Summer 2015 1

The health magazine forBody, Mind & Motivation

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

BalanceVolume 7 – Issue 2 – Summer 2015

PLAY SAFEPublic pools a great wayto beat the heat, butthere are rules to live by

STRENGTH INNUMBERSWeight Watchers groupcompletes hike up Lewiston Hill

HOPE TAKESCENTER STAGERegion’s hospitals recognize importance of palliative care

LAST ACT OF LOVEAll grieve di� erently

PLAY SAFEPublic pools a great wayto beat the heat, butthere are rules to live by

�  Balance

Summer 2015 �

4 Balance

Contents Balance – volume 7, issue 2 – Summer 2015

18

ALSO | BODY IMAGE 6 | MASSAGE 11 | SLEEP 16

Allen, Dr. Richard ..................................21Alternative Nursing Services .................17Altura College .............................................11Community Health Association Spokane ...22Compassionate Care, Inc. ........................9Dynamic Physical Therapy ......................7Electrolysis - Permanent Hair Removal ..19

Garges, Lawrence, M.D. ........................23Huckleberrys at Rosauers .......................5Leavitt DMD, Erin ..................................15Maplewood Dental ...............................21MJ’s Pot Shop ..........................................5Ozeran, Steven, M.D. ............................22Pathologists’ Regional Laboratory ..........9

Peak Performance Physical Therapy ......17St. Joseph Regional Medical Center .......24Tri-State Memorial Hospital ....................2Valley Medical Center ..............................3Whitman Senior Living .........................23Wilkinson, David, DDS ..........................19

ADVERTISER INDEX

More. Better. Brighter.

MENTAL HEALTH

LAST ACT OF LOVEEveryone grieves di� erently

8HEALTH

STRENGTH IN NUMBERSWeight Watchers group completes hike up Lewiston Hill with a little help from their friends

12WELLNESS

HOPE TAKES CENTER STAGERegion’s hospitals recognize importance of palliative care

14COVER STORY

PLAY SAFEPublic pools great way to beat the heat, but there are rules to follow

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 the Moscow-Pullman Daily News advertising department at (208)882.5561 or Advertising Director Angela Kay at akay@lmtribune.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.

Summer 2015 5

Vegetarian diets must be paired with other lifestyle changes for effective weight loss

By Dominique WalD

I n any weight loss plan, a change in diet is the most effective way to see results.

While some people choose to cut out carbohydrates and sugar, others are taking a more extreme approach — cutting out meat altogether.

The biggest question is does it really work?Pullman Regional Hospital dietitian

Melissa Francik said people must make other changes in addition to cutting out meat to see results.

“Most of weight loss is diet change, but it has to be supported with something else, whether it be behavioral or physical,” Francik said. “It’s just one component in a plan that has many.”

When done correctly, Francik said, veg-etarian diets have proven to have both long- and short-term health benefits, such as lower body mass index, lower risk of prostate and colon cancer, and lower cholesterol and blood pressure. According to a study published by the U.S. National Library of Medicine, post-menopausal vegetarian women were found to have hormonal differences that possibly led to lower rates of endometrial and breast cancer.

“The important thing to note is that evidence could very well be a result of what is being eaten rather than what isn’t being eaten,” Francik said.

Vegetarian diets are defined as avoiding all animal flesh, including poultry and fish. Francik said there’s a lot of flexibility in what you choose to cut and to what degree.

“A lot of people will cut out meat and poultry but leave fish in their diets to get those

Dropping meat to drop pounds

omega 3 fatty acids,” Francik said. For those who are switching to veg-

etarianism, Francik recommends talking to a dietitian to come up with an eating plan that is both healthy and feasible. She also recom-mends gradually introducing meatless meals into an every-day diet.

It is possible, Francik said, to substitute protein foods to replace the protein one would normally be getting from meat. Some popular choices include beans, peanuts and lentils. Soy beans, such as edamame, are also proven to be a good source of protein.

While switching to a vegetarian diet can help with weight loss, Francik said it’s not something she sees in a lot of her patients. She said she has seen four or five

women who decided to cut out meat for weight loss purposes in the four years she has been working as a dietitian.

Francik also said it can be perfectly healthy for children to be raised on a vegetarian diet. One thing to remember, she said, is that children need higher intakes of iron and zinc because they don’t absorb it as well as adults do. Pregnant women can also be on a vegetar-ian diet, as long as they’re supplementing with adequate amounts of protein, she added.

“The important thing to tell yourself is you don’t have to be an extremist about becoming a vegetarian, if that’s what you decide to do,” Francik said. “By starting small you’re going

to develop an eating plan that’s healthy and right for you.”

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�  Balance

Positivity movement encourages women to accept who they are

By CHELSEA EMBREE

M ichela Dalsing has traded in her sweatpants for spandex.

The Pullman resident has been an athlete nearly her whole life, but it wasn’t until she got involved with the Rolling Hills Derby Dames that she found a group of women who helped her see her body as beautiful.

“Back in high school, I wore a lot of baggy sweatpants. Sweatpants were like my go-to,” Dalsing said. “I was 50 pounds lighter than what I am in high school, and I wouldn’t even go to practice in spandex in high school.”

Dalsing is part of a growing number of women investing in body positivity, a movement that encourages women to work on accepting and loving their bodies at any and every shape, size, age and skin color.

The movement may have roots as far back as the fat acceptance movement that was part of the second wave of feminism in the late 1960s. Lysa Salsbury, director of the Women’s Center at the University of Idaho, believes the contemporary body positivity movement has a lot to do with women pushing back against ideal-ized beauty stan-dards.

“I think it’s a result of … women spend-ing all this money on diet pills and regimes and certain types of exercise, and realizing that not only does it not work, but even if they achieve the goals and the results that they’re looking for, they’re not any happier,”

Salsbury said.The image of female beauty in America

— tall, thin, full-chested, with blonde hair and blue eyes — is a limited one, she said.

“A lot of people don’t think about the fact that our idea of beauty is extremely Western and very white,” Salsbury said.

“There are many cultures around the world where having a curvy body is seen as a sign of fertil-ity and wealth and is desirable. … In some cultures, very, very dark skin is re-ally highly prized.”

Salsbury said advertising plays a

significant role in shaping what American women think is beautiful, noting the aver-age woman sees 3,000 images of idealized beauty daily.

“To see 3,000 images of airbrushed and photoshopped models every single day,

you’re going to think, ‘Oh, I don’t look like that, and that’s what’s beautiful,’” she said.

Ashley Centers of Moscow, who was first introduced to body positivity at the UI Women’s Center, recognized the negative effect that media can have.

“The media tells us that we need to look a certain way and act a certain way and think a certain way, and if we don’t, then we’re not worthy of anything or anyone,” Centers said.

Centers, who uses a wheelchair, said body positivity “is a struggle every single day,” but that she recognized the importance of working toward it.

“These are the only ones we’ve got,” she said. “There are multiple different things that you can do to try to change your body, and some of it is good and some of it isn’t good. But I think before we can make any change that’s going to really stick, we have to be comfortable with the body that we have.”

What Centers does to work toward accepting and loving her body includes thinking of at least one thing she likes about it before going to sleep each night.

Body beautiful

Tribune/barry Kough

The definitions of a body image changes through the years, between different groups of people, and between nations.

“A lot of people don’t think about the fact that our idea of beauty is extremely Western and very white.There are many cultures around the world where having a curvy body is seen as a sign of fertility and wealth and is desirable.”

Lysa Salsburydirector of the Women’s Center

at the University of Idaho

Summer 2015 �

“I don’t like it a lot of days, but I’m still here. It’s still working. And those are good things,” Centers said.

Friends have also helped her along in the process. One friend took the idea of a swear jar and had Centers pay one dol-lar whenever she said something negative about her body.

For Dalsing, the friends she made participating in roller derby also helped her start thinking differently.

“It’s really nice to be a part of a group of women that are like, ‘Yeah, you’re beautiful, we love your curves, we love your shape,’” Dalsing said. “So once you hear that mes-sage enough, it becomes your thought process.”

Dalsing originally got involved with roller derby because she was looking to lose weight, but after a few months of practices, her motivations shifted.

“Now I’m realizing that self-betterment isn’t necessarily weight loss. It’s about being with a wonderful group of women who build me up, who make me feel powerful,” she said.

Courtsesy MiChela Dalsing

(LEFT) Michela Dalsing’s self-image continues to climb as a member of the Rolling Hills Derby Dames. She is among a growing number of women who are part of the body positivity movement. (ABOVE) Finding support through groups or friends can be helpful in improving your body image.

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�  Balance

Weight Watchers group completes hike up Lewiston Hill with a little help from their friends

By JOEL MILLS

M embers of the Clarkston Weight Watchers chapter hopped off the scale this spring and hiked up

the Old Spiral Highway.While the classic Weight Watchers

program focuses on closely watching and recording what one eats, exercise is only encouraged, not mandated. So when Pat Baker, a member of the Clarkston group, and a couple of her friends did the 7.3 mile walk up the twisty road last fall, they got an idea.

“We were talking about it throughout the year, so we got excited,” said Lynne Beck, one of the friends. “Pat announced it

at one of their Saturday meetings, and they picked a date.”

Baker said there are typically 30 mem-bers of the Clarkston chapter, and about 10 committed to the steep walk on the morn-ing of Sunday, April 19. She was confident in her abilities since she’d done it before, but the others weren’t so sure.

“None of the other ladies had ever at-tempted it, and were real nervous about whether they could do it or not,” she said.

But strength comes in numbers, and the

Strength in numbers

Summer 2015 �

women leaned on each other for encour-agement.

“When we met up at the bottom of the hill, Pat generally stayed toward the front of the group, and I was kind of the caboose to make sure that the people who were struggling were able to make it to the top of the hill,” Beck said.

“We just all kind of stayed together, and encouraged one another, and made it to the top,” Baker added.

While only women participated in the walk, they were of diverse ages, from those in their 40s to one woman who was 82. Baker said many were surprised that they were able to make it to the top, but the companionship definitely played a part in the accomplishment.

“I’m sure there were a number of ladies who went home and put their feet up for the rest of the day,” Baker said. “But we were all very encouraging, and cheerful, and everyone was giving high-fives and hugging at the top.”

Baker credits the Weight Watchers program for her own weight loss and good health. Two years ago, she weighed 220 pounds. Now, she is down to 130.

“That’s a combination of going to the meetings, working the plan and getting out and walking and exercising,” she said.

The walk was so successful that another is being planned for some time this fall after the weather cools down. That will be another climb up the Old Spiral High-way, but Baker said future walks will take advantage of the area’s other great walking venues.

Those interested in joining Clarkston Weight Watchers may attend their regular 8:30 a.m. Saturday meetings at the Val-ley Community Center, 549 Fifth St. in Clarkston.

(LEFT) The Clarkston Weight Watcher Ladies climbed to new heights, putting their doubts and fears aside. Hiking up the Spiral Highway to the top of Lewiston Hill was for many a great achievement having never attempted anything like this before. Names of Ladies in Photo (L-R): Michelle King, Debbie Estlund, Brenda Johnson, Joan Wilson, April Outland, Patricia Baker, LouAnn Carter and Betty WeissenfelsLynne Beck photo

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10  Balance

Moderation is key

By Samantha malott

R esearch is now showing some alco-holic beverages — like wine — can provide heart and anti-inflammato-

ry benefits when consumed in moderation, according to Samantha Ramsay, a regis-tered dietitian nutritionist at the University of Idaho.

An anti-inflammatory, simply put, reduces inflammation in the body that can commonly be referred to as pain, swelling and fever.

Chronic inflammation can cause chronic pain and lead to heart disease and other age-related diseases, according to a January article by Rachel Pomerance Berl for U.S. News. Stress, environmental toxins, physical activity and diet all have a part in an individual’s inflammatory state, she wrote.

Ramsay said anti-inflammatories can be beneficial for cardiovascular health, arthri-tis, general aches and pains, and even when recovering from injury. These benefits, however, can be obtained from other non-alcoholic beverages, which may be a better option, she said.

Melissa Sanborn with Colter’s Creek Vineyard and Winery in Juliaetta said red wine contains antioxidants beneficial for the body. Antioxidants are agents such as vitamins E and C that allow for oxidation to occur in the body’s cells and fight off cell damage. Other antioxidant rich drinks, aside from red wine, include green tea and some juice-based drinks like pomegranate, orange and grape juice.

Ramsay said moderation is key when it comes to absorbing any health benefits from your favorite alcoholic beverage. She said “moderate consumption” equals about one glass or serving for women and two glasses or servings for men.

If a person consumes more than the

recommended amounts, then health risks increase, putting a person at greater odds for cardiovascular disease, cancer and many other diseases, she said.

Ramsay also added a person who does not consume alcoholic beverages will

be overall healthier, and it would be in their best interest to refrain from alcohol consumption and focus on other beneficial health behaviors. Drinking alcohol for its potential health benefits is not the best op-tion, she said.

Health benefits of wine

Research is now showing some alcoholic beverages can provide heart and anti-inflammatory benefits when consumed in moderation, according to Samantha Ramsay, a registered dietitian nutritionist at the University of Idaho.

Summer 2015 11

A good back rub provides a slew of benefits

By Tom Hager

A back massage might seem like a luxury reserved for only those with disposable money, but as it

turns out, a massage provides a variety of health benefits that make it worth the cost.

The message is catching on — in a recent survey sponsored by the American Massage Therapy Association, 77 percent of people who got a massage in the past year did so because of medical reasons. Back massages can help alleviate pain in muscles that are tight or knotted, but that is hardly the only benefit, said Mandi Denning, a massage therapist at Healing Hands in Pullman.

“You’re going to be moving around blood and limbs and you’re going to be getting circulation moving more. People talk about toxins being in the body, and the massage moves around toxins,” Denning said. “That is kind of difficult because what exactly is a toxin? ... There isn’t research that says, ‘Yes, massage re-moves toxins out of the body.’ But if you ask most people who have gotten a mas-sage, especially ones that are deep tissue, they notice that they feel different.”

Denning said Healing Hands treats a variety of symptoms in patients, many of whom were referred by area doctors. In addition to increasing circulation and loosening muscles, massages can get rid of headaches, improve posture, lower blood pressure and decrease cortisol, also known as the stress hormone, Denning said.

“Your body has the tera-sympathetic and the sympa-thetic part of your nervous system. The sympathetic is that fight or flight re-sponse that we get, and the terasympathetic is rest and digest. So when you’re get-ting a massage your body it goes into an emotional state where you’re in that rest,” Denning said. “And most of the time throughout the day we’re not in that state, we’re in more of that fight or flight.”

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12 Balance Summer 2015 13

Hope takes center stageRegion’s hospitals recognize importance of palliative care

BY ELAINE WILLIAMS

T he hopes of patients with serious ill-nesses can easily get lost in a whirl-wind of hospitalizations, doctors’

appointments and confusing information.St. Joseph Regional Medical Center in

Lewiston recently hired Dr. Leah Jones, a full-time hospital board certi� ed pallia-tive care and hospice physician. Her job is to help alleviate unnecessary su� ering by giving patients better tools to navigate the medical system and identify ways to con-tinue activities that bring them joy.

� e addition of Jones is an indication of the growing importance of palliative care in north central Idaho and southeastern Washington. � e St. Joe’s team consists of Jones, along with a director, a nurse prac-

titioner, pharmacist, social worker

and a chaplain.Pullman Regional Hospital created a

similar team in 2010. One of the hospital’s two hospitalists is board certi� ed in pallia-tive care and is part of a team. Two of the members are receiving additional special-ized training in the � eld. Syringa Hospital in Grangeville has a physician who is the medical director of its hospice program.

At St. Joe’s, Jones’ goal is to encour-age more physicians to refer patients to palliative care in part through cor-recting misconceptions about what it entails, she said. She will be part of the team that sees patients in the hospital, but won’t have her own out-patient practice.

O� en doctors don’t request pallia-tive care for their patients because of the false belief that doing so

Dr. Leah Jones, a board certi� ed palliative care and hospice physician, is seeing paitents at St. Joseph

Regional Medical Center’s new palliative care suite.TRIBUNE/KYLE MILLS

is giving up the battle against cancer or other potentially life-threatening diseases, Jones said.

� e reality is that palliative care can be useful starting at the diagnosis of any serious illness or a hospitalization for life-changing events such as a vehicle accident, Jones said.

Palliative care is frequently delivered while patients are undergoing treatments to cure, not just manage diseases. It as-sists patients as they weigh the pros and cons of possible cures in relationship to how much the treatments will e� ect their day-to-day activities, said Katie Evermann Dru� el, director of social work at Pullman Regional Hospital.

� e teams can also help patients and their families understand symptoms, and direct patients’ families and friends to resources so they can better care for the patients at home.

With fatal diseases, the team can help pinpoint patients’ last wishes so that they get the most out of their remaining time. A patient with severe leg pain might request medication that would mitigate the pain, but not leave them so groggy that they couldn’t join in family conversa-tions around the dinner table, Evermann Dru� el said.

“We hope we can help people stay in the community because that’s what they want to do,” Jones said.

12 Balance

Hope takes center stageRegion’s hospitals recognize importance of palliative care

BY ELAINE WILLIAMS

T he hopes of patients with serious ill-nesses can easily get lost in a whirl-wind of hospitalizations, doctors’

appointments and confusing information.St. Joseph Regional Medical Center in

Lewiston recently hired Dr. Leah Jones, a full-time hospital board certi� ed pallia-tive care and hospice physician. Her job is to help alleviate unnecessary su� ering by giving patients better tools to navigate the medical system and identify ways to con-tinue activities that bring them joy.

� e addition of Jones is an indication of the growing importance of palliative care in north central Idaho and southeastern Washington. � e St. Joe’s team consists of Jones, along with a director, a nurse prac-

titioner, pharmacist, social worker

and a chaplain.Pullman Regional Hospital created a

similar team in 2010. One of the hospital’s two hospitalists is board certi� ed in pallia-tive care and is part of a team. Two of the members are receiving additional special-ized training in the � eld. Syringa Hospital in Grangeville has a physician who is the medical director of its hospice program.

At St. Joe’s, Jones’ goal is to encour-age more physicians to refer patients to palliative care in part through cor-recting misconceptions about what it entails, she said. She will be part of the team that sees patients in the hospital, but won’t have her own out-patient practice.

O� en doctors don’t request pallia-tive care for their patients because of the false belief that doing so

Dr. Leah Jones, a board certi� ed palliative care and hospice physician, is seeing paitents at St. Joseph

Regional Medical Center’s new palliative care suite.TRIBUNE/KYLE MILLS

Summer 2015 13

Hope takes center stage

is giving up the battle against cancer or other potentially life-threatening diseases, Jones said.

� e reality is that palliative care can be useful starting at the diagnosis of any serious illness or a hospitalization for life-changing events such as a vehicle accident, Jones said.

Palliative care is frequently delivered while patients are undergoing treatments to cure, not just manage diseases. It as-sists patients as they weigh the pros and cons of possible cures in relationship to how much the treatments will e� ect their day-to-day activities, said Katie Evermann Dru� el, director of social work at Pullman Regional Hospital.

� e teams can also help patients and their families understand symptoms, and direct patients’ families and friends to resources so they can better care for the patients at home.

With fatal diseases, the team can help pinpoint patients’ last wishes so that they get the most out of their remaining time. A patient with severe leg pain might request medication that would mitigate the pain, but not leave them so groggy that they couldn’t join in family conversa-tions around the dinner table, Evermann Dru� el said.

“We hope we can help people stay in the community because that’s what they want to do,” Jones said.

14 Balance

Public pools great way to beat the heat, but there are rules to follow

BY RALPH BARTHOLDT

W ith its noise, splashing and heat the side decks of public outdoor pools may seem a

likely place for injuries to occur, but hazards can lurk in the cool shade of the

changing rooms as well.“We once had a guy slip and fall in

the bathrooms,” Lewiston Orchards Pool Manager Hope Mastroberardino said. “It can be slippery in there.”

That is why lifeguards and pool man-agers recommend parents outfit their children in non-slip footwear such as rubber sole flip-flops when the young-sters use area pools, whether the facility is inside or out of doors.

When temperatures climb beyond

100 degrees, the cement deck around outdoor swimming pools can reach temperatures of 140 to 160 degrees, according to the National Weather Service. Skin will start to burn at 110 degrees.

“A lot of times kids who are barefoot will start running on the deck because it is so hot,” Mastroberardino said.

Pool safety rules require walking on the deck. Walking in footwear is more pleasant — and safer — than walking on

Play safe

Summer 2015 15

the hot surface in bare feet, she said.

Public pools dur-ing summer months can be crowded places. Anywhere from 50 to 150 people pack into area pools daily, especially during the open and family swim times, said Andrew Light, the manager at Lewiston’s Bert Lipps Pool. Having that many people splashing, swimming, diving and playing inside pools of Olympic-size (50 meters long and 25 meters wide) to short-course size (25 meters long), makes for a potentially accident-prone environment. Pools in the Lewiston-Clarkston Valley keep five lifeguards on duty, with three on deck at all times, pool managers said. Lifeguards do more than enforce pool rules.

“We have sunscreen available, and recommend it (to patrons) if we think they are getting burned,” Mastrobe-rardino said.

Lifeguards remind patrons to drink liquids when the sun hangs near its zenith, flashing reflected light like glass shards across the deck.

“They should stay hydrated, wear sunscreen, bring a towel and flip-flops,” said Payton Weakland, a Bert Lipps lifeguard.

Staying hydrated, wearing polarized sunglasses and wearing hats can help prevent the onset of heat stroke, which can result through prolonged exposure to heat and sun, lifeguards said. Some

symptoms include headaches, nausea, hot and dry skin, or sometimes skin that feels cool or clammy. It is another thing they watch out for.

It’s a good idea to learn to swim, whether by taking swim lessons or learning on your own — before ventur-ing into areas that may seem challeng-ing. Lewiston pool rules require young people to swim at least 30 meters unaid-ed before they are allowed to slip under the ropes and into the pools’ deep ends — where the bottom drops to between 6 and 9 feet at Bert Lipps to more than 11 feet deep at the Orchards Pool.

Common accidents at public pools include people getting dinged by care-lessly jumping into the pool, jumping on, or too-near other people, or using diving boards and ladders irresponsibly.

“We get bloody noses, some scratch-es,” Mastroberardino said.

And then there are bees. Bees and wasps are attracted to water on hot days, so packing insect sting, or bite relief is a good idea, she said.

(LEFT) Public swimming pools provide an umbrella of safety for their swimmers with multiple lifeguards to keep an eye on enthusiastic swimmers, like these at the Lewiston Orchards pool. (RIGHT) There are a few rules that all swimmers need to keep in mind at all times.Tribune/barry Kough

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16  Balance

Sleeping your way to a healthier life

By Shanon Quinn

O ne of the healthiest lifestyle moves a person can make is one they’re unlikely to remember and — after

some preparation — can become an effortless, enjoyable routine.

“Sleep is a major part of a person’s overall health,” registered polysomnographer Mark Johnson said.

Johnson, who works at Gritman Medical Center’s sleep center, facilitates sleep studies that

can diagnose narcolepsy, sleep apnea and some sleep-related seizures.

A good night’s sleep can be the difference between feeling stressed, depressed and unable to focus and enjoying a bright, energetic start to each day.

But all sleep is not created equal.“Good sleep is when you feel refreshed and

awake and alert during the day,” Johnson said, while irregular, interrupted nights can leave you at less than your best.

One of the first steps to getting the benefits of a restful night is to have a regular sleep schedule.

Although most people had a set bedtime as a child few carry that habit into adulthood — but they should, Johnson said. Regardless of the

season, weekend, weekday or holiday, a regular schedule is a crucial part of reaping the benefits of healthy sleep.

“It is very important to have a regular sleep schedule and very important to get up the same time every day,” Johnson said. “Getting up the same day time every day helps to reset your circadian rhythms.”

Johnson said although seven to nine hours of sleep a night is necessary to stay healthy, the amount of sleep a person needs can differ depending on variables like age.

“Young people need more sleep than older people,” he said.

Getting to bed on time is not always the big-gest challenge — the challenge may be getting

The road to dreamtown

Summer 2015 17

to sleep.In order to beat the tossing and turning

many encounter, especially when beginning a new sleep schedule, board certified sleep special-ist John Grauke recommends using a series of techniques that fall under the heading of sleep hygiene.

Grauke said preparations for sleep should begin as early as two hours before readying for some shut-eye.

One of the first issues to address is creating an environment conducive to sleep, he said.

“We recommend people have a room that controls sound, light and temperature,” Grauke said.

While the control of such stimuli is impor-tant, the ideal environment is often up to the individual. Grauke said most people are com-fortable with a room temperature of between 68 degrees and 74 degrees year-round, but some may snooze better in slightly warmer or cooler environments. The same is true of the use of relaxing teas or aromatherapy oils and what sort of ambient noise should be present. Anything from a droning fan to sounds of the ocean, the

forest, a babbling brook or even soft music can help people drift off, depending on personal preference.

Some sound is of value, as it minimizes sleep disruption due to the shock of a sudden noise.

“Ambient noise raises the level of noise that you’re accustomed to,” he said. “I’m a big advo-cate of white noise.”

Darkness is also necessary, especially during the warmer seasons when daylight may still be present when bedtime comes. Grauke said he

recommends heavy curtains or block-out shades to keep out any remaining daylight. Natural daylight, which contains blue wavelengths — or blue light — is beneficial to the body during the day, as it helps focus and wakefulness, but at night can throw a wrench into sleeping sched-ules, he said.

Experts also recommend avoiding caffeine, nicotine and other stimulants during the last hours of wakefulness and avoid allowing pets in the bed.

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Dave BieryOwner

Annie KaneRehab Aide/Office Support

Tami BieryPhysical Therapist

OwnerOwnerTony Edmison

Rehab AideColleen Schlangen

Physical TherapistHannah Gibbs

Physical TherapistMatt Schaack

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18  Balance

Everyone grieves differently

By HannaH SHirley

A nnie Pillers said she was once told grief is the last act of love.

For someone like Pillers, who encounters grief every day, this is an idea that encourages and comforts her.

“When we love someone deeply and they leave us, we will have grief,” Pillers said. “We’ve earned the right to grieve and to be afraid.”

Pillers has worked in grief support

since the early 2000s, and now she’s the director of the Friends of Hospice grief support group in Pullman. She’s sat with grieving people in their 20s and griev-ing people in their 90s — people who have lost their spouses, parents, siblings, friends, children, pets, health and jobs.

Pillers said she’s found grief is both a universal experience and profoundly personal. It’s something no two people feel the same way, but something no one can escape.

“Sometimes we don’t recognize the impact of our grief,” Pillers said.

The grief that comes with loss goes beyond being sad. People might experi-ence forgetfulness, a lack of interest in things they enjoy or their demeanor may simply be different. They may also experience physical symptoms, such as aching, trouble sleeping or a loss or increase in appetite. Sometimes, grief doesn’t feel like sadness at all — some people say it manifests as fear.

Healing means going through the grief, not around it. How long this process takes varies for everyone, but generally, Pillers said, it takes longer

A last act of loveHealing means going through the grief,

not around it. How long this process takes varies for everyone, but generally it takes longer than people expect, and

certainly longer than culture allows.

Summer 2015 19

Grief support groupsFriends of Hospice: Free, eight-week group series. Contact Annie Pillers at (509) 595-1129 or griefsupport@palouse.com for more information or to register.Living with Loss: Free, open support group held at noon on the second and fourth Tuesdays of each month at the United Church of Moscow. Contact Glenda Hawley at (208) 882-3197 for more information.Willow Center for Grieving Children: Free children’s bereavement program offering peer support for children ages 3-18. For more information, call (208) 669-0731 or visit www.willow-center.org.Grieving children’s support groups, 7 p.m. first and third Tuesday, Seventh-day Adventist Church, 1212 19th St., Lewiston. Participants are asked to call the Willow Center at (208) 791-7192.Bereavement Support Group, coordinated through Home Health & Hospice, (509) 758-2568.

than people expect, and certainly lon-ger than culture allows. In this way, it can be very painful, she said.

“In our wanting to help someone, we are want to take the grief away, but it’s not something we can take away,” Pill-ers said. “In our effort to make you feel better, we rush to fix you, but nothing is broken. Our heart is empty for a while. There’s no fixing that. We just have to work through it.”

Watching a loved one grieve can be painful, especially when the process takes longer than expected. Well-mean-ing loved ones might try to hurry the grieving process along, but Pillers said it’s best to be patient.

“We can only deal with our grief as we’re meant to. People may say, ‘Oh, they’re avoiding their grief,’ but that’s just where they are right now,” Pillers said. “I don’t question how people open up to their grief, whether it’s a long time from now or right away. I respect what they need to do for themselves.”

Exploring grief is different for every person. One person may find solace in art, the next in being active and another in church. Many who feel anxious about their grief find comfort in hearing oth-ers’ experiences and stories — that, Pill-ers said, is the value in a support group.

“In our culture, we feel alone, be-cause people are afraid of grief,” she said. “In a support group, we realize we’re not alone — we find some com-monalities in our experiences, and find that we’re not really going crazy after all.”

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20  Balance

By Sheena FahertyThe PhiladelPhia inquirer

PHILADELPHIA - It’s hard to teach empa-thy in the classroom, yet it’s one of the foun-dations of the doctor-patient relationship. How well physicians can put themselves in their patients’ shoes is directly linked with patient satisfaction.

“When I was in med school, no one told me how to do that,” said Dennis Novack, professor of medicine and associate dean of medical education at Drexel University College of Medicine. “You could watch your mentors, if you were lucky. Or make mistakes.”

Numerous studies have shown patients with empathetic caregivers are more likely to stick to their doctor’s treatment plan, leading to better health results. Doctors who can better under-stand their patients also are more satis-fied with their work. And hospitals know how important patient satisfaction is to their bottom line, now that it is a factor Medicare considers in reimbursement.

Medical educators at Drexel have designed a tool for Internet-based training for medi-cal students using actors – or “standardized patients,” as they’re called in this context. Stu-dents get to practice what have been deemed the most effective communication techniques in a simulated setting before they face real patients.

The patented program develops “more advanced skills, such as giving bad news, or counseling a mom who is reluctant to give immunizations to a child. These are dicey, difficult conversations,” said Novack, who co-developed the program. During medical care,

you’re “dealing with strong emotions. How do you manage when a patients’ family is mad at you? What do you do?”

The program fills the need for this kind of training by allowing students to interact with trained actors through a webcam. It’s like a Skype session on educational steroids.

During training, students are evaluated on their performance by the “patient” and receive immediate feedback on strengths and weaknesses from the actors, who have been rigorously trained in what to look for. The program also lets students see a recorded clip of their performance, as well as prepared scenes of an expert breaking bad news to a patient.

“Learning in clinical medicine is always multimodal,” said program co-creator Christof Daetwyler, associate professor in the

department of fam-ily, community and preventive medicine at Drexel. To fully understand the skills, he said, it helps to see a master do it first.

“I think that this is very novel,” said

Amy Windover, director of communication skills training for the Center for Excellence in Healthcare Communication at the Cleveland Clinic. “I think a lot of people are working on developing something like this.”

Today’s medical students are especially receptive to this type of e-learning technol-ogy, because they’ve grown up with it. “We need to get with the times, because this is the language they speak and we need to adapt,” she said.

Communication skills and empathy training are “taught universally at medical schools,” said Maryellen Gusic, chief medi-cal education officer for the Association of American Medical Colleges. “People are do-

ing it in many different ways.”Still, she said, the Drexel program is inno-

vative because it’s taking what many schools are doing in the classroom, but making it available through the web-based platform. Additionally, a program like this could be used as a uniform format across all medical schools.

In 2013, out of 140 schools that reported their methods, 84 were using computer-as-sisted instruction to teach clinical skills, such as empathy training.

Windover notes, however, that such pro-grams have limits.

“How much of a true relationship can you have between a student and a standardized patient? And even more so with an standard-ized patient who is just Skyping in?” she asked.

In collaboration with DecisionSim Inc., Drexel’s technology is being licensed, although neither side would say what Drexel will be paid. The technology is being unveiled under the new name, CommSim, short for communication simulation.

Drexel’s technology “has been piloted in health systems,” said Bob Yayac, chief executive of DecisionSim Inc. “That was a big reason why we decided to purchase it.”

Communication training needs to be repeated throughout a physician’s career, not just in medical school. That’s why Yayac says he thinks this product has potential to reach many health care systems.

The Cleveland Clinic’s Windover agreed that such e-learning programs are useful for refresher training.

“It’s like a booster shot for communication skills training,” she said. “It’s not just one and done.”

2015 The Philadelphia InquirerVisit The Philadelphia Inquirer at www.philly.com

Distributed by Tribune Content Agency, LLC.

Empathy training for doctors

“I think that this is very novel.I think a lot of people are working on developing something like this.”

Amy Windoverdirector of communication skills training

for the Center for Excellence in Healthcare Communication at the Cleveland Clinic.

Summer 2015 21

HOW TO PLAY: Sudoku puzzles are formatted as a 9x9 grid, broken down into nine 3x3 boxes. To solve a sudoku, the numbers 1 through 9 must � ll each row, column and box. Each number can appear only once in each row, column and box. You can � gure out the order in which the numbers will appear by using the numeric clues already provided in the boxes. � e more numbers you name, the easier it gets to solve the puzzle!

CLUES ACROSS 1. Stonestreet character 4. What part of (abbr.) 7. 4th Caliph of Islam 8. Boojum tree 10. Ancient Irish people 12. Civil Rights group 13. Celery (Spanish) 14. Ed Murrow’s network 16. No (Scottish) 17. Classic dramatic music 19. Former OSS 20. Oven for ceramics 21. � e Palmetto State 25. Rapid bustling

movement 26. Mauna ___, volcano 27. Ridge of wind-blown

sand 29. Brilliantly executed

action 30. Alias 31. Head of a large company 32. Bill Nye 39. Sources of otaheite

starch 41. Small amount 42. A � at or level surface 43. European cave

salamander 44. Nickname for Robert 45. Syrian tablets from

3000 B.C. 46. Lasso 48. Fabrics of camel or goats 49. Old name for an area

in Turkey 50. Shock therapy 51. UC Berkeley nickname 52. Partridge Family’s Susan

CLUES DOWN 1. Cocoa beans 2. N.W. Syrian city 3. Environmental condition 4. Actress Zadora 5. Skulls 6. Technology Information

Center for Administrative Leadership (abbr.)

8. Central Nervous System 9. Not shut or closed 11. Legal action for damages 14. Data executive 15. Hot air, trial or party

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instrument 27. Dashes 28. Hawaiian guitar 29. Singer ___ Lo Green 31. Spanish hero El ___ 32. Prima ballerina

Karsavina

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Xenophanes 36. Talked 37. Undo garment ties 38. Exuberantly creative 39. Meat from a pig (alt. sp.) 40. About ilium 44. Blat 47. ‘__ death do us part

HOW TO PLAY:

MentalFitness

Crossword

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Puzzle Answers on p.22

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22  Balance

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24  Balance