PRSRT STD U.S. Postage P A I D SEQUIM, WA Permit No. 23

THE REPORT

WellnessSpring 2014

O M C Medical Services Building 840 N. 5th Avenue Suite 2100 Project Lifesaver Your Immune System Sequim, WA 98382 roject Lifesaver is a LoJack SafetyNet tracking equim Medical Associate’s will present a forum (360) 582-2850 Psystem used by law enforcement departments Son “10 Easy and Proven Ways to Boost your nationwide which uses a GPS-enabled device. The ­Immune System.” This forum is open to all our tracking system locates adults and children who patients, their friends and family and will be held wander due to Alzheimer’s, dementia, autism, down’s on Thursday, April 10, 2014, from 1:30 – 3:30 in the syndrome, and other related cognitive impairment upstairs ­conference room. Barb Paschal, a retired diagnoses. The City of Sequim has been using this physical therapist, will be the presenter and ­offer program since 2007. The program has reduced techniques to improve your ability to heal and search times from hours or days to just minutes. The manage disease and stress. Here is a sampling: risks and costs of a typical search have also dropped • Laughter...actual laughter out loud is best! significantly, with an average rescue time of less than 30 minutes. • Music...It is most effective when you Participants wear a transmitter on their ankle sing, hum or play an instrument but just or wrist about the size of a watch, which emits an listening works too! continued on page 3 individualized tracking signal on an assigned radio frequency. The transmitter is a battery-operated radio­ Improving Your Immune System wrist transmitter ­emitting an automatic tracking signal every second, 24 hours a day. The signal can be PRESENTER: tracked on the ground over approximately one mile. Barbara Paschal, Retired Physical Therapist Each wristband has a unique radio ­frequency. Project April 10, 2014 1:30 – 3:30 pm Life­saver’s battery provides a continuous signal for Olympic Medical Park American Diabetes Association 30-45 days. 840 N 5th Ave, Sequim EXPO 2014 When caregivers notify police that the participant Second Floor Conference Room Tell us is missing, a team of specially-trained police and Fire Begin your journey to health at EXPO. Find out • 10 Easy and proven techniques to heal more Department personnel responds and uses the ­mobile quickly how we're your risk for developing ­diabetes, risk, stroke, locator tracking system to search for the missing • Feel healthier by resourcing your own doing… heart and kidney disease with our free health person. screenings and consultations. Learn how to eat natural capacities healthy, be active and change the future of For More Information • Better manage disease and stress 24 HOURS A DAY, 7 DAYS A WEEK… diabetes in Seattle at the ­largest community Any questions about the program, please contact h (360) 582-2850 gathering dedicated to health. the Sequim ­Police Department at (360) 683-7227. Please call Casey at 582-2850 to sign up. The EXPO is FREE and in addition to health You can also find more information online at http:// Family and friends welcome…. www.sequimmed.com screening includes cooking demonstrations, www.sequimwa.gov/index.aspx?NID=297. expert presentations, product and service OFFICE HOURS: MONDAY-FRIDAY 8:00 am to 4:30 pm exhibitors and much more! We would like to take this opportunity to ­extend Visit the American Diabetes Association EXPO hank You… a sincere thank you for your many cards, kind APPOINTMENTS: (360) 582-2850 T and Join the Millions™ in the fight to Stop words and remembrances. Your thoughtfulness was AFTER HOURS: (360) 582-2850 or (888) 810-3116 (urgent care) As most of you know, Sequim Medi- Diabetes®. cal Associates lost our dear friend and so appreciated and a true testament to just how FAX: (360) 582-2851 April 5, 2014 coworker, Anita Warner, on December many people Anita touched with her smile, keen EMAIL: [email protected] Washington State 23, 2013. Anita’s passing was tragic and sense of humor and compassion for others. REFILLS: CALL YOUR PHARMACY Convention Center, North Hall 4E/F we continue to struggle with the loss of We will never be able to replace Anita, nor will we ever forget her. We will hold our memories close Seattle, WA such a vital member of our team. and smile. EMERGENCY: DIAL 911 9:00 a.m. – 3:00 p.m.

FROM THE DESK OF now appears to improve on its own with conservative Your Immune System Samatha Reiter, M.D. management and sometimes with antibiotics if the area from page 1 becomes exposed area becomes infected. Morning Glory Fear is a protective mechanism that we have evolved • Moderate aerobic exercise... Fractures & Misfearing: to help us avoid dangerous situations and outcomes. 20-30 min/day. Every day. Muffins Mayo Clinic Healthy Recipes But we spend a lot of time avoiding and worrying about • Diaphragmatic breathing... Ingredients When Emotion Trumps Facts things that will never cause us harm – this has been Deep and full exhalation is the key. 1 cup all-purpose (plain) flour called misfearing. To be emotionally and physically 3/4 cup sugar hip fracture can change your life. healthy, we need to find a balance – to be informed • Meditation or Prayer 2 teaspoons ground cinnamon A Aside from the pain, a broken hip about risks of treating, and risks of not treating, a dis- • Make sleep a priority... 1/2 cup vegetable oil can be devastating, moving an inde- order. Fearing an unlikely side effect is an unfortunate best time for the body to heal. 2 teaspoons vanilla extract Remember… pendent person from their home to a reason to forgo an effective treatment that could keep 1/2 cup raisins nursing home. There can be complica- you from suffering a devastating event. Part of the prob- • Positive and Grateful thoughts 2 tablespoons chopped pecans We’re here to provide you quality healthcare. Part of our tions like blood clots, deconditioning lem is that when we sit down in front of the TV, we are • Kindness...Notice what you 1 cup whole-wheat flour and general decline in health and sense barraged by the lists of possible medication side effects 2 teaspoons baking soda job is to educate and assist you do/say and your tone of with your healthcare needs. of well-being. One of our goals is to without any indication of how infrequent those things voice. Go the extra mile 3/4 cup egg substitute 1/2 cup unsweetened applesauce Use the numbers below to get identify who is most at risk and to try to prevent these may be or how mild or severe. Then, there is the mis- for someone. incidents. representation by the media and many self-proclaimed 2 cups chopped apples (unpeeled) in touch with the people who Efforts to prevent fractures and osteoporosis are medical experts, that sometimes takes a little bit of fact • Create!! Garden, 3/4 cup grated carrots can answer your questions. multifaceted and include general strengthening, healthy out of context and ignores all of the other relevant data, paint, quilt, Directions diet, adequate intake of calcium and vitamin D, quitting facts and studies that may change how one views their woodwork, write... Preheat the oven to 350 F. Line a muffin pan with Office . . . . . 582-2850 smoking, and avoidance of excess amounts of alcohol personal risk. whatever you enjoy. paper or foil liners. In a large bowl, combine the flours, sugar, baking soda and cinnamon. Whisk to and caffeine. When these measures aren’t enough, there Many non-medical persons, TV personalities and • Get out in nature...Enjoy the fresh air, Office Fax . . . 582-2851 are medications that can help increase the mineraliza- unfortunately even some medical doctors that do not blend evenly. In a separate bowl, add the egg sub- daylight, trees, flowers, animals. stitute, oil, applesauce and vanilla. Stir in the apples, tion of the bones and reduce the rates of fractures. adhere to the idea of evidence-based medicine promote raisins and carrots. Add to the flour mixture and After Hours supplements or medicines that have not passed the tests Our first-line and best-studied treatment is a class of Please grab a friend and/or family and blend just until moistened but still slightly lumpy. (Urgent Care) 582-2850 medications called bisphosphonates such as alendro- for effectiveness and safety. Keep in mind that lack of Spoon the batter into muffin cups, filling each cup join us! Signing up with Casey at (360) or 888-810-3116 nate (Fosamax), risedronate (Actonel) and zoledronic evidence of harm is not the same as proof of safety. 582-2850 is encouraged but not re- about 2/3 full. Sprinkle with chopped pecans and acid (Reclast). Yet, when I recommend these, many of And all “clinical studies” are not created equal – they bake until springy to the touch, about 35 minutes. quired. We look forward to seeing you. Let cool for 5 minutes, then transfer the muffins to Email: my patients are fearful of side effects. That’s because need to be analyzed and scrutinized by experts and a wire rack and let cool completely. pam@sequimmed com. recently bisphosphonates are one of the more highly- interpreted in light of all other relevant studies. FOR NONURGENT NEEDS ONLY publicized medications that get a bad reputation for So what is your risk for these things? Your doctor can causing something called osteonecrosis of the jaw (ONJ) discuss risk factors that make you more likely to have a Monthly Fee Questions, and atypical fractures. Well, of course, you don’t want serious fracture from osteoporosis. One statistical mea- either of those things. But you don’t want a typical hip sure is called your FRAX score that is usually reported Tips to Relieve Dry Skin Pam . . . . . 582-2850 fracture either. along with the results of a bone density scan. Address- Limit showers or baths to 10 minutes. Creams that contain olive oil, jojoba oil ing other factors such as poor eyesight and unsteady Insurance Billing Questions First, let’s put the risks into perspective. In a study Use warm rather than hot water. or shea butter work well. from 1997 to 2007 looking at 90 million US hospital gait are additional measures that can reduce your risk of Deck . . . . . 582-2850 Wash with a gentle, fragrance-free Other soothing additives: lactic acid, records, an increase in the use of bisphosphonates fracture. cleanser (such as Dove or Cetaphil). urea, hyaluronic acid, dimethicone, Referrals from 3.5% to 16.6% was associated with a 32% decrease Stacey . . . . 582-2850 in the rate of fractures. However, as with any treat- Use just enough cleanser to remove dirt glycerin, lanolin, mineral oil, and ment, there can be side effects. If something can have and oil without making thick lather. petrolatum. Events around town… Blot you skin gently with a towel Use only gentle, unscented skin care Prescription Coverage a desired effect, then it can also have some undesired Becky ...... 582-2850 effects. For that reason, no treatment should be under- There are many free opportunities around instead of rubbing. products. town to inspire and promote a healthy taken unless the expected, likely benefit outweighs the Slather on moisturizer immediately after Avoid deodorant soaps and skin care Protime/Cholesterol/ lifestyle. Check out these websites: drying before moisture evaporates. products that contain alcohol, possible adverse effects for an individual patient. In the Hemoglobin A1C study mentioned above, it was estimated that for every • Nash’s Organic Farms – Use laundry detergent that is labeled ­fragrance, ­retinoids, or alpha- “hypoallergenic”. hydroxy acid (AHA) that can rob Mon & Wed 8–12, 1–4 100 typical hip fractures that was prevented, there was www.nashsorganicproduce.com/events.html Haley . . . . 582-2850 one atypical fracture observed. • Sequim Aquatic Recreation Center – Wear cotton or silk under wool or your skin of its natural oils. Another study of 2000 Canadian women showed that www.sarcfitness.com other rough materials. Preventing Dry Hands: there was a 2.7 times higher risk of atypical fracture Wear layers instead of sitting in front • Dungeness Health and Wellness Clinic – Wear gloves when you go outdoors in Sequim with bisphosphonates. But those are relative numbers. of a heat source. winter. 2.7 times higher risk sounds high, but the absolute risk www.sequimfreeclinic.org/news-events/ Medical Add moisture to the air with a Wear rubber gloves to prevent your is small. 3 times a very small number is still a small • Sequim Chamber of Commerce – ­humidifier. Associates, PLLP number. They also saw a reduction of 25% of typical www.sequimchamber.com/events-calendar/ hands from getting wet. Check if your home heating system Wear protective gloves when working 840 N. 5th Avenue fractures. That means that 1 out of every 4 fractures was • Sequim Tourism – has a humidifier and is working. Suite 2100 prevented – a much larger and more significant amount. www.visitsunnysequim.com/ with chemicals, greases and other Sequim, WA 98382 Likewise, osteonecrosis of the jaw is extremely How to Choose a Moisturizer: ­substances on your hands. www.sequimmed.com • Sequim Senior Center ( Shipley Center ) – Ointments and creams are more effec- Carry a tube of non-greasy hand lotion rare, with 1 case in every 10,000 to 100,000 patients. www.olypen.com/sequimsr/ ­Although it was previously treated aggressively, ONJ tive and less irritating than lotions. with you to apply right after washing (360) 582-2850 your hands.