, it allows us to expand our services.”

In the meantime, Sanders touted Project Access Northwest, to which patients in need can apply online at www.projectaccess-nw.org for a chance to be seen by medical and dental specialists and receive complete coverage for their care.

“It’s still a drop in the bucket compared to the demand that’s out there,” Sanders said. “At the community health centers, we recog-nize that our patients can’t afford a lot of tests, and if they need an ultrasound or an MRI, we’ll try to select a less expensive option

and we’ll accept payments. One of the toughest parts of this job is hearing single mothers tell me that they don’t know if they can afford medication because they can’t even afford enough food to last them through the end of the month.”

Aguila cited a lack of access to food as another health problem facing many members of the working poor, who often find them-selves stranded in “food deserts.”

“There is a huge industry devoted to producing manufactured food, which receives huge subsidies,” Aguila said. “What we think

of as ‘health food’ doesn’t get those same subsidies, so food that isn’t overly processed is often more expensive. This limits people’s choices when they already have to choose between buying food or coming to see the doctor.”

Aguila suggested that people seek out farmers’ markets and other local options, where they might be able to get a better deal on a better quality of food.

“My other concern is the mythologizing of immunization that’s been going around,” said Aguila, who criti-cized the anti-vaccination media that has found believers in all income levels. “People tell me every day that I save lives, but in my opinion, who really saves lives are the people who invent and manufacture vaccines, and the people who pick up our garbage. Fears of vaccines causing autism have been allayed by very good science, and in the vast majority of cases — as in, 99.9999 percent — people have a better outcome than if they hadn’t taken those vaccines. Fortunately, most of the people I’ve seen here in Arling-ton have done a good job of getting their kids vaccinated, but I’d love to allay any other parents’ fears on this subject.” l

Health & WellnessSEPTEMBER 2013 5

“We’ve got a sliding fee scale, but I still have patients who tell me, ‘I’ve got just enough money

for gas to get here.’”

Dr. Greg Sanders Sea Mar Community Health Center in Marysville

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When the weather gets colder and the holidays start creeping up, it’s easy to abandon physical activity and healthy eating for a more hibernation-like lifestyle. Although fall and win-

ter wouldn’t be the same without Halloween candy, turkey dinners and sugar cookies, it’s important to practice moderation during this time of the year in order to prevent deadly illness.

Annaka Garcia is a dietitian working with Cascade Valley Hospi-tal in Arlington and has some tips on maintaining a healthy eating regimen during the colder months.

“I think it’s a good idea for people who want to start taking a look at their diet to write down everything they eat for three days,” said Garcia. “That way, they are more accountable for what they are eat-ing. One of the first things I think that people should focus on is eat-ing smaller, more frequent meals. Breakfast is important, it really is. It kick starts your metabolism and if you skip breakfast, you will eat a huge lunch. Think of your metabolism as a fire — you want to stoke it so give it small logs to keep it fed. A whole bunch of logs just puts it out. And when you are overeating, the stuff you don’t use as energy you will store in your body as fat.”

It is important to take a significant eating change slowly, to give yourself the best chance for success.

“Make small changes, don’t do it all at once. Make realistic goals,” said Garcia. “I think the challenge people face in the winter months is the holidays. There is so much temptation during that time of year so people find it difficult to avoid unhealthy things. It’s hard to lose weight in the winter, but if you can maintain your weight dur-ing the holiday months, you’re doing well.”

Some tips for making it through to the new year without adding any extra pounds include bringing your own healthy snacks and eating before you go to a party.

“Eating high fiber foods, fruits and vegetables and whole grains before a party will help you be full and you won’t overeat with all the sweet things,” said Garcia. “Also, if you find yourself hovering near the snack table, move the conversation away from the food, because you’re more likely to snack and eat while you are talking. Bring your own healthy dish to a party so you can snack on that and you’ll know exactly what went into it.”

How to maintain your health during the holiday season

Foods that are rich in color are more nutrient-rich than colorless food.

Health & Wellness SEPTEMBER 20136

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Although eating healthy food is important, it’s also a good idea to keep track of what kind of food you are eating.

“Cooking meals from scratch and using whole ingredients instead of processed foods makes a big difference,” said Garcia. “Doing large batch cooking and freezing works well too. For ex-ample, cook a whole big batch of vegetable soup and put it in smaller containers and freeze it. Then you have a quick lunch that you can grab before work. Right now, there are lots of ber-ries on sale and you can buy larger quantities and freeze them so that in the winter you can make smoothies. Good winter produce includes broccoli, carrots, cabbage — anything deep in color is where you are going to get the most nutrition and nutrients. Tan-gerines, grapefruit, kale, sweet potatoes, pears and mandarin or-anges are all great choices and you can freeze or can fresh and local food. If you can’t get fresh produce in the winter, the next best thing is frozen and then canned.”

Jamie Due, of Due’s Produce in Marysville, said there are a number of fresh produce items available during the fall. Freez-ing and canning fruits and vegetables harvested in the summer and fall is a good option for people looking to eat locally grown, healthy food.

“Apples are in season in the fall, which is great,” said Due. “There are all different varieties of squash as well, many of them edible. The primetime for strawberries is June, while in July it’s

a good time to pick raspberries and blackberries. In August, blueberries are ready for pick-ing and in Eastern Washington they have peaches, pears and nectarines. If you get fruit on sale during the summer, a lot of people start canning in the fall because it’s the perfect time for it and you are able to can pretty much everything.”

Garcia also stressed the importance of exercise in addition to a nutritious diet.

“Exercise is really important. It does get darker earlier in the winter. If you are joining a gym or have a buddy to work out with, you are more apt to go. Find someone to help and encourage you to go exercise. Also, exercise right when you get home from work. Don’t wait because you’ll be less likely to do it.”

Maintaining a healthy diet and exercising regularly is not just good for your self-esteem — it can also save your life.

“I think diabetes has really become more of an epidemic,” said Garcia. “The number of diagnoses are growing by leaps and bounds and that’s something to be concerned about. And, of course, heart disease. Watching what you are eating and not overeating simple sugars, processed food and fast food will help prevent diabetes and heart disease.” l

Health & WellnessSEPTEMBER 2013 7

Tips forHealthy Eating:

l Eat Fiber/Whole Grainl Freeze or Canl Batch Cookingl Reduce Simple Sugarl Eat Breakfast

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Fall brings its...

Even without the end of Daylight Saving Time — which occurs on Sunday, Nov. 2, this year — the transition to the fall season includes a number of environmental factors which impact

our internal rhythms, which means more patients for Dr. Ronald Green, one of the sleep specialists in adult and pediatric sleep medicine at the Everett Clinic’s Sleep Center.

“The Germans have a word, ‘zeitgeber,’ which literally trans-lates to ‘time-giver,’” Green said. “It’s the name for the external forces which help set our biological clocks, the most powerful of which is light. Temperature, levels of exercise, how much you eat or drink and social interactions also affect it, but in general, when there’s more light, you wake up earlier and stay up later, and when it’s darker, you sleep longer. This is why people can gain weight when it’s darker, because you’re less active than you are when it’s sunnier and warmer.”

“During the middle of the winter we’re leaving for work when it’s dark and we’re getting home when it’s dark,” said Dr. Greg Sanders, family physician and clinical director of the Sea Mar Community Health Center in Marysville. “That’s going to affect your energy levels.”

One treatment that Sanders and Green both recommend is light therapy, in the form of 10,000 lux light boxes which Green noted can be used at home or work.

“You can use it in conjunction with an alarm clock, by setting it to start glowing slowly brighter and brighter between 30-60 min-utes before you have to wake up,” Green said. “Blue light is the most important wavelength you can get. You can also put it on your desk at the office. You shouldn’t stare into it directly, but if its proximity is within a few feet of your eyesight, it’ll help activate you.”

Green also touted the value of exercise, either first thing in the morning or around midday, to help wake you up, although he cautioned against either exercise or the use of a light box within four hours of your bedtime, since those energizers will make it more difficult for you to sleep.

“One thing we’re finding is that people with screens in their bedrooms are finding it harder to sleep, since the bright lights from their televisions and computers and video games and Face-book on their phones aren’t letting them wind down,” Green said. “If you have screens in your bedroom and they’re not giving you any trouble, you shouldn’t worry about it, but we’re seeing a lot of patients with insomnia and circadian rhythm disturbances who have those bright lights right next to them when they’re trying to sleep.”

“You also shouldn’t be consuming too many stimulants, whether they’re caffeine or nicotine,” said Sanders, who seconded Green’s exercise advice by telling people to try and walk outdoors for one hour out of every day. While Green pointed out that there is over-the-counter medication for shift-workers and jet-lagged travelers which relies upon melatonin, the hormone released by the brain during the dark to tell it when to go to sleep, Sanders added, “Sometimes people think they need pills to solve all their

problems, when an ounce of prevention is worth a pound of cure. Eating healthy and practicing good sleep hygiene are much better long-term solutions.”

Green explained that school-age children suffer from their own unique set of sleep disorders, since their internal clocks run al-most exactly in opposition to their school schedules.

“Younger children tend to wake up earlier and go to bed earlier, but puberty naturally delays those circadian rhythms by about an hour and a half, so adolescents get up later and delay going to sleep as well,” Green said. “This becomes a problem when they hit high school and have to get up earlier. Ideally, elementary school would start at 7:30 a.m. and high school would start at 9 a.m., when it’s actually the other way around. A normal teenager will want to wake up around 9 a.m. and stay up until midnight, and the problem is that when they sleep in and stay up late on the weekends, it rewards their biological clocks and ensures they won’t adjust to their school schedules.”

To facilitate this adjustment, Green encourages parents to start setting gradually earlier bedtimes for their high school students before the school year even starts.

Dr. Steve Aguila, of the Community Health Center of Snohom-ish County in Arlington, cited the number of other conditions that can cause chronic sleepiness, regardless of the season, from airway closures to body weight issues, and warned that its symp-toms can run the gamut from fatigue and cognitive dysfunction to hypertension.

“We usually don’t spot things like sleep apnea in ourselves be-cause it takes a spouse or a roommate to tell us that we’ve been having troubled sleep,” Aguila said. “As a resource, Andrew Weil and Ruben Naiman have done a CD series on optimal sleep con-ditions that I recommend to all my patients who want to practice proper sleep hygiene.” l

Less light in the fall affects sleep schedules

Health & Wellness SEPTEMBER 20138

Dave Roberts, a Registered Polysomnographic Technologist at the Everett Clinic’s Sleep Center, monitors patients’ vital signs while they sleep to determine the causes of their sleep disorders.

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Each season has its own set of ailments, and as kids get ad-justed to going back to school and people of all ages wind up spending more time indoors, a new round of allergies and ill-

nesses crops up each fall and winter.“People start getting more exposure to indoor allergens such

as pets and dust mites in the fall,” said Dr. Brett Buchmiller, a spe-cialist in allergies, asthma and immunology at the Everett Clinic in Smokey Point. “The Seattle area has a huge dust mite concen-tration.”

While alleviating pet allergies can be as simple as avoiding con-tact with cats and dogs when possible, Buchmiller recommended washing bedding in hot water weekly to reduce dust mite expo-sure, and even suggested special sealed covers for mattresses and frames that are designed to defend against dust mites.

Buchmiller explained that changing your house’s air filters reg-ularly helps combat both dust mites and mold, the latter of which is one of the leading causes of fall allergies.

“When it gets humid and wet, you’ll get more mold spores,” said Dr. Rosana Go of the Cascade Valley Pediatrics Clinic in Ar-lington. “Mold likes to grow in the small crevices of your house, so you need to wipe them down, and keep everything as dry and clean as you can. Vacuuming regularly also helps.”

Dr. Greg Sanders, family physician and clinical director of the Sea Mar Community Health Center in Marysville, suggested a so-lution of bleach diluted in water to clean your home and allevi-ate mold, and added to Buchmiller’s advice by noting the impor-tance of air circulation in countering both mold and dust mites.

“While there are antihistamines and even steroid nasal sprays, a saltwater irrigation of the nose can clean out both mold spores and mucus,” Sanders said.

“Rinsing out the nose with saltwater can also clear out pol-len, but you should be very careful that the water is sterile in any event,” Go said. “You also shouldn’t administer any antihista-mine to any child younger than a year old without consulting a doctor first.”

Just as Sanders agreed with Go that the local rainy season fos-ters the moisture on which mold thrives, Dr. Steve Aguila, of the Community Health Center of Snohomish County in Arlington, pointed out that mold benefits from the lack of a hard freeze in the area, which allows mold and a number of other allergens to survive year-round.

“You actually have two immune systems — one that fights ev-erything, and another that stops the first immune system from fighting things that don’t hurt us,” Aguila said. “Allergies are when the second immune system isn’t doing as well in controlling the first.”

Aguila clarified that allergies are different from the “back-to-school sniffles” and other illnesses that arrive each fall and win-ter, which have less to do with the chill winds outside than the relatively cramped quarters inside.

“It has nothing to do with the temperature outdoors,” Aguila said. “Those fall and winter colds come from people being en-closed in close contact indoors.”

“As we’re cooped up in close quarters, that means more op-portunities for us to pass infections back and forth between us,” Buchmiller said. “Often, our children get sick and spread it to us.”

Buchmiller and Aguila both emphasized the importance of getting vaccinated against the influenza virus.

“There is no disadvantage in getting your flu shot early,” Buch-miller said. “In fact, because it can take up to 14 days for the vac-cine to take effect, if you wait until the middle of flu season to get your shot, you still might wind up with the flu. Especially if you have asthma or sinusitis or bronchitis or any other form of lung disorder, that’s not something you want to play around with.”

“What we’re finding is that the flu is becoming non-seasonal, so it can hit you any time of the year now,” Aguila said. “Yes, get the new vaccines when they start in the fall, but feel free to come in anytime to get vaccinated as well.”

For less serious illnesses, all four doctors deemed two of the simplest remedies — washing your hands, and covering your coughs and sneezes — to be the most effective.

“We obviously use our hands for a lot of things, and we’re con-stantly touching our own faces,” Buchmiller said.

“I know it’s hard to keep kids clean, but you can do things like using hand sanitizer to wipe down toys that they share with each other,” Go said.

Sanders acknowledged that he sees many anxious moms who worry that their children require antibiotics for their illnesses, but he thinks twice about prescribing them, to prevent children from developing a resistance to that medication.

“And while I understand that it can be difficult to do in this economy, if you’re a parent with a sick child, or if you yourself aren’t feeling well, then you need to bite the bullet and keep your kid or yourself at home, if at all possible, so that you don’t risk spreading the infection to others,” Aguila said. l

Seasonal allergies, illnesses arrive with the fall

Health & WellnessSEPTEMBER 2013 9

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Going back to school can also mean returning to sports for many local high schoolers. Even adults find themselves attempting more rigorous activities as they return to work from summer vacation or prepare for the holiday season.

It is important to prepare for athletic activity properly to avoid injuries. and to treat injuries as they arise to prevent more damaging long-term issues.

“The most common injuries when coming back to sports are strains and sprains,” said Barak Pearson, physical therapist assistant at Arlington Physical Therapy. “Usually this is caused by going from zero activity in the summer to full speed in the fall when practice starts.”

Pearson sees a lot of ankle, quad, knee and hamstring injuries in high school athletes.“We see a lot of ligamental strains caused by activity that they are not used to doing,”

he said. “For example, in football if someone takes a hit to the knee and they aren’t pre-pared for it, it can cause an injury.”

“First of all, really being active consistently will help prevent injuries. Stretching, running and other basic activities will help. Don’t just go from the couch to the field. The same goes for anyone. If you are a teacher returning to work, slowly return to your normal level of activity — being on your feet on a hard surface for hours at a time. If you like to ski, you need to give yourself time to be conditioned for that activity.”

Organized sports in this area offer conditioning opportunities over the summer and Pearson encourages athletes to take advantage of them so that they are more prepared when competition starts. He also warns that athletes should take pain seriously, and shouldn’t avoid going to the doctor.

“There is a lot more potential for greater damage if an issue goes untreated. If a kid ends up playing hurt, they will ultimately put themselves at risk for other injuries and

Physical therapy can help you recover from an injury incurred in an athletic activity.

Preventing sports injuries with proper technique

Health & Wellness SEPTEMBER 201310

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problems later. Back injuries and concussions are dangerous because they can lead to long-term issues. A lot of people minimize back pain or concussions, but back pain in a young person should be paid at-tention to, because it is not common. And after a head injury, look for signs of a concussion — headaches, vomiting, dizziness. If an athlete is showing those symptoms, they need to be seen right away.”

Brody Kadow is an athletic trainer who works with Arlington High School’s varsity programs and echoed Pearson’s advice on returning to athletics.

“Everything really depends on your fitness level,” said Kadow. “Normally when kids are getting out there and they haven’t been ex-ercising, we see a lot of muscle pulls and sprained ankles.”

Kadow also has suggestions for making sure that you are at your healthiest in all athletic activity.

“When you are getting into a sport or any activity stretching is really important,” he said. “Dynamic stretching, which is when you use movement to stretch your muscles, as well as static stretching, which is just your basic stretches, can both help keep you ready for the season.”

It’s not just preparing body from the outside either. Kadow empha-sized the importance of keeping an eye on what goes in.

“A big thing that everyone forgets is nutrition and staying hydrated. It’s important knowing that what you eat is what you are going to get on the fields,” he said. “Right now, football is doing daily doubles and when kids take a break in between and are chowing down on McDonald’s, it’s obvious.”

“I think that right after exercise, it’s good to replenish basic car-bohydrates. They need to make sure that when they are eating, they are eating whole grains and a bit of protein to build muscles. Juice, milk, water, whole grains, protein, fruits and vegetables are going to

get you lasting ef-fects.”

The danger of not preparing the body for activ-ity could include a long-term break from sports due to an ACL tear, or worse.

“There are so many different kinds of severe in-

juries,” said Kadow. “For the athletes, the things you worry about most are ACL tears and ligamental tears. Preventing these also comes from practicing good form, technique and motions, as well as hav-ing a base level of strength. There is a lot of research about prevent-ing ACL injury. It’s a very long recovery of more than eight or nine months now and it’s always a devastating blow to athletes.”

Kadow believes that it is important to incorporate into your ex-ercise routine any full-body motion you plan to do in your work or sport. “Improve core strength and flexibility,” he said. “The core is the basis for all of your movement — kicking, throwing, hitting. Strengthen it by doing planks, crunches, pushups and basic squats, which are really going to help strengthen core region.”

Of course, after all the hard work is done, it’s also a good idea to take a day off.

“You need time to recover,” said Pearson. “Give yourself an off-day and just give your body a little bit of time to bounce back.” l

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4404 80th St. NE Marysville, WA 98270

360-659-1231

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location andproviders. Only now you have access to a wider network of medical specialists.Welcome to Marysville Family Medicine.

Andy Kruse, ARNP

Mark Holland, MD

Lauren Carlson, ARNPSusana Escobar, MD

Philip Smith, MD Harold Clark, MD

We are neighbors caring for neighbors.

4404 80th St. NE Marysville, WA 98270

360-659-1231

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location andproviders. Only now you have access to a wider network of medical specialists.Welcome to Marysville Family Medicine.

Andy Kruse, ARNP

Mark Holland, MD

Lauren Carlson, ARNPSusana Escobar, MD

Philip Smith, MD Harold Clark, MD

We are neighbors caring for neighbors.

4404 80th St. NE Marysville, WA 98270

360-659-1231

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location andproviders. Only now you have access to a wider network of medical specialists.Welcome to Marysville Family Medicine.

Andy Kruse, ARNP

Mark Holland, MD

Lauren Carlson, ARNPSusana Escobar, MD

Philip Smith, MD Harold Clark, MD

We are neighbors caring for neighbors.

4404 80th St. NE Marysville, WA 98270

360-659-1231

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location andproviders. Only now you have access to a wider network of medical specialists.Welcome to Marysville Family Medicine.

Andy Kruse, ARNP

Mark Holland, MD

Lauren Carlson, ARNPSusana Escobar, MD

Philip Smith, MD Harold Clark, MD

We are neighbors caring for neighbors.

4404 80th St. NE Marysville, WA 98270

360-659-1231

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location andproviders. Only now you have access to a wider network of medical specialists.Welcome to Marysville Family Medicine.

Andy Kruse, ARNP

Mark Holland, MD

Lauren Carlson, ARNPSusana Escobar, MD

Philip Smith, MD Harold Clark, MD

We are neighbors caring for neighbors.

4404 80th St. NE Marysville, WA 98270

360-659-1231

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location andproviders. Only now you have access to a wider network of medical specialists.Welcome to Marysville Family Medicine.

Andy Kruse, ARNP

Mark Holland, MD

Lauren Carlson, ARNPSusana Escobar, MD

Philip Smith, MD Harold Clark, MD

We are neighbors caring for neighbors.

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location and providers. Only now you have access to a wider network of medical specialists. Welcome to Marysville Family Medicine.

4404 80th St. NE Marysville, WA 98270

360-659-1231

Our team of providers is ready to meet the healthcare needs of you and your family.

Nothing has changed. Same location andproviders. Only now you have access to a wider network of medical specialists.Welcome to Marysville Family Medicine.

Andy Kruse, ARNP

Mark Holland, MD

Lauren Carlson, ARNPSusana Escobar, MD

Philip Smith, MD Harold Clark, MD

We are neighbors caring for neighbors.

Seek medical treatment if you develop chronic pain at a young age, because this could be a sign of a more severe issue.

Health & WellnessSEPTEMBER 2013 11

“Normally when kids are getting out there and they haven’t been exercising, we see a lot of muscle

pulls and sprained ankles.”

Brody Kadow Athletic trainer with Arlington High School

Page 12: Health And Wellness 2013 - Fall Health And Wellness 2013

Marysville Vision Source

Call to schedule your eye exam and... give your eyes a “smart start” for school!

Kim M. Kron, O.D. • Jessie L. Liu, O.D.360-659-6255

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08 www.GuidanceThroughLife.com 360-435-0799Call Margarett Mae ~ Guidance Through Life

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Home & Hospital Visits Available

Large group community acupuncture for senior centers helps to lower the cost of the pain relief technique. Chronic pain, insomnia, migraines, anxiety and more are condi-

tions that are traditionally treated with medication. Although a doctor may prescribe pharmaceutical treatment for medi-

cal issues, some would prefer to avoid taking medicine that can be abused or cause uncomfortable and even dangerous side effects.

Dr. Cole Alexander, who earned his doctorate in acupuncture and oriental medicine from Bastyr University, a program that focuses on oncology and advanced pain management, is the ex-ecutive director of Free Range Health, a 501(c)(3) nonprofit orga-nization that provides affordable acupuncture to those in need. According to Alexander, acupuncture is a good treatment alterna-tive to medication.

“Typically, I do lectures before I start at a location, and I go over the three big myths that are out there about acupuncture,” he said. “The first is that acupuncture is only for pain. Acupuncture can actually be used to treat hot flashes, insomnia, anxiety, stress — you name it, we can treat it. The second myth typically related to acupuncture is that there is no research on it, but there is actually a lot of scientific research being done in the West on its benefits.”

Health & Wellness SEPTEMBER 201312

Acupuncture can offer alternatives

to medication

Page 13: Health And Wellness 2013 - Fall Health And Wellness 2013

Many believe that acupuncture is pain-ful, having seen photos of patients in progress with needles sticking out of their heads or backs.

“That is a question that I get a lot — is it painful? When you go to the doctor to get a shot, those needles are hollow because fluid has to go through them. Well, 16 of our needles will fit into one of the needles at the doctor’s office,” said Alexander. “When people get worried or say that they are afraid of needles, I show them that it’s a very thin, stainless steel needle and you shouldn’t be feeling any pain. In fact, most people feel nothing. Or they may feel what we call ‘Getting the Qi.’ That is the sensa-tion of feeling electricity or it could feel like a dull ache, and that’s really the heal-ing activity that the needles are creating, so when you feel those sensations you know that you will have a really good, effective treatment.”

The most common complaint that draws people to seek acupuncture treatment is pain.

“For me, obviously pain is the number one complaint,” said Alexander. “Typi-cally people find acupuncture after they’ve done everything else and rather than going through surgery or taking 15 different pills, they will come to us as a last resort. I treat a

lot of seniors, that’s the work that my non-profit does. I get a lot of osteoarthritis, knee pain, migraines and back pain.”

Often patients will have questions about how acupuncture works, but it can differ between the Eastern culture where it origi-nated and Western cultures.

“Here’s where we kind of go from West-ern perspec-tive and Eastern p e r s p e c t i v e ,” said Alexander. “Where we put the needles and how deep they go, that depends on the presentation, and placement depends on the issue. Each location has its own specific depth — for example the scalp requires a shallow insertion and the calf requires a deeper insertion. These are a part of what we are trained to do and each point has its own rule. All of the points of the body have channels, each channel cor-responds to an organ. In the West, there are theories and this is where research is still coming up. One of those theories is that when the needles are inserted, they are stimulating a release of endorphins which act as an anti-pain mechanism in the body

and makes you relax. Another theory is the Gate Control Theory — you have what are called slow twitch and fast twitch nerve fi-bers and the brain can only handle a signal from one at a time. Chronic pain travels along slow-twitch fibers, so when we insert the needles we are sending signals along fast-twitch fibers and close the gate to the

slow-twitch fibers, blocking out the pain.”

Although many people feel relief from their ailments immediately follow-ing a treatment ses-sion, some require between four and

12 sessions.“The Chinese saying is the longer you

have had something, the longer it will take to resolve,” said Alexander. “It’s a much more holistic, internal, long-term solu-tion.”

Free Range Health sponsors low-cost community acupuncture at a number of area senior centers, including the Stillagua-mish Senior Center in Arlington. For infor-mation visit www.freerangehealth.org. For schedules or information on the Stillagua-mish Senior Center, call 360-653-4551. l

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Health & WellnessSEPTEMBER 2013 13

“All of the points of the body have channels, each channel

corresponds to an organ.”Dr. Cole Alexander Executive Directory Free Range Health

Page 14: Health And Wellness 2013 - Fall Health And Wellness 2013

While Seasonal A� ective Disorder owes to many of the same causes as seasonal sleep disorders, its symptoms are often more profound, especially in the northern latitudes such as

Washington state.“According to the National Institute of Mental Health, Seasonal

A� ective Disorder a� ects 3 percent of the population on average,” said Dr. Paul Schoenfeld, clinical psychologist and director of the Everett Clinic’s Behavioral Health Department. “In Florida, it’s only 1.7 percent of the population, but in Finland, it’s 9.5 percent. � ere are about 14 million Americans who go into full-bore depressive episodes, which develop slowly over the autumn before hitting their peaks of intensity in November, December and January.”

While in an increase in sleepiness and a decrease in the ability to concentrate are among the symptoms that Seasonal A� ective Disorder shares in common with sleep disorders, other symptoms include an increase in irritability, a loss of interest in pursuits that patients had previously enjoyed, and weight gain, the latter due of-ten not only to a decrease in activity, but also because patients � nd themselves craving carbohydrates and consuming holiday foods such as cookies, cake and pasta.

“� ere are 33 million Americans who su� er from depressive symptoms versus larger, major depressions,” Schoenfeld said. “I ac-tually su� er from Seasonal A� ective Disorder myself, and it wasn’t until I came to Washington nearly 20 years ago that I was a� ected by it.”

“� ere’s a couple of di� erent kinds of depression,” said Dr. Greg Sanders, family physician and clinical director of the Sea Mar Com-munity Health Center in Marysville. “� ere’s the kind that stems

from a chemical imbalance, which is genetic and often shows up in your family history, that’s independent of your environmental conditions, and then, there’s the kind that owes to the environment and your circumstances. Depression is more common during the winter because it’s dark and cold and gloomy outside.”

While Sanders and Schoenfeld agreed on the value of daylight simulators and regular exercise in helping to boost one’s spirits, es-pecially since Seasonal A� ective Disorder can cause its su� erers to eat more and develop more of a vegetative state, Sanders added that those with depressive symptoms should consider seeking profes-sional help as well.

“Seasonal A� ective Disorder can a� ect how well you’re able to ful� ll the responsibilities of your job and relationships,” Sanders said. “Health care providers can evaluate your depressive symp-toms on a rating scale with a questionnaire, and the treatment can include antidepressants and other medication, depending on how bad it is. And of course, anyone who’s experiencing suicidal thoughts should know that there is always help available, from 24-hour crisis lines to counseling services that they can be referred to, even from community health centers such as Sea Mar.”

Sanders acknowledged that patients with low incomes, and those who are either uninsured or underinsured, are especially suscep-tible to environmental condition-based depression, but he assured them that Sea Mar’s government-subsidized sliding fee scales are designed to ease those economic burdens when they seek treat-ment for Seasonal A� ective Disorder.

“Mental health care tends to get second-tier treatment in this country, unfortunately,” Sanders said. “But mental health makes up a huge number of the problems that we as health care providers deal with.” ●

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Health & Wellness SEPTEMBER 201314

SAD affects more people in northern latitudes

Dr. Greg Sanders, family physician and clinical director of the Sea Mar Community Health Center in Marysville, checks Paul Platt of Tulalip for any signs of seasonal ailments. With the onset of fall, Sanders will be evaluating a number of patients for the slightly less tangible symptoms of Seasonal Affective Disorder.

Page 15: Health And Wellness 2013 - Fall Health And Wellness 2013

Dr. Justin Smith

Looking for a fun and child-friendly atmosphere for your child’s dental needs?

State of the art office specializing in care for infants, children and teen-agers. We offer the latest in comprehensive care including: digital x-rays, tooth-colored fillings, sealants, laughing gas (nitrous oxide), oral sedation and general anesthesia depending on your child’s needs. Always accepting new patients! Available for exams, consultations, cleanings and restorative appointments! Our child-friendly environment offers a wide variety of movies and a playroom with toys.

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Health & WellnessSEPTEMBER 2013 15

Marysville For information about Marysville classes or activi-ties, or to register online, please visit ‘Parks & Rec.ePlay’ at marysvillewa.gov or call Marysville Parks and Recreation at 360-363-8400.

self-Defense for WomenKung Fu Northwest will take you on a fun yet

focused exploration of women’s self defense. This informative workshop will take place from 1-3 p.m. on Saturday, Oct.26, at the Kung Fu North-west Academy, 804 Cedar Ave. The cost of the workshop is $25. Pre-registration is required.

Beginning Cheerleading for ages 6-8 and 9-13

Marysville Parks and Recreation is offering Be-ginning Cheerleading classes for youth ages 6-8 and 9-13. Learn cheer terminology, jumps, cheers, levels and a progression of skills. Class meets Mondays, Oct. 28 through Nov. 25. Classes for youth ages 6-8 meet 4:30-5:20 p.m., and classes for youth ages 9-13 meet 5:30-6:30 p.m. Located at the Ken Baxter Community Center at 514 Delta Ave.

Parenting Workshops: Consequences and rewards – What are we really teaching?

Marysville Parks and Recreation invites parents to attend an informative workshop taught by na-tionally recognized parent educator, Penny Davis.

Learn positive parenting techniques regarding consequences, rewards and the long term results of such methods. The workshop will be held Thursday, Sept. 26, 6-8 p.m. Cost is $25. For no additional charge, feel free to bring an additional adult with you. Located at the Marysville Library at 6120 Grove St.

insanity WorkoutYou have seen the infomercials on TV, now do

the Insanity workout live and in person! Get ready to burn lots of calories in this 30-minute interval training workout. Classes are held Tuesdays and Thursdays 6:30-7 p.m., Oct. 1-31, and also Mon-days and Wednesdays, Oct. 2-30, from 8-8:30 a.m.at the Ken Baxter Community Center, 514 Delta Ave. The monthly fee is $69. Pre-registration is required.

arliNGTONChild & Babysitting safety Class

Covers child safety and basic care techniques for infants and children. Stresses the priority to keep the babysitter and the children being cared for safe. Includes first aid and CPR, meal times, bedtime, stranger knocks and hand washing. Students receive a textbook, certificate and first aid kit. For those 10 years older. Class will be held at Hadley Hall, 18513 59th Ave NE, on Monday,

Nov. 11, 9 a.m. to 3:30 p.m. The cost is $40.Call 360-403-3448 to register. 

Basic First aid Participants learn to recognize the signs and

symptoms of injuries and sudden illness. Crucial information about how to deal with emergencies. Certified Instructor. Renew your existing certi-fication or become First Aid Certified. OSHA, WISHA, L&I and DSHS approved. For adults and youth ages 12 and older. The class will be on Monday, Sept. 30, 6-9 p.m., and Saturday, Nov. 16, 9 a.m. to 12:30 p.m. It will be held at Hadley Hall, 18513 59th Ave. NE. The cost is $30 which will be reduced to $25 if also taking CPR class. Call 360-403-3448 to register

 CPr, aeD Certification

This course teaches the chain of survival, ac-tivation of 911, emergency response, airway ob-struction and Cardiopulmonary Resuscitation (CPR). Also, information on adult heart attacks and strokes. AED certification included.  This basic certification conforms to new 2010 na-tional standards and is based on the same scien-tific guidelines and treatment recommendations used by the American Heart Association and American Red Cross.     For adults and youth 12 & older. The class will be on Tuesday, Oct. 1, 6-9 p.m., and Saturday, Nov. 16, 1-4 p.m., at Hadley Hall, 18513 59th Ave. NE. The cost is $30. Call 360-403-3448 to register.

Parks and recs offer classes, workshops

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Health & Wellness MARCH 201314

Health & Wellness SEPTEMBER 201316

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