Spring 2013 1

The health magazine forBody, Mind & MotivationBody, Mind & MotivationBody, Mind & MotivationBody, Mind & MotivationBody, Mind & Motivation

Published quarterly by the Lewiston Tribuneand the Moscow-Pullman Daily News

BalanceVolume 5 – Issue 1 – Spring 2013

BABY ONBOARDDoulas, midwives

offer delivery options

POWEROF LIGHTExperts recognize the value of sunlight

OLD SCHOOLWEIGHT LOSSMoscow’s Clint Payton drops 235 pounds

HEARTHEALTHYMediterranean diet is good, good for you

�  Balance

Spring 2013 3

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Contents Balance – volume 5, issue 1 – Spring 2013

COVER STORY

HAVE IT YOUR WAYWomen giving birth have range of help from doulas to midwives to traditional obstetricians

6

HEALTH & WELLNESS

OLD SCHOOL WEIGHT LOSSMoscow’s Clint Payton dropped 235 pounds by eating less, working out more

18

ALSO | STRETCH MARKS 10 | VERA WHITE 22 | E-CIGARETTES 24

FITNESS

FINDING THE RIGHT PAIRStance, strike pattern important when buying running, hiking, walking shoes

12

MENTAL WELLNESS

THE POWER OF THE SUN� e e� ect of sunlight — or lack thereof — is much greater than you might think

26

Spring 2013 �

LOCAL CONTRIBUTORS

ELAINE WILLIAmSLewiston Tribune staff writerElaine started reporting at the Tribune in 1991 and has covered the business beat since 2000. She’s an aspiring distance runner who completed the Lewis-Clark Half Marathon in 2 hours, 25 minutes and 23 seconds, her best time yet.

More. Better. Brighter.

JESSE HUgHESGraphic designerJesse has worked for the Daily News and Lewiston Tribune since 2008 in the advertising department. He and his wife try to eat a healthy, well-balanced diet and stay active by walking, hiking, and being kept on their toes by two boys.

Balance is published quarterly by the Lewiston Tribune and Moscow-Pullman Daily News and printed at the Tribune Publishing Co. Inc.’s printing facility at 505 Capital St. in Lewiston. To advertise in Balance, contact the Lewiston Tribune advertising department at (208)848.2216 or Advertising Director Fred Board at fboard@lmtribune.com, or the Moscow-Pullman Daily News advertising department at (208)882.5561 or Advertising Manager Craig Staszkow at cstaszkow@dnews.com. Editorial suggestions and ideas can be sent to Tribune City Editor Craig Clohessy at cclohessy@lmtribune.com or Daily News City Editor Murf Raquet at murf@dnews.com.

KERRI SANdAINELewiston Tribune staff writerKerri covers the southeast corner of Washington for the Tribune. Her favorite activities are tennis, running marathons and chasing news stories.

KEvIN gABOURyLewiston Tribune staff writerOregon native Kevin Gaboury covers education for the Tribune. He’s currently in a slump, but hopes to get back into a workout routine soon.

KELCIE mOSELEyLewiston Tribune staff writerKelcie covers Lewiston, Nez Perce County cops and courts at the Tribune. She lives in Moscow and is currently on a journey to fitness herself.

JOEL mILLSLewiston Tribune staff writerJoel Mills lives with his family in Moscow. He’s currently enjoying the growing abundance of fresh, local foods available on the Palouse, and turning them (with some success) into good, healthy meals.

A Full Life Agency ................................................................... 29Allen, Dr. Richard ................................................................... 27Alm, Dr. Ronald ..................................................................... 25Alternative Nursing Services ................................................... 21Balance Spa ............................................................................ 27Bishop Place ........................................................................... 31Bluesky Dentistry ................................................................... 13Court Appointed Special Advocates ........................................ 11Clarkston Denturist Clinic........................................................ 9Clearwater Medical ................................................................ 30Comp. Care, Inc. ....................................................................... 9Electrolysis--Permanent Hair Removal .................................. 11Elm View Chiropractic ........................................................... 28Garges, Lawrence M., M.D. .................................................... 31Henderson DDS, Robin .......................................................... 30Huckleberrys at Rosauers ....................................................... 22Leavitt DMD, Erin .................................................................. 25Maplewood Dental ................................................................. 29Moscow Family Medicine ....................................................... 17Moscow Food Co-Op .............................................................. 15Moscow Yoga Center ............................................................... 13North Idaho Athletic Club ...................................................... 15Ozeran, Steven, M.D. ............................................................. 21Pathologists’ Regional Laboratory .......................................... 17St. Joseph Regional Medical Center ........................................ 32Tri-State Memorial Hospital ..................................................... 2Valley Medical Center ............................................................... 3Vig’s Produce .......................................................................... 27Whitman Hospital & Medical Center ..................................... 23Whitman Senior Living .......................................................... 25

AdvERTISER INdEX

ELIzABETH RUddDaily News staff writerElizabeth is the business editor for the Moscow-Pullman Daily News, as well as page designer and copy editor. She lives in Moscow and enjoys running and biking along the Palouse.

TOm HAgERDaily News staff writerTom is the WSU football and basketball beat reporter for the Moscow-Pullman Daily News. He has never conquered the training hill on a snowboard, despite hours of trying.

BEN HANdELDaily News staff writerBen covers University of Idaho/Idaho prep sports. His favorite activities are playing with his puppy, eating pizza and watching the Packers.

�  Balance

Women giving birth have range of help from doulas to midwives to traditional obstetricians

By ELAINE WILLIAMS

A ndrea Hedrick caught five babies on a recent weekend at St. Jo-seph Regional Medical Center.

Babies being born at the Lewiston hospital isn’t news. Having them

arrive under the care of a certified nurse-midwife is.

Hedrick, a former labor and delivery nurse,

is the hospital’s first certified

nurse mid-wife and the only person to

hold that credential at any area hospital.Her practice is a sign of how childbirth

is evolving in north central Idaho and southeastern Washington. Women who give birth at St. Joe’s can pick Hedrick, at Valley Medical Center in Lewiston, or an obstetrician as their primary care pro-vider.

Doulas, women who provide non-medical support before, during and after delivery, are more common at hospital births, said Nancy Draznin, a certified professional midwife in Genesee, who has been helping women give birth for 20 years.

In the last decade, the number of dou-las serving the region has grown from two to 10, said Draznin, who is licensed in the state of Idaho. “There’s a bigger demand for doula support. Women are really catching on to the fact that there’s a big benefit to having that kind of emotional care.”

Home births are changing too. Idaho began licensing midwives — who aren’t certified nurses — in 2010, creating a new category of birth professionals, Draznin said. Washington has had similar rules for

at least two decades.Unlike those with Hedrick’s cre-

dential, people in this category typi-cally attend home or birth center

births and ordinarily don’t have hospital privileges.

The requirements for each profession differ. Certified nurse midwives earn a master’s degree in nursing, then receive specialized training in child

birth and must pass board exams, Hedrick said.

They also have to oversee a certain number of births under the supervision of certified nurse midwives. Hedrick received her training at Deaconess Medical Center in Spokane, where certified nurse midwives have had hospital privileges for 20 years.

Hedrick’s duties are similar to those of obstetricians, with a couple of exceptions.

Obstetricians typically aren’t in the de-livery room full time until the baby is ready to be born. Hedrick stays with women who have opted for natural childbirth from the time they’re dilated to five or six centi-meters through delivery. And if a birth requires interventions, such as a Caesarian section or a vacuum delivery, the obstetri-cian on call handles the delivery.

Idaho and Washington have no certifica-tion requirements for doulas, but normally they are women who have witnessed a number of births and learned how to make the experience more comfortable and less stressful.

Certified professional midwives, who normally aren’t nurses, have to pass cogni-tive and skills exams and handle a certain number of births before they strike out on their own, Draznin said.

Women who choose midwives or dou-las, frequently, but not always, are trying to avoid medical interventions, Hedrick said.

“The model of care is one of empower-ing women, making sure women know all of their options when it comes to birth,” Hedrick said. “Birth is not an emergency. We only need to intervene if things fall outside of normal.”

Have it your way

Spring 2013 �

Tribune/barry Kough

Bobbi Bennett-Wolcott has frequent visits with Josie Clark at her home, plus phone conversations, while they prepare for the birth of Jaela Elizabeth Clark.

Area hospitals allow doulas to be involved in births as long as they adhere to policies similar to those for sisters or friends who join women in the delivery room.

The doula’s role in birth is different than that of a physician, midwife or husband, said Pullman doula ViviAnne Fischer. They meet with couples before the birth to develop a plan and talk through any fears they might have.

Chief in that process is what women want, whether it’s epidurals to relieve pain, or support to get them through birth with-out drugs, Fischer said.

Once labor starts, doulas usually stay with women in their homes until labor starts to intensify, something they judge by a woman’s behavior, not with a vaginal check, said Bobbi Bennett-Wolcott, a doula from Pullman.

Once they’re at the hospital, they offer assistance such as providing a massage, placing hot and cold packs on the woman and helping find positions that make their contractions as productive as possible.

“We have tools to create a comfortable environment and we have tools to help the mother cope,” Fischer said.

Dr. Tema Jessup at Syringa Hospital in Grangeville offers this advice when it comes to hiring a doula: Find out how much training and experience they have and seek references from former clients.A skilled doula can be a huge help during birth, but an incompetent one can create challenges, said Jessup, a family medicine physician who delivers babies. “I have no problem with doulas. I usually put them to work when they are here.”

Certified Nurse MidwivesTraining required: Master’s degree in nursing. Additional training in child birth and women’s health issues that include attending a certain number of births under the supervision of someone already certified in the field. Board exam.Scope of practice: Full prescriptive privileges. Usually deliver babies in the hospital. Can assist with surgeries. Provides care throughout pregnancy as well for almost any reproductive health issue, including annual exams.How normally paid: Through insurance.State license required in Idaho and Washington? Yes.

Certified Professional MidwivesTraining required: Attending a certain number of births. Passage of cognitive and skills exams.

Scope of practice: Limited use of pharmaceuticals such as oxygen, intravenous fluids and antibiotics. Usually deliver babies at home or in birth centers. Provide care from conception through six weeks after birth. Rarely, if ever, have hospital privileges.How normally paid: Through private pay, Medicaid and insurance in Idaho. Through insurance and Medicaid in Washington.State license required in Idaho and Washington? Yes.

DoulasTraining required: None. Many have certifications through organiza-tions such as Doulas of North America. Scope of practice: Emotional support for pregnant women before, during and after birth. Don’t provide medical assistance such as vagi-nal checks or monitoring of fetal heart beats. How normally paid: By the patient with the cost ranging from about $300 to $750. In certain instances, doulas can refer those with low in-comes to doulas in training who may offer their services at a discount or for free.State license required in Idaho and Washington? No.

Sources: Andrea Hedrick, certified nurse-midwife at Valley Medical Center in Lew-iston; Nancy Draznin, of Genesee, a certified professional midwife who’s licensed in Idaho; ViviAnne Fischer, Pullman doula; Bobbi Bennett-Wolcott, Pullman doula. Fischer and Bennett-Wolcott are certified through Doulas of North America.

�  Balance

By LAURAN NEERGAARDThe Associated Press

WASHINGTON — Nearly every woman takes a medication at some point during pregnancy. Yet there’s disturbingly little easy-to-understand information about which drugs pose a risk to her baby, and what to do about it.

Need some pain relief? In the fine print is the warning that painkillers like Advil aren’t for the third trimester. Left unsaid is whether to worry if you took them earlier.

An awful cold? Don’t panic if you used decongestant pills, but doctors advise a nasal spray in early pregnancy.

And don’t abandon antidepressants or epilepsy medicines without talking to your doctor first. Some brands are safer during pregnancy than others - and worsening depression or seizures aren’t good for a mom-to-be or her baby.

“To come off of those medications is often a dangerous thing for the pregnancy itself,” warns Dr. Sandra Kweder of the Food and Drug Administration. “They need information on what to expect, how to make those trade-offs.”

A new study shows how difficult that information is to come by.

Women often turn to the Internet with pregnancy questions. But researchers examined 25 pregnancy-related websites and found no two lists of purportedly safe drugs were identical. Twenty-two products called safe on one site were deemed risky on another.

Worse, specialists couldn’t find evidence to back up safety claims for 40 percent of the drugs listed, said Cheryl Broussard of the Centers for Disease Control and Pre-vention, who led the recent study.

“The reality is that for most of the medi-

cations, it’s not that they’re safe or not that’s the concern. The concern is that we just don’t know,” she said.

Broussard experienced some of that confusion during her own two pregnancies - when different doctors handed over dif-ferent lists of what was safe to use.

It’s a growing dilemma. The CDC says medication use during the first trimester - especially vulnerable for birth defects be-cause fetal organs are forming - has jumped 60 percent in the last three decades. Plus, women increasingly are postponing pregnancy until their 30s, even 40s, more time to develop a chronic health condition before they’re expecting.

The CDC is beginning a Treating for Two program to explore how to get better

information, and the FDA plans to revamp prescription drug labels with more details on what’s known now. But people want an easy answer - use it or don’t - and for many drugs, they won’t get one anytime soon.

“Women agonize over it,” said Dr. Chris-tina Chambers of the University of Califor-nia, San Diego. She helps direct California’s pregnancy risk information hotline that advises thousands of worried callers every year.

Some drugs pose particular birth-de-fect risks. For example, the FDA requires versions of the acne drug isotretinoin, first marketed as Accutane, to be sold under special tight controls. Similarly, last year FDA said women who want to use a new weight-loss drug, Qsymia, need testing first

Hard to find good info on drug safety in pregnancy

THINKSTOCK®

New studys show how information about taking medications while pregnant is difficult to come by.

Spring 2013 �

to be sure they’re not pregnant.Other medications are considered safe

choices. Obstetricians say pregnant women need a flu shot, for example. A recent mas-sive study in Denmark offered reassurance that taking the anti-nausea drug Zofran for morning sickness won’t hurt the baby.

But many drug labels bear little if any details about pregnancy. Drugmakers shy from studying pregnant women, so it can take years for safety information to accumu-late. Moreover, the CDC says 1 in 33 babies has some type of birth defect regardless of medication use. It can be hard to tell if a drug adds to that baseline risk.

Consider antidepressants, used by about 5 percent of pregnant women. Certain brands are suspected of a small risk of heart defects. Studies suggest a version called SS-RIs may increase risk of a serious lung prob-lem at birth - from 1 in 3,000 pregnancies to 3 in 3,000 pregnancies, Chambers said. Also, some babies go through withdrawal symp-toms in the first days of life that can range from jitteriness to occasional seizures.

Women have to weigh those findings with the clear risks of stopping treatment, she said.

“The time to be thinking about all this is when you’re not pregnant,” when your doctor can consider how to balance mom’s and baby’s health and might switch brands, Chambers said.

That’s what heart attack survivor Kelli Tussey of Columbus, Ohio, did. The 34-year-old takes a variety of heart medications, including a cholesterol-lowering statin drug that the government advises against during pregnancy.

So when Tussey wanted a second child, she turned to doctors at Ohio State Uni-versity who specialize in treating pregnant heart patients. They stopped the statin and switched her to a safer blood thinner.

“They said my heart could take it,” Tussey said. Now four months pregnant, “it seems everything’s fine.”

Sometimes it’s a question of timing . That painkiller ibuprofen, sold as Advil and other brands, isn’t for the third trimester but isn’t a big concern earlier on, said Dr. Siobhan Dolan, an adviser to the March of Dimes.

And women should watch out for over-the-counter drugs with multiple ingredients, like decongestants added to allergy medi-cines, Dolan said. While any potential risk from decongestant pills seems small, “the question is, ‘Do you really need it?’” she asked, advising a nasal spray instead.

Ask your doctor about the safest choices, Dolan said. Also, check the Organization of Teratology Information Specialists, or OTIS - www.otispregnancy.org - for consumer-friendly drug fact sheets or hotlines to speak with a specialist.

Stay tuned: The FDA has proposed big changes to drug labels that now just say if animal or human data suggest a risk. Kweder said adding details would help informed decision-making: How certain are those studies? What’s the risk of skipping treatment? Is the risk only during a certain trimester?

• • •

Online: www.otispregnancy.orghttp://www.cdc.gov/pregnancy/meds/index.html

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10  Balance

Stretch marks: Frustrating, embarrassing, and for some an issue that’s more than skin deep

By AngelA HillOakland Tribune

OAKLAND, Calif. — For many women, they’re the red, white or sometimes brown badges of bearing children.

But while pregnant women are the group with whom we most frequently as-sociate stretch marks, a larger percentage of the population is not immune. Weight gain can bring on stretch marks, too - men and women alike can end up with unsightly reminders of heavier days. Even people who went through sudden extreme growth spurts during adolescence often have marks around their joints or on their backs. And bodybuilders sometimes get them on the upper chest and shoulders.

Sometimes. That’s part of the frustra-tion - and the mystery. Some people get them, and some people don’t, even under similar conditions. Whatever the cause, the main sticking point is they never really go away, and certainly not on their own. The topic - espe-cially for women - is a delicate one, akin to discussing personal finances or face-lifts. For some, the problem is more than skin deep.

Anne Nguyen, 32, a San Jose, Calif., accountant, says she felt like “damaged goods” when pronounced stretch marks ap-peared after she had her first two children.

“It has affected my confidence, and I never wear a bathing suit and avoid situ-

ations where I would have skin showing,” she said. “I hardly get in the pool with my kids, and they don’t understand why.”

What frustrated her is that she has al-ways been physically fit. During pregnancy the weight gain came rapidly and stretched her skin.

“It’s embarrass-ing, and it’s hardly ever discussed,” she said. “I know there are other problems that are more traumatic and life-threatening, but stretch marks do affect a person’s emotional state.

Knowing it will never go away affected me.”Many dermatologists say the cause is

literally a stretching of the skin, hence the name, pushing it to the point where connective tissue breaks down. Yet others assert it’s not entirely a matter of stretching

but of hormonal variations during extreme changes to one’s body. Almost all believe there’s a genetic component.

Various laser and even radio frequency treatments can minimize the appearance, but if you’re prone to getting stretch marks, you’re pretty much stuck with some perma-nent road maps to your skin’s past.

Nguyen has undergone several laser treatments with Dr. John Tang at the Rejuve nonsurgical cosmetic care clinic in Saratoga, Calif., and there has been a softening of the marks.

“We can reduce the appearance, but you can’t ever really eliminate them,” Tang said.

He adds that hormones can be a factor.“On a young healthy person, stretch

marks are normally caused by rapid increase or decrease in weight,” he said. “When we get older, the stretch marks we have often look worse due to hormonal loss, especially for women because of loss of estrogen and growth hormone, which controls elasticity and collagen production.”

More than skin deep

www.newface.com

Whatever the cause, the main sticking point is stretch marks never really go away, and certainly not on their own.

“It has affected my confidence, and I never wear a bathing suit and avoid situations where I would have skin showing. I hardly get in the pool with my kids, and they don’t understand why.”

Anne Nguyena San Jose, Calif., accountant

Spring 2013 11

Dr. Richard Nolan of Laser Skin Source in Alameda, Calif., specializing in aes-thetic medicine, likens human skin to a delicate fabric.

“If you push your finger through the fabric, you stretch out the fibers, and it never will go back,” he said. “But it’s not the same for everyone. You’ll have a wom-an with five kids and no stretch marks and then a guy who was fat at age 14 and a muscle builder at 28 who gets them.”

The marks occur in the dermis, the resilient middle layer of the skin that helps it keep its shape. They most often show up in areas of your body where fat is stored - the stomach area, breasts, upper arms and thighs.

Many dermatologists say hormonal changes and genetics influence the skin’s capacity to withstand stretching. And some researchers have artificially created stretch marks on normal skin by applying strong topical steroid creams, suggesting a hormonal cause. Also, sun exposure, smoking and diet can affect connective tissue, Tang said.

“And there’s obviously a genetic predis-position,” said Dr. Min-Wei Christine Lee, a dermatologic surgeon and the director of the East Bay Laser & Skin Care Center in Walnut Creek. “It tends to be if your mom and grandmother had them, you’ll get them, too. It’s so variable. For some people, even a slight bit of weight gain will do it.”

Not all stretch marks are equal. Some appear reddish, while some are purple or whitish. Some start out pink then change over time to a silvery appearance, which

indicates the most damage. And they vary with different skin tones and types. Nolan says Asian skin seems to be particularly prone to the development of the marks, and dark skin must be treated more gently, or the pigment can darken even more in those areas, making the marks more pronounced.

“There’s an art to it,” Nolan said. “With light skin, there’s less melanin, and it can take more aggressive treatments. With darker skin, too aggressive treatments can increase brown lines.”

Currently, the most popular procedures are various laser therapies to stimulate new growth of collagen and elastin. Tang uses a radio frequency device in conjunc-tion with lasers. A study in the journal Dermatologic Surgery showed that radio frequency combined with pulsed-dye laser treatment provided “good and very good” improvement of the appearance of stretch marks in 33 of 37 patients, but more re-search is needed, doctors say.

A relatively new treatment is fractional

laser resurfacing, using scattered pulses of light on one “fraction” of the mark at a time over the course of several visits. This creates thousands of microscopic wounds, and the skin responds by pro-ducing new collagen and tissue at the body’s outer surface.

As to over-the-counter creams, Lee has not found them to be very effective on their own. “Anti-stretch-mark creams sound magical, and they may be helpful combined with other treatments,” she said. “But they’re only really good mois-turizers. They may help keep skin from looking worse and improve skin texture, but they’re not a cure.”

And perhaps there doesn’t need to be. In this age of online exposure, some ce-lebrities have gone public. Country sing-er LeAnn Rimes recently tweeted about hers. And according to StretchMarks.org, in a pre-airbrushed image from a recent photo shoot one of the sexiest women alive - Jennifer Lopez - showed off her bared marks.

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12  Balance

Stance, strike pattern important when buying running, hiking, walking shoes

By ElizaBEth Rudd

W hen it comes to buying a good pair of running shoes, there’s more to consider than the colors

— you’ve got to know your gait.Tige Arnold, a sales associate in the shoe

department of Tri-State in Moscow, said when he has customers who come in looking for either a running or a walking shoe, he has two areas he evaluates first — their stance and strike pattern.

Arnold said there are three different stances people have: overpronation (rolling their foot in), neutral stand (no roll out or in) or supination (rolling their foot out). He said everyone wants to get to a neutral stance. To determine what a customer’s stance is, Arnold said he will analyze how they walk or have them balance on one foot. If they can easily balance, he said they usually have a neutral gait.

There are also three strike patterns which, Arnold said, include forefoot (on the ball of the foot), midfoot (flat on heel and forefoot) and heel (hit on the heel and then roll for-ward). He said there are two ways to tell what a person’s strike pattern is: look at their old running shoes or watch them run.

“The most accurate way is to have the customer bring in their current pair of run-ning shoes to tell where the wear marks are,” he said.

Logan Clark, merchandising visual team leader at Sports Authority in Lewiston, said they have a heat pressure tab that a customer can stand on that will show an outline of their foot. He said it shows if a person has a high

or low arch, where the most pressure is when they stand and some indication of rolling. But he agreed with Arnold, that it is best if customers come in with their old shoes.

Arnold said people will strike and stand the same when walking, but it is not as pro-nounced as when they run.

“That’s usually the main category of shoe that we’ll be checking people’s gaits for because you can have a lot of injuries if you don’t get the right category of shoe or the right style of shoe,” Arnold said.

He said even when he has people looking for a walking shoe, he will try to get them into a running shoe because they are basically a “beefed up walking shoe.” He also said that walking shoes are becoming less popular and Tri-State only carries one right now.

“The walking shoes will have less cushion and are less durable because it’s not designed for impact,” he said.

Clark said he also tries to steer custom-ers away from walking shoes for the same reasons. He said running shoes are also more comfortable even if a person only plans to walk.

Clark said what he’s found to be the most helpful when trying to determine what a customer needs is ask them questions about their walking or running habits.

“The biggest thing I’ve noticed is you just have to get into a conversation with them,” he said.

It really comes down to a personal prefer-ence, Clark said, and the more you can learn about what a customer wants from their running or walking shoes the better you can help them.

The biggest thing is to gain the customer’s trust, Clark said.

“We’ll get you in something that will fit your foot the best,” Clark said.

Finding the perfect pair of shoes

Geoff Crimmins/Daily news

Tri-State in Moscow sells a variety of styles of shoes, including these running shoes.

Spring 2013 13

Arnold said the same is true for people who are looking for shoes to go hiking.

He said it depends on the kind of hiking they plan to do, the expected terrain and the need for ankle support. Arnold said he asks first if the customer is looking for waterproof or nonwaterproof, with or without ankle support.

“Every situation is different,” he said. “Everybody’s got their preferences.”

Arnold said he just starts with the basic questions and goes from there.

“The big thing is you get what you pay for,” he said. “With us, we carry higher-end stuff and the biggest shock to some people is the price.”

Regardless of what a customer is looking for, Arnold said he tries to give customers the knowledge base they need to buy good shoes, and if they’re not sure what to look for he will help.

“There’s a lot more than running, hiking and walking,” he said.

Geoff Crimmins/Daily news

(ABOVE) Tige Arnold, right, helps Vincent Allen, who was shopping for speed hiker shoes at Tri-State in Moscow

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14  Balance

Organization key to successful running season

By Ben Handel

W arm weather has started to flirt with the Palouse and runners everywhere have started to

dust off their shoes and wash their jogging shorts. For many people, this is the time of the year to start planning a running season.

Some people run because they want to lose weight, some because they enjoy getting out of the house and some because they want to enter a race. Others may go running with their friends or their dogs, using running as a social tool.

“I guess the reason I run is because I want to shed a few pounds and get in shape,” said Rachel Miller, a Lewiston na-tive. “I don’t particularly enjoy it, but I want to look good. It’s also a good way to meet other people.”

Miller said she doesn’t follow a strict running schedule, but she tries to go sev-eral times a week.

“As it gets warmer I’ll go out more often though,” Miller said. “Last year I went run-ning just about every morning and would write my times down to keep track of how I was doing and so I could see how much I was improving. Having a schedule helps a lot.”

Keeping a journal of your running times is a handy trick to help sustain motivation over a long period of time. It also provides a sense of accomplish-ment as times for various runs slowly decrease.

“When I first started recording my times, I wasn’t very fast,” Miller said. “It’s so rewarding seeing the difference a few weeks can make though.”

For other people, running is more busi-ness and less pleasure.

“Maybe 15 percent of the time I run it’s for my own pleasure,” Caleb Struble, a cadet with the University of Idaho Army ROTC program, said. “The rest of the time, it’s bright and early for drill.”

As a member of the armed forces, Struble doesn’t need to worry too much about plan-ning a running strategy. Uncle Sam has that covered.

“Our running pro-gram gives us a good variety to build our car-diovascular strength,”

Struble said. “For example, on Wednesdays we do intervals where we run about four miles total but we do it in spurts where we’ll run as fast as we can for a half mile or so. Mondays we’ll just go on one long run.”

For those who don’t have the added

Running with a purpose

“I guess the reason I run is because I want to shed a few pounds and get in shape. I don’t particularly enjoy it, but I want to look good. It’s also a good way to meet other people.”

Rachel Miller of Lewiston

Spring 2013 15

motivation of an angry drill sergeant breath-ing down their backs, there are many other things to help organize a running season. iPhone apps are a great new way runners can keep track of a plan and stick to it.

� e app, “RunKeeper Pro” enables GPS tracking, distance, speed monitoring, caloric output and activity history for any number of activities the user partakes in, including sports such as running, cycling, hiking, ski-ing and swimming. Users can also sync all their data to RunKeeper’s website to monitor progress and share publicly.

“Ghost Race,” another app, enables users to track their times on various routes and compare their performance from day to day. � e app’s audio function also keeps users updated on their progress against their “ghost” in real-time.

And of course there’s music – possibly a runner’s best friend. A good set of tunes can keep workout junkies motivated and focused long a� er they normally would have thrown in the towel.

“Music always helps me go the extra dis-tance,” Miller said. “It takes my mind o� my tiredness and gives my feet a rhythm.”

RUNKEEPER, LLC

RunKeeper makes tracking your workouts fun, social, and easy to understand so that you

can improve the quality of your � tness.

16  Balance

Fitness apps and gadgets abound, but which ones to pick?

By KELCIE MOSELEy

The advent of technology has made it easier than ever to track every calorie burned and consumed, heart rate beats per minute and even sleep

patterns in a 24-hour period.But with that comes a problem: With

thousands of phone apps and many gadgets available, how to choose?

If popularity is the only deciding factor, a quick Google search can give the answer. But more research on details, feedback from current users and how an app fits with your current lifestyle can make the difference.

Best gadgets for $150 or lessl Fitbit One — This gadget is an updated

version of the Fitbit Ultra that does more for a lower cost, at right around $100. The device is about the size of a Bluetooth earpiece, and can sit right on a belt loop to track activity throughout the day. It also has a wristband that the user can slip on to measure the qual-ity and hours of sleep through the night. All of the data logged with Fitbit can wirelessly sync to a phone, iPad or computer, and the user can examine charts and other reports of mileage and calories burned. Most of the re-views on Amazon.com for the device, which debuted late last year, are positive, saying it’s easy to use and is a good motivational tool.

The Fitbit can also be purchased at www.fitbit.com/one.l UP by Jawbone — If the Fitbit’s constant

switching between a belt loop or pocket to your wrist is a turnoff, consider the Jawbone UP wristband. While it costs a little bit more at $130, the extra cost might be worth it for some users. UP also has a sleek, understated design, and a well-designed, free accompany-

ing app. Unlike the Fitbit, UP doesn’t have the option of wireless data syncing, but the details of the data found in the app are valuable and easy to access.

The app is limited only to iOS devices — meaning devices made by Apple. It’s available through the Apple store, on Amazon.com or at www.jawbone.com/up.l Nike+ FuelBand —

Those in need of motivation and love competition — even with complete strangers — look no further. Though the price tag of $150 might make some cringe, the FuelBand comes with an entire line of accompanying merchandise and apps through Nike. The band has an inner counter and LCD display that tracks “fuel points” throughout the day, which can be earned by taking a quick walk, climb-ing stairs or any other physical activity. The user can compete with others to get the most fuel points on any given day, or just try to beat a personal record.

Wireless headphonesHeath Kelley, a nutrition specialist at

Gold’s Gym in Lewiston, said bluetooth head-phones are trending in the fitness world as well. He said the technology behind wireless headphones has improved to the point where people are buying them more often and hav-ing fewer problems with them.

“Those are kind of the big one coming up,” Kelley said.

Many people enjoy the Beats headphones by Dre, Kelley said, but Motorola and Sony also have brands available. Beats wireless headphones cost about $280, while other

brands range between $40 and $100.

Fitness appsl Nike+ Running: Another product of

Nike that is also popular is its running app for iPhone or iPod Touch. Kelley said this app is one people at Gold’s enjoy using, as it often comes standard on Apple devices and is free for download. One of its drawbacks is the need for a wifi connection to properly utilize the GPS for measuring distance and pace, and even then, some reviewers report problems with the GPS accuracy. But for regular runners, the ability to track runs and encouraging recorded messages from celeb-

Getting fit with zombies

Tribune/barry Kough

Zombies, Run! is one of the most popular fitness apps available for Apple devices. The app revolves around a story about the zombie apocalypse,

and the user is randomly chased by a pack of zombies, forcing the runner to speed up or die. It is available in the Apple store for $3.99.

Spring 2013 17

rity athletes are attractive features.l MyFitnessPal: This free app has a large

food and exercise database for calorie track-ing, active message boards for advice and encouragement, a large base of members and the ability to sync with many different devices, including the Fitbit. While it doesn’t come equipped with training plans, it is easy to set goals and make friends who can cheer you on when you log weight loss or other activity.l Zombies, Run!: This interactive app is

by far one of the most popular in existence for working out. Unlike others that are full of numbers, charts and graphs, this one is purely about having fun while exercising. Once the user starts a “mission,” a story begins about how zombies have taken over the world. If the user is running outside and tracking is turned on, the app will randomly have zombies start to attack. At that point, if you don’t speed up — well, it’s brains for breakfast. The app is a little expensive at $3.99, but worth it for those who are motivated by continuing the story — and maybe the adrenaline rush of zombies in your ear.

www.myfitnesspal.com

The iPhone app gives you full mobile access to your MyFitness-Pal.com account, so you can log your food and exercise from

anywhere, at any time. All changes made on your iPhone will be synchronized with their website and vice versa.

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18  Balance

Moscow’s Clint Payton dropped 235 pounds by eating less, working out more

By KERRI SANDAINE

C lint Payton shed 235 pounds the old-fashioned way: He ate less and exercised more.

No surgery, no special diets, no gimmicks. The 38-year-old Moscow man just quit eating processed foods and switched to water and whole foods — and it worked. Over the course of two years, the 6-foot-2-inch father of two went from 440 pounds to 205 pounds.

“There’s only one way to lose weight,” Payton said. “You have to burn more calories than you consume. You can eat Twinkies and lose weight if you’re running a marathon every day. You either eat very little or exercise a lot, whatever combination works best for you.”

Payton, an information technology professional at the University of Idaho, decided to take a healthy approach to weight loss. It wasn’t that complicated, he said. He gave up junk food and started riding his bike to work.

“I wanted to do more with my kids and make sure I was active as they were growing up, so I totally changed my diet. I cut out all processed foods and I never cheat-ed. In order to do it, I got really rigid with my diet.”

His rule of thumb was pretty simple: If it grows, runs or swims, it’s OK to eat.

“I ate all types of proteins. I still ate

bread, just very small amounts and only whole grain. I gave up cheese

completely and switched to soy instead of milk.”

The most dif-ficult processed food to bid fare-well to was chips. “I liked corn chips, mostly be-cause I like salsa.

I found other ways to eat salsa. I would put it on brown rice or homemade kale

chips.”Every week, Payton dropped another

2 to 3 pounds. In addition to reduc-ing his calorie intake, he made another change that helped him lose weight. He got a standing desk at his job. Standing instead of sitting all day burns more calories, he said.

“Losing weight is not as mysterious as people try to make it,” Payton said. “Your body is a closed system. You con-sume energy and you burn energy. You have to find some balance of those two things. If you start losing weight, you

Old school weight loss

photos from Clint payton

Clint Payton of Moscow is shown with his children Jacob, 7, and Kylie, 5, before changing his diet and exercise routine, dropping more than 200 pounds.

“I wanted to do more with my kids and make sure I was active as they were growing up, so I totally changed my diet. I cut out all processed foods and I never cheated. In order to do it, I got really rigid with my diet.”

Clint Payton of Moscow

Spring 2013 19

maintain that balance.”Payton said he was always a big kid.

He grew up in Texas and was overweight from middle school on, but he remained pretty active, playing sports and partici-pating in the marching band. In 1992, he moved to Moscow to attend the univer-sity, and he continued to gain weight. The No. 1 culprit in his case was a bad diet. A couple of years ago, he decided it was time to make a change.

“I didn’t really have a pivotal mo-ment. I just decided I was going to do it. A lot of people don’t recognize me now. They think I had surgery. I tell them no

way. I did it the old-fashioned way, mainly because I couldn’t afford anything else.”

The weight loss allows him to do more with his kids, ages 5 and 7, and engage in more outdoor activities. It also helped him realize his dream of becom-ing a volunteer firefighter.

“I joined the Moscow Fire Department and I wouldn’t have been able to do that,” he said. “I am doing a lot of stuff I wouldn’t have been able to do. I feel much better and have more energy.”

photos from Clint payton

(ABOVE) Clint Payton of Moscow decided to lose weight and used a simple diet of whole foods to lose more than 200 pounds in two years. His children Jacob, 7, and Kylie, 5, are also happy about it. (RIGHT) Clint Payton’s ID tags show his weight loss.

20  Balance

Full- and half-day trips make it easy to exercise in the great outdoors

By Kevin GaBoury

S o you have the day off, the sun is shining and you’re looking for something cheap to do that doesn’t

require too much driving.If you’re not sure where to start, there

are plenty of options in and around the region to get you out of the house for the day while getting some exercise.

Hells Gate MarinaThe Hells Gate Marina at Hells Gate

State Park, just two miles south of Lew-iston, offers rentals of canoes, kayaks or rowboats from around Memorial Day to Labor Day. The cost is $35 per day.

Marina manager Jock Pring recom-

mends turning left from the marina and paddling upriver as far as you can go. When you’re done, just sit back, let the current take you home.

“I’ve had some people go up to Asotin,” he said. “I had one guy go beyond Asotin, but that was in a canoe.”

The rowboat is ideal if you want to do a little fishing, Pring added.

Hells Gate State Park also has a system of dirt trails for hiking, horseback riding or trail running and there’s a designated area for swimming. For more information, call the park office at (208) 799-5015.

Outfitters offer rafting tripsSeveral local outfitters offer rafting

trips on the Lochsa, Clearwater, Snake and Salmon rivers in Idaho. For more information on how to book a trip, visit the Hells Canyon Visitors Bureau at www.visitlcvalley.com or call them at (509) 758-7489.

State parks provide recreation opportunities

Three state parks a short distance from Lewiston and the Palouse offer beautiful scenery and great hiking opportunities for a half- or full-day trip.l Just 77 miles west of Lewiston,

Palouse Falls State Park features several miles of hiking trails and dramatic views of the 198-foot-tall falls. The park is open from 6:30 a.m. to dusk during the summer months and requires a Washington Dis-cover Pass for all vehicles or a $10 day pass.l Nestled at the base of the Blue Moun-

tains 30 miles south of Clarkston, Fields Spring State Park offers several miles of hiking, biking and running trails. It’s also a popular cross-country skiing and snow-shoeing destination in the winter. Summer hours are from 6:30 a.m. to dusk, and a Discovery Pass is required for all vehicles.l Kamiak Butte County Park, just 12

miles north of Pullman in Whitman Coun-

Get out and get fitAP

Paddling a kayak on the calm waters of the Snake River at sunset is a way to escape the ratrace, get exercise and not travel too long to get there.

Spring 2013 21

ty, features � ve miles of forested hiking trails that reach an elevation of 3,641 feet. Visitors are treated to panoramic views of the Palouse region and more than 150 bird, mammal and plant species. � e park is open from 7 a.m. to dusk in the summer.

Hells Canyon National Recreation Area

With its craggy peaks and awesome depths, Hells Canyon o� ers some breath-taking views for hikers. � e Hells Canyon National Recreation Area boasts nearly 1,000 miles of trails, so � nding a good day hike is easy. � e most popular trails are a few hours south of Lewiston and require travel on unpaved roads. � e Snake River Kirkwood Ranch

Trail is a moderate, 10.6-mile out-and-back route that takes hikers from the Upper Pittsburg Landing to the Kirkwood Living History Ranch, according to www.Trails.com. � e trail o� ers spectacular views of Hells Canyon, ending at the Kirkwood Ranch, an idyllic oasis of green

grass nestled between the steep walls of the canyon.

� e best time to go is April or May, and the route takes approximately � ve hours to complete. Camping is also available at the ranch if you plan on an overnight stay. No water is available, so bring plenty of your own. To get there, drive south from Lewiston to White Bird, then take the 17-mile maintained gravel road to Pittsburg Landing. � e Snake River Trail is a 54-mile

route that starts about 6 miles downriver from the Kirkwood Ranch Trail. � e mod-erate-to-strenuous route o� ers spectacular views from river level to the peaks of the Seven Devils Mountains. Wildlife, such as bighorn sheep, can also be spotted. It is best in the spring when the canyon is green and it’s perfect for a long day hike or four- to six-day backpacking trip.

For more information on these or other Hells Canyon hikes, visit the Hells Canyon National Recreation Area o� ce in Riggins or call (208) 628-3916.

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22 Balance

Mediterranean diet is good and good for you

BY VERA N. WHITE

D uring my years of writing food columns, I developed the habit of reading food magazines like

normal people might pour over the latest best-selling novel.

In the past few months, I’ve noticed a trend developing of people who are adopting the Mediterranean diet for a heart-healthy eating plan.

According to the Mayo Clinic sta� , this diet incorporates the basics of healthy eat-ing plus a splash of � avorful olive oil and perhaps a glass of red wine among other components characterizing the traditional cooking style of countries bordering the Mediterranean Sea.

Most healthy diets include fruits, veg-etables, � sh and whole grains and limit un-healthy fats. While these parts of a healthy diet remain tried-and-true, subtle varia-tions or di� erences in portions of certain foods may make a di� erence in your risk of heart disease.

Research has shown that the traditional Mediterranean diet reduces the risk of heart disease. In fact, a recent analysis of

more than 1.5 million healthy adults dem-onstrated that following a Mediterranean diet was associated with a reduced risk of overall cardiovascular mortality, a reduced incidence of cancer and cancer mortality, and a reduced incidence of Parkinson’s and Alzheimer’s diseases.

I had occasion a few years back to take a Mediterranean cruise. At a stop in Ath-ens, I picked up a cookbook titled, “222 Recipes, the Greek Cookery Book.” I am sharing some recipes below that re� ect this tasty and healthy style of eating.

Egg with Tomato 6 eggs 5 tomatoes ½ cup of oil salt and pepper

Wash the tomatoes well, skin and cut them up as � nely as possible. Put the oil in a frying pan once it is heated well, add the tomatoes. Salt and pepper it and allow to fry for 5 min-utes until a sauce is obtained. In the meantime, beat the eggs well, then add to the tomatoes in the frying pan.

Lower the heat and allow the omelet to cook well. Prick with a fork all over for better and even cooking. � en when one side is done, turn the omelet carefully over to the other side. � ree portions. 280 calories each.

Meat Balls Marinated 600 grams of minced meat,

not too lean 2 onions, grated 2 slices of bread, soaked without

crusts 2 teaspoons full of milk 2 teaspoons full of salt A little black pepper 1 cup of oil Vinegar 3 tablespoons of � our ½ cup of tomato juice 3 cloves of garlic crushed Red pepper Parsley, � nely chopped

Mix the minced meat with the onions, the soaked bread, the salt and tablespoons of vinegar. Knead these ingredients and mold into big meat balls. Coat each one with � our and fry them, using the 4 cups of oil mentioned in the ingredients. � en strain the oil from the frying pan, wash the pan and use 5 tablespoons of frying oil. Add the � our and stir until brown. Pour in the tomato juice, the water (or meat stock if used), the crushed garlic, 3 tablespoons of vinegar and some parsley. Allow the sauce to come to a boil and pour over the 4 meat balls. 8 to 10 portions. 2 meat balls per serving, 90 calories.

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Spring 2013 23

Custard Piel 6 sheets of ready-made crust pastryl 3 cups of milkl 5 tablespoons of sugarl 5 tablespoons of semolinal 2 eggs beatenl 4 tablespoons of butterl 1 cup of castor sugarl ½ tablespoon of cinnamon

Put the sugar, milk and the semolina in a small saucepan to heat on a moderate flame. Stir until it has thickened slightly. Remove from heat and add the eggs gradually stirring well. Spread 1 sheet of crust pastry coated with melted butter. Put in the center of the pastry a small portion of the mixture remembering to divide the mixture so that you have enough for five more sheets. Fold the pastry over the stuffing carefully and form a square shape. Repeat the procedure with the other five sheets. Coat the top sheet with butter. Coat the baking tin as well and bake in a moderate heated oven for about 20 minutes.

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24  Balance

E-cigarettes, used by some to kick the habit, on the FDA’s hit list

By JOEL MILLS

T hey come in flavors like peach man-go and minty grape, but consumers won’t find them on the candy aisle at

the local drug store.They are electronic cigarettes, or e-ciga-

rettes, and they have a brief but embattled history in the U.S.

Some producers and vendors claim they are a safer alternative to tobacco that can help smokers kick the habit. But the Food and Drug Administration has tried to ban the nicotine-delivery devices, and is in the process of trying to regulate them as tobacco products.

“I think it’s actually a legitimate way to help people quit,” said Derek Russel, who sells e-cigarettes at a Moscow smoke shop.

Bess Isaacson, a Mayo Clinic-certified tobacco treatment specialist at St. Joseph Regional Medical Center in Lewiston, can’t recommend them as a cessation aid.

“I can’t support it because we only go with FDA-supported medications,” Isaac-son said.

And Dr. Hugh Haegelin, a Lewiston specialist in pulmonology, said he doesn’t think e-cigarettes are helpful, and can even contain small amounts of known carcino-gens.

Most e-cigarettes resemble regular ciga-rettes in shape, and work by using a battery to heat an element that vaporizes a liquid that usually contains water and synthetic nicotine. Some also contain propylene gly-col, which produces a visible vapor when heated.

E-cigarettes were introduced to U.S. markets in 2007, but were briefly banned by the FDA in 2009 and 2010. Since then, they have steadily gained a following, especially among those looking for a way to quit.

Others choose e-cigarettes because it allows them to “smoke” indoors and take fewer breaks on the job, Russel said.

Isaacson has heard anecdotal evidence during some of the classes she teaches of e-cigarettes helping people quit. But she’s also heard of people who misuse them and get sick from inhaling too much nicotine.

“They’re sucking on them like a regular cigarette,” she said.

The FDA also has warned of other adul-terants in some e-cigarettes, like diethylene glycol, an ingredient in antifreeze. And

there are several reported incidences of the lithium ion batteries inside the devices overheating and exploding, sometimes causing injuries.

But Russel said e-cigarettes continue to gain popularity. About three quarters of the customers who buy them are over 40, and the rest are in their 30s. Virtually no teens or college students buy them because that demographic prefers regular cigarettes, and hasn’t yet tried to quit, he said.

And even though many brands are engineered to taste like candy, the most popular varieties taste like tobacco, he added.

“That’s mainly what I sell,” Russel said. “People really don’t seem to go for the flavors.”

Minty fresh or deadly alternative?

AP

Blair Roberts, a 22-year-old sales associate at Colorado E-Smokes, holds an electronic cigarette and the filter end that holds the liquid nicotine solution at an E-Smokes store in Aurora, Colo.

Spring 2013 25

He sees a spike in sales every January. “Everybody’s making that New Year’s reso-lution to quit smoking.”

Haegelin recommends either nicotine gum or the prescription drug Chantix to his patients. Chantix has a 100 percent suc-cess rate in his experience, Haegelin said, but it does have the risk of psychological side-effects like hostility, agitation, depres-sion, and suicidal thoughts or actions.

Isaacson belongs to the Association of

Treatment of Tobacco Use and Depen-dence, and she said its members are eager for more information about e-cigarettes.

“We agree that it’s here to stay, and we’d like to get studies on it and see what are the benefits,” she said. “We know the negative end of it.”

And even Russel said his firsthand experiences with customers indicate mixed results.

“It’s a big hit or miss with people.”

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26  Balance

The effect of sunlight — or lack thereof — is much greater than you might think

By Tom Hager

S unny days can often seem scarce on the Palouse in spring, and that can spell trouble for people in a variety

of ways. Not only does the lack of sunlight cause a higher frequency of Seasonal Af-fective Disorder in the Pacific Northwest, it can also lead to a sleep and vitamin D deficiency.

Dr. Hans Van Dongen, a scientist at the Washington State University Sleep and Performance Research Center, says sunlight plays a role in our sleep habits. Sunlight, he says, controls the timing of our biological clock, a part of the brain that keeps time.

“It’s a real group of cells, actually,” Van Dongen said. “You can point it out. We know where it’s located.”

There’s a spot in the brain where the nerves from the eyes cross over each other on the way to the visual cortex in the back of the brain, he said. A group of cells there gets to see the light that the eye sees before you actually see it in your visual brain.

“That group of cells knows what time it is based on light exposure outside and,” he said, “... will be responsible for making sure that you adjust to a time zone.”

Unfortunately, for the tens of thou-sands of college students in this area, he said, they are likely not getting the sun exposure that other age groups are getting.

“Their biological clock is naturally inclined to be a little bit later than that of older people and so they are automatically driven biologically to get up later and to

The power of the sungo to bed later,” Van Dongen said. “This is a biological phenomenon. This is not something they do because they are lazy or they want to party all night.”

The lack of sunlight also causes a defi-ciency in vitamin D in the body. Separate-ly, there is growing evidence that a lack of sunlight can increase your risk of cancer, diabetes, and multiple sclerosis. They will never be the sole cause of any disease, but it certainly creats an issue for people living in overcast areas.

The most com-mon problem, how-ever, is that the lack of sunlight causes seasonal depres-sion. The produc-tion of serotonin in the body, which is known as the happiness hormone, drastically decreases during the winter. Although WSU estimates that 6 percent of the general population suffers from seasonal depression, over 10 percent of people living in the Pacific Northwest suf-fer from S.A.D.

Fortunately for college students, there is a solution. Both the University of Idaho and Washington State University offer free confidential testing and counseling. The main approach counselors use is light therapy, which replicates the healing ef-fects of the sun.

“It’s been used for about 20 years… It’s

one of the first approaches that people tried,” said Dr. Cassandra Nichols, direc-tor of WSU’s counseling center.

While it doesn’t work for everybody, she said, for those who respond, it tends to work pretty well.

WSU students seeking light therapy can call (509) 335-4511 to set up an appoint-ment, while UI students can call (208) 885-6716.

For residents of the area who don’t attend either of the universities, Nich-ols recommends they visit a psychia-trist. Anyone can purchase the lights online, which gen-erally cost less than $200, but a trained

professional would know which one to choose and whether any other factors may be causing the depression. They may rec-ommend anti-depressant medication, talk therapy, and exercise, she said, but more likely than not they will recommend the light therapy if sunlight deficiency is the source of the problem.

There is a perception that because a lack of sunlight causes a deficiency in

“This is a biological phenomenon. This is not something they do because they are lazy or they want to party all night.”

Dr. Hans Van Dongenscientist at the Washington State University

Sleep and Performance Research Center

Spring 2013 27

vitamin D, one can simply take vitamin D pills to prevent S.A.D. But the depression is caused by the lack of sunlight, as is the vitamin D deficiency. Vitamin D pills can’t replace the light therapy.

The biggest misperception, however, is that one can simply mitigate the effects by more exposure to the outdoors. That gains you little if the sun is hidden behind clouds, Nichols said.

RobeRt HubneR/WSu PHoto SeRviceS

Dr. Hans Van Dongen in the observation room of the sleep lab with a research assistant

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By Shelia M. PooleThe Atlanta Journal-Constitution

ATLANTA — Delia Fernandez is looking for her perfect match.

Not for love, but to stay alive.The married mother of four, who was diag-

nosed with chronic myeloid leukemia in 2008, has waited nearly two years for a new bone marrow transplant.

Anti-cancer drugs didn’t work. Nor did a previous transplant.

Donor and recipient DNA have to be closely matched for transplants to work.

So far, doctors scouring a registry of poten-tial bone marrow donors for a match that will work and not cause new complications have come up empty-handed.

That’s why Fernandez, 38, a resident of Hiram, Ga., wants people to join the registry as potential donors, particularly African-Ameri-cans, Asians and Latinos.

Minorities are underrepresented on Min-neapolis-based Be The Match, a large registry of potential bone marrow donors.

More than 70 types of diseases, including leukemia and lymphoma, can be treated with bone marrow transplants.

She said the decision by “Good Morn-ing America” co-anchor Robin Roberts to go public with her battle against myelodysplastic syndrome, a rare blood disease, helped raise

awareness about the importance of bone mar-row transplants, which replace dysfunctional blood-forming stem cells with healthy ones. Roberts, who recently returned to work, re-ceived a bone marrow donation from her sister.

“This is not just for me, but to help save other people’s lives,” said Fernandez, a logistics analyst for an Atlanta company.

For those needing such transplants, there’s a 30 percent chance that a family member, particularly siblings with the same two parents, will be a full match.

The greatest risk for complications for recipients is graft-versus-host-disease, in which the donor’s immune system recognizes the patient’s cells as foreign and attacks them, said Dr. Otis Brawley, chief medical officer of the American Cancer Society.

Fernandez’s siblings are only partial match-es, so now she is looking outside her family.

People with the same ancestry are most likely to be matches. But genetics can be tricky. Latinos, for example, come from a very diverse genetic pool, which makes it more difficult to find a full match.

“You think of your genetics as a fingerprint,” said Dr. Scott Solomon, an Atlanta hematolo-gist and oncologist and medical director of the Unrelated Donor Transplant Program at Northside Hospital in Atlanta.

“Trying to find someone with the same fin-gerprint is very, very difficult.” And there have

been “some amazing matches” between people of different ancestries, Brawley said.

“There have been good matches between individuals who appear to be European and individuals who appear to be black,” he said.

Be The Match has facilitated more than 55,000 transplants since 1987. It has more than 10.5 million potential donors in its registry.

“So the challenge is that we have to find more people of ethnic diversity to join the reg-istry to help meet our needs,” said Tina Saadat, the Southeast recruitment and community development supervisor for Be The Match.

One problem donor-matching organiza-tions face is that people think there are risks to donating, when there are few.

“I think a lot of it has to do with education on the topic,” said Fernandez. “There are still a lot of misconceptions about donating.”

Some of her older relatives think “they will take out an organ or that you will end up in a wheelchair.”

There are several ways to donate, including by bone marrow stem cell collection, a surgical outpatient procedure done in a hospital.

Peripheral blood stem cells can also be given in an outpatient procedure similar to donating platelets or plasma.

Blood stem cells are the most frequent donation, and fewer than 1 percent of PBSC donors experience a serious side effect from the process.

Dr. Al Soltan, president of Georgia Cancer Specialists, said transplant outcomes have im-proved over the years in part because of better patient-centered programs and better control of infections.

“We get to see many people benefit from the gift of life,” he said.

The optimum age to donate is between 18 and 44, but people generally stay in the registry until age 61, when they automatically roll off.

Solomon said finding a potential donor can be complicated. Once a donor joins a registry, he may not be identified as a potential match until years later.

Transplant advocate understands the need on a personal basis

Dr. Terri J. Drury

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CLUES ACROSS 1. Confederate soldier 4. __ Lilly, drug company 7. Negative 10. Teacher 12. Informal term for

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32 Balance