Health Resources

PACMED DONATES SPECIALTY CARE TO OUR NIEGHBORS

While programs exist that help cover basic health needs, specialty care for more serious issues can be hard to access for people at financial risk.

Project Access Northwest aims to close that gap. PacMed is proud to be a long-time partner of Project Access Northwest. It’s one of many ways we support our community.

People who use Project Access Northwest are often un- or underinsured. It coordinates specialty care and provides other programs for people on the brink. Last year, PacMed physicians provided over 10% of all donated specialty care sought through Project Access Northwest.

We honor the people struggling to make ends meet and are grateful for our partners at Project Access Northwest and many other local nonprofits and programs. Together, we can help our neighbors find and maintain stability in these changing times.

To seek assistance or learn more, visit www.projectaccessnw.org

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

RETHINK YOUR DRINK

“Dry January” Festive Mocktails


Leaving alcohol behind doesn’t mean an end to fun. Muddle some fresh fruit and herbs in a fancy glass to spritz up your social gatherings or after-work drink—for January and beyond!

Pink Kombucha Mojito*
Passion-berry kombucha, mango LaCroix, muddled mint and lime (pictured above).

Passion-Pomegranate Pepino
Crushed cucumber, lime and pomegranate seeds topped with passionfruit seltzer.

Miami-Moscow Mule
Half fresh grapefruit juice, half ginger beer, with a squeezed wedge of fresh lime stirred by a sprig of fresh rosemary.

Claustherada
Bloody Mary mix, a lime wedge squeezed and dropped in, topped with World Beer Award-winning Clausthaler Lager.*

Leaping Limonada
Cilantro and jalapeño muddled with lemon juice and agave/simple syrup, topped with soda in a salt-rimmed glass.

Peachy Palmer
Lemonade, iced tea and muddled peach.

Midnight Coffee
Dark chocolate melted and whisked with coconut milk, a shot of decaf espresso or coffee and a sprinkle of cinnamon.

*Commercially sold kombucha and Clausthaler “non-alcoholic” beer may each have up to 0.5% alcohol.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

GET THE MOST FROM YOUR DOCTOR VISITS

Did you know doctors can have up to 2,000 patients under their care? That’s a lot to keep track of for any human being.

Rather than assuming your doctor will think of everything, it pays to drive your own care. Successful patients work with their doctors as partners in their health care.

We’ve seen successful patients do some creative things to take ownership of their care. See if any of these can improve your trips to the doctor.


Prepare
Keep track of symptoms or questions you have. Note the date, time and situation where symptoms show up. Take pictures if needed, and note temperatures or pain levels.

Use a notepad or an app like Evernote to record everything, including your medications. If something seems urgent, use this information when calling your clinic or nurse helpline to see if you should make an appointment, go to an urgent care clinic or visit the emergency room.


Prioritize
As you prepare to see the doctor, organize your most important questions at the top of your list. Tell your scheduler or care team what you want to discuss. This will help them schedule the right type of appointment so you have enough time.


Print
Bring two typed copies of your questions to your appointment. Give the first to your MA or nurse when they show you to the exam room. Ask them to give it to the doctor, to help them get oriented before coming in to see you.

The other copy is for you to consult during your appointment. Go down the list, making sure to cover all your items. Take notes there too, since it’s hard to remember everything. You can invite a friend or family member along to help if needed.


Persist
After your visit, you may have specialist visits, tests or follow-ups to schedule. Make these before you leave the clinic, while it’s fresh in your mind.

Ask how long test results will take and set a reminder to check MyChart. Message your doctor if you need help understanding results when they come in and to find out follow-up steps to take.

Navigating the medical system can be complicated. Taking ownership of your doctor visits is one thing you can do to have a better experience—and better health outcomes.


Let us know if these tips helped you at .(JavaScript must be enabled to view this email address).

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

RECONNECT AND HELP DEPRESSION WITH ONE MORE QUESTION

If you’ve ever been depressed, you know how easy it can be to hide it. People struggling with mental health can walk through the world with a smile and a “Fine,” hiding a sometimes-serious need for help.

PacMed created the #OneMoreQuestion campaign in 2019 after one of our primary care providers followed her intuition and gave a teenage patient a depression screening at the end of the family’s doctor visit. When asked, the young man revealed he had planned to end his life that night. Because of one more question, we were able to connect the teen and family to resources and support.

The example of this doctor is something we can all emulate in our daily lives—to be more present when checking in with friends, acquaintances or even strangers.

We all “need to be seen and heard in an honest way,” said Dr. Lisa Ivanjack, PacMed co-chief of primary care, in an interview last year with Seattleite. “We may not have all of the answers or be able to solve someone else’s problems, but we can listen. This simple act can drastically change someone’s outcome or perspective during a hard time in their life.”

Mental health issues will affect one in five Americans during their lifetimes. Chances are someone you know is affected right now. Not sure what to ask? Here are some ideas:

  • I really want to know: how are you feeling today?

  • You don’t seem like yourself. Is there anything you’d like to talk about?

  • Are you feeling down? Would you like to talk?

“Big or small, these acts can bring a sense of caring into someone’s darkest times. One more question can have a profound, positive effect on which path someone takes when struggling,” said Dr. Ivanjack. By talking openly about mental health, we help break down the stigma around it.

Your primary care doctor can help identify resources and support systems. They also can refer you to a licensed mental health provider. In most PacMed clinics, we have behavioral medicine therapists right down the hall from your primary care doctor.

When things get busy this year, remember to slow down and find an opportunity to ask one more question. You never know how healing that simple act might be.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

RESET YOUR SOCIAL LIFE

Being social—whether in person or online—is good for your health! Harvard, Psychology Today and others say being social helps us live longer, boost our immune system and reduce risks of dementia, depression and even cancer.

Whether you prefer large groups of new people or small gatherings with trusted friends, extraverts and introverts alike can find ways to overcome isolation this season and socialize for good health.

Phone date
Schedule time to connect from the comfort of your favorite couch or chair.

Host someone
Invite a friend for a dinner or walking date. Have a friend or family member over for coffee or tea.

Babysit or help with homework
Short bursts with grandkids, nieces or nephews are sometimes better than a full day. They help avoid the stress and spending of grand gestures.

Get a pet
Furry or feathered friends can provide sweet companionship and health benefits as well.

Create something to talk about
Visit a museum, show or game with a friend and chat about what you see. Or join a book group you find through the library, internet or word of mouth.

Skype or FaceTime
Catch up with distant family and friends with a video call.

Walk openly
Stroll through your neighborhood and make a point of stopping to say hello to people you meet.

Follow that dream
Take a class or find a group on meetup.com to develop writing, music, woodworking or any other talent you’ve always meant to explore.

Volunteer
Many causes need help. Call to offer your skills, or start with an organization experienced with volunteers like Habitat for Humanity.

Sweat together
Join a local club or league for soccer, softball, rowing, bowling or another sport you enjoy or want to learn. Or invite a friend to jog, walk, swim or work out with you.

Slack together
For a laid-back group experience, check out Underdog Sports Leagues for bocce ball, cornhole, kickball, dodgeball and more.

Be board
Organize a game or card night, or visit one at a local game shop.

Throw a party
It’s a great excuse to clean up your place. Plus you can ask other people to bring the food.

Pop up (at an event)
Subscribe for alerts to surprise music or comedy events around town.

“Show” up
Use the app BandsInTown to link your music preferences to local shows by your favorite artists—and see which friends are going, too.


WE RECOMMEND

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

RESHAPE YOUR HABITS FOR BETTER HEALTH

How we choose to eat, drink and unwind plays a major role in our health over time. Entering the new year, we asked several PacMed providers to offer insight into what’s trending—and what should be.


GET MOVING
“An hour of activity outside of work per day complements the other factors of good health: diet, sleep and stress management. It doesn’t need to be strenuous—walking is an excellent option. Find an activity buddy. Studies show even an online accountability partner helps the behavior stick.”
Charles Falzon, MD, MBA, Family Medicine doctor at Northgate

WE RECOMMEND



A MEDITERRANEAN BOOST
“A ‘Mediterranean’ diet of mostly fruits, vegetables, whole grains, beans, nuts, seeds and olive oil lessens the risk for stroke. It also may link to longevity, weight loss and a lower risk for cardiovascular and fatty liver diseases. The diet allows for low-to-moderate consumption of wine, fish, poultry and dairy (but very little red meat).”
Rex G. Cheng, MD, Gastroenterology and Hepatology specialist at Canyon Park and First Hill



TRY “DRY JANUARY”
“Many people start the new year by abstaining from alcohol for a month. Why is this a good thing? People can develop a tolerance with regular drinking. Taking a break helps reset and gives your liver a chance to repair itself.”
Dimple Sahay, MD, Family Medicine doctor at Renton



WHOLE30: TRY IT (NOT A DIET)
“If you decide to get on the Whole30 bandwagon, remember it’s a 30-day elimination diet—not a long-term strategy for health or losing weight. There may be success stories, but there’s no scientific evidence backing Whole30 yet. Even if you find some foods to eliminate, you’ll need to follow a proven healthy eating plan—like the Mediterranean diet—for lasting health.”
Christy Goff, MS, RDN, CD, and Christine Stirparo, RDN, CDE, CD—dietitians serving PacMed clinics, plus local employers through the Living Well Alliance

WE RECOMMEND



BE A QUITTER
“Smokers who are ready to quit can be helped by individual or group therapy, as well as websites or phone apps. Smoking is tied to cardiovascular and coronary diseases, lung diseases such as asthma and COPD, bronchiectasis and lung cancer.”
Lu Gao, MD, PhD, Internal Medicine doctor at Renton



IS VAPING A HEALTHY OPTION?
“Although e-cigarettes are relatively new, there are a number of case reports connecting vaping to lung diseases like ‘popcorn lung’—named for workers in the popcorn-making industry exposed to the compounds used to color and flavor the popcorn. The solutions that go into vaping solutions are fairly unregulated, and inhaling any extraneous chemicals is fraught with health dangers.”
Hina Sahi, MD, Pulmonologist at Beacon Hill, First Hill and Renton

WE RECOMMEND

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

REFOCUS PARENTING

Submitted by a PacMed team member.

One of the most challenging roles I’ve held as an adult is being a mother to my sons. I take it seriously, thanks to the example set by my mother. She was loving, attentive and committed, which taught me to value parenting my little people.

I believe focused, uninterrupted time is key. In the midst of the daily routine, build in connecting “moments.” These can be in the mornings before day care, over family dinner or throughout the weekend. Our family is fortunate to have a yard, and the kids have a couple of small plants they must water every day—a perfect reason for us to explore and play outside. In these moments, my husband and I allow our sons to open up and share from their perspective.

We unplug so we can fully engage with our sons. We ask probing questions about emotions and check in on the day’s highlights and challenges. By listening, we encourage and model positive behaviors. Conversations with kids can be surprisingly rich—they just need space to share themselves with us.

Remember, each child is an individual. They vary in interests, strengths, opportunities, emotions and how they respond to environments and people. As kids explore and find their way, set guidelines and boundaries that are appropriate. As kids grow and their worldview expands, do community outreach together (garbage clean-ups, fundraisers, walks for a cause, volunteering, etc.) to teach them about social issues in a relational way. In my humble opinion, you cannot show children enough love and encouragement. We are an affectionate family. We tell our children how important they are to us and that we will always have their backs—no matter what. The reward is seeing our children become strong contributors to life and the world around them.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

REKINDLE LOVE AT ANY AGE

Love is an important factor for our emotional well-being. While some can fill that need through friends, pets, community or other outlets, many of us look to intimate relationships for love.

Below are some scenarios you might relate to—looking for new love, adding spark to a long-term relationship or mending a family bond. Each is followed by advice from PacMed Behavioral Medicine specialist Rebecca Wolff, LMHC.

Keep in mind, relationships are complex, and there is no one-size-fits-all advice for everyone. We encourage seeking additional support if needed.


Keep the fire burning
Tia and David have been married for 15 years. They have a healthy marriage, except their whirlwind romance early on has cooled significantly in recent years. Privately they wonder, “Will we ever have passion again?”

“With any relationship, the amount of time you devote to it is what you’re going to get out of it. Find ways to show love for your partner in the way they experience love. We often show love in the way that is most meaningful to us, even though our partner may feel loved in a totally different way. Have a conversation to discover what feels meaningful to each other and incorporate those ways of showing love into your everyday lives. Also, look for activities you enjoy doing together. Life gets busy, so schedule shared activities on a regular basis to help maintain a strong connection. Finally, don’t let technology supersede your relationship. We often spend too much time watching TV or on our phones, so our partner may feel a disconnect or unvalued.”


Find a new flame
Anita and Jim met in college, married and had three wonderful children. Tragically, Anita was left to raise them alone when Jim passed away unexpectedly. Two years have passed, and Anita is open to exploring relationships again—but she’s not sure where to begin.

“Online dating is a popular go-to for dating and can work for many people; however, it can be helpful sometimes to ground dating in a process of self-discovery as well. Focus on finding new activities you might enjoy—join a new group or get out of your comfort zone a bit. Maybe take that trip you’ve always dreamed of. Put yourself in a situation where your senses are awakened, and you’ll be more receptive to meeting someone along the path.”


Repair a scorched relationship
Anthony had a close relationship with his daughter until the divorce. Despite shared custody, he felt his daughter favored his ex-wife. Then, a series of minor disagreements with his daughter led to her cutting off contact with him. Now it’s been a few years since they spoke.

“Repairing a family relationship is a big challenge. In those situations, each party genuinely feels hurt. As the adult, you need to be willing to hear a tough conversation and let your guard down to really focus on what the other person is saying. It requires self-reflection. Ask yourself honestly, ‘What have I contributed to this situation?’

“Whether the breakdown is with a child, a parent or a sibling, it’s important to accept each other for who you are. Not for who you always hoped they would be, but for who they actually are. This goes for yourself as well. Learn to begin from a place of self-compassion, to allow yourself to fail and try again. When you realize no one is always perfect, it’s easier to extend kindness and grace to those you care about the most.”

Rebecca Wolff, LMHC, sees patients at our Renton clinic. You can see Rebecca, or one of our 20 other Behavioral Medicine providers, if you have a PacMed primary care doctor.

www.PacMed.org/MentalHealth

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTHY TIPS – JANUARY / FEBRUARY 2020


Topics This Issue:


Reshape your habits for better health!


How we choose to eat, drink and unwind plays a major role in our health over time. Entering the new year, we asked several PacMed providers to offer insight into what’s trending—and what should be.

Get Moving
“An hour of activity outside of work per day complements the other factors of good health: diet, sleep and stress management. It doesn’t need to be strenuous—walking is an excellent option. Find an activity buddy. Studies show even an online accountability partner helps the behavior stick.” Charles Falzon, MD, MBA, Family Medicine doctor at Northgate

A Mediterranean Boost
“A ‘Mediterranean’ diet of mostly fruits, vegetables, whole grains, beans, nuts, seeds and olive oil lessens the risk for stroke. It also may link to longevity, weight loss and a lower risk for cardiovascular and fatty liver diseases. The diet allows for low-to-moderate consumption of wine, fish, poultry and dairy (but very little red meat).” Rex G. Cheng, MD, Gastroenterology and Hepatology specialist at Canyon Park and First Hill

“Dry January”
“Many people start the new year by abstaining from alcohol for a month. Why is this a good thing? People can develop a tolerance with regular drinking. Taking a break helps reset and gives your liver a chance to repair itself.” Dimple Sahay, MD, Family Medicine doctor at Renton

Whole30: Try It (Not a Diet)
“If you decide to get on the Whole30 bandwagon, remember it’s a 30-day elimination diet—not a long-term strategy for health or losing weight. There may be success stories, but there’s no scientific evidence backing Whole30 yet. Even if you find some foods to eliminate, you’ll need to follow a proven healthy eating plan—like the Mediterranean diet—for lasting health.” —Christy Goff, MS, RDN, CD, and Christine Stirparo, RDN, CDE, CD—dietitians serving PacMed clinics, plus local employers through the Living Well Alliance™

Be a Quitter
“Smokers who are ready to quit can be helped by individual or group therapy, as well as websites or phone apps. Smoking is tied to cardiovascular and coronary diseases, lung diseases such as asthma and COPD, bronchiectasis and lung cancer.” Lu Gao, MD, PhD, Internal Medicine doctor at Renton

Is Vaping a Healthy Option?
“Although e-cigarettes are relatively new, there are a number of case reports connecting vaping to lung diseases like ‘popcorn lung’—named for workers in the popcorn-making industry exposed to the compounds used to color and flavor the popcorn. The solutions that go into vaping solutions are fairly unregulated, and inhaling any extraneous chemicals is fraught with health dangers.” Hina Sahi, MD, Pulmonologist at Beacon Hill, First Hill and Renton

IDEAS TO EXPLORE…

Back to Top


Rekindle love at any age


Love is an important factor for our emotional well-being. While some can fill that need through friends, pets, community or other outlets, many of us look to intimate relationships for love.

Below are some scenarios you might relate to—looking for new love, adding spark to a long-term relationship or mending a family bond. Each is followed by advice from PacMed Behavioral Medicine specialist Rebecca Wolff, LMHC.

Keep in mind, relationships are complex, and there is no one-size-fits-all advice for everyone. We encourage seeking additional support if needed.

Keep the fire burning

Tia and David have been married for 15 years. They have a healthy marriage, except their whirlwind romance early on has cooled significantly in recent years. Privately they wonder, “Will we ever have passion again?”

“With any relationship, the amount of time you devote to it is what you’re going to get out of it. Find ways to show love for your partner in the way they experience love. We often show love in the way that is most meaningful to us, even though our partner may feel loved in a totally different way. Have a conversation to discover what feels meaningful to each other and incorporate those ways of showing love into your everyday lives. Also, look for activities you enjoy doing together. Life gets busy, so schedule shared activities on a regular basis to help maintain a strong connection. Finally, don’t let technology supersede your relationship. We often spend too much time watching TV or on our phones, so our partner may feel a disconnect or unvalued.”

Find a new flame

Anita and Jim met in college, married and had three wonderful children. Tragically, Anita was left to raise them alone when Jim passed away unexpectedly. Two years have passed, and Anita is open to exploring relationships again—but she’s not sure where to begin.

“Online dating is a popular go-to for dating and can work for many people; however, it can be helpful sometimes to ground dating in a process of self-discovery as well. Focus on finding new activities you might enjoy—join a new group or get out of your comfort zone a bit. Maybe take that trip you’ve always dreamed of. Put yourself in a situation where your senses are awakened, and you’ll be more receptive to meeting someone along the path.”

Repair a scorched relationship

Anthony had a close relationship with his daughter until the divorce. Despite shared custody, he felt his daughter favored his ex-wife. Then, a series of minor disagreements with his daughter led to her cutting off contact with him. Now it’s been a few years since they spoke.

“Repairing a family relationship is a big challenge. In those situations, each party genuinely feels hurt. As the adult, you need to be willing to hear a tough conversation and let your guard down to really focus on what the other person is saying. It requires self-reflection. Ask yourself honestly, ‘What have I contributed to this situation?’

“Whether the breakdown is with a child, a parent or a sibling, it’s important to accept each other for who you are. Not for who you always hoped they would be, but for who they actually are. This goes for yourself as well. Learn to begin from a place of self-compassion, to allow yourself to fail and try again. When you realize no one is always perfect, it’s easier to extend kindness and grace to those you care about the most.”

You can see Rebecca, or one of our 20 other Behavioral Medicine providers, if you have a PacMed primary care doctor.

WE RECOMMEND…

  • Authors John and Julie Gottman: 10 Lessons to Transform Your Marriage; Eight Dates
  • Airplane mode for your phone during dinner or date night
  • Meetup groups: www.meetup.com
  • Individual/couples/family counseling

Back to Top


Reconnect and help depression with One More Question

If you’ve ever been depressed, you know how easy it can be to hide it. People struggling with mental health can walk through the world with a smile and a “Fine,” hiding a sometimes-serious need for help.

PacMed created the #OneMoreQuestion campaign in 2019 after one of our primary care providers followed her intuition and gave a teenage patient a depression screening at the end of the family’s doctor visit. When asked, the young man revealed he had planned to end his life that night. Because of one more question, we were able to connect the teen and family to resources and support.

The example of this doctor is something we can all emulate in our daily lives— to be more present when checking in with friends, acquaintances or even strangers.

We all “need to be seen and heard in an honest way,” said Dr. Lisa Ivanjack, PacMed co-chief of primary care, in an interview last year with Seattleite. “We may not have all of the answers or be able to solve someone else’s problems, but we can listen. This simple act can drastically change someone’s outcome or perspective during a hard time in their life.”

Mental health issues will affect one in five Americans during their lifetimes. Chances are someone you know is affected right now. Not sure what to ask? Here are some ideas:

I really want to know: how are you feeling today?

You don’t seem like yourself. Is there anything you’d like to talk about?

Are you feeling down? Would you like to talk?

“Big or small, these acts can bring a sense of caring into someone’s darkest times. One more question can have a profound, positive effect on which path someone takes when struggling,” said Dr. Ivanjack. By talking openly about mental health, we help break down the stigma around it.

Your primary care doctor can help identify resources and support systems. They also can refer you to a licensed mental health provider. In most PacMed clinics, we have behavioral medicine therapists right down the hall from your primary care doctor.

When things get busy this year, remember to slow down and find an opportunity to ask one more question. You never know how healing that simple act might be.

RESOURCES…

Back to Top


NUTRITION CORNER

Heart Healthy

It’s always a good time to take care of your heart, and February is no exception. In fact, February is National Heart Month! Though genetics do play a role in heart health, daily habits and choices can make a difference in your health.

This month give your heart a little extra love to start the year off strong. Try these three big-hitting tips to get started!

  • Stress less. In today’s fast-paced world, it can be hard to find peace. Overworking and under sleeping are two common stressors that many Americans endure. While stress in short bursts can be positive, chronic, daily stress is harmful to your cardiovascular health.
  • Plant power. While going full vegetarian is not necessary, research shows the benefits to heart health of adding more plant foods into our diets. Plants contain healthy, unsaturated fats, loads of fiber, antioxidants and phytochemicals. Furthermore, the potassium content in plant foods can help to reduce blood pressure because potassium lessens the effects of sodium. Aim for foods like bananas, sweet potatoes, avocados, cantaloupe, dark leafy greens, potatoes and prunes.
  • Cut the salt and add some spice. Overdoing it with salt can increase blood pressure. Some common places for increased sodium are from restaurants, packaged foods, frozen meals and sauces. In the grocery store, compare products! A quick glance at Sodium in the nutrition label is easy. Aim for a percent daily value that’s below 30% per serving! Also, to increase flavor without salt, try reaching for fresh, dried or ground herbs and spices instead of the saltshaker.

If you have concerns about your heart health, the PacMed Cardiology department is here to help. To make an appointment, use our online appointment tool or call 206.505.1300.

Fast, easy, healthy Super Bowl snacks!

Having a Super Bowl party on February 2? Great! Ready for all those greasy chips, rich dips, salty meats and too-sweet nibbles? Not so much?! We can help.

No need to break all your 2020 resolutions in one afternoon. Try these enticing, easy recipes for a healthy, victorious party scene.

Pork Satay from Taste of Home.
Thin, skewered slices of pork in a lightly peanut–Thai seasoning.

Healthy Guacamole with Peas from Eating Bird Food.
Secret ingredient? Frozen peas. Enjoy!

Sweet Potato Skins from Pinch of Yum.
You know these are going to taste good, even before you see the sweet potatoes, spinach, and chickpeas in the recipe!

Garlic Bean Dip from Taste of Home.
Mm, garlic. What more do we need to say? Maybe, “sour-cream-free”?

Light Crock Pot Buffalo Turkey Meatballs from The Creative Bite.
Crockpot will travel! At least these delectable meatballs will.

Back to Top


Dry January Kombucha Mocktail*


See this recipe demonstrated by an LWA expert!

Kombucha is a fermented,* lightly effervescent tea-based beverage that is relatively low in calories and sugar. It contains live and active cultures (similar to yogurt) that help strengthen your gut microbiome. Kombucha is refreshing, bubbly and subtly sweet, especially if the brewer combines it with fruit juice.

Serves 4. Serving size 1 cup. Prep time 15 minutes; cook time 15 minutes.

Ingredients

  • One 16-oz bottle passion-berry kombucha (such as Synergy GT)
  • Two 12-oz cans mango-flavored seltzer water (such as LaCroix)
  • 10 mint leaves, lightly chopped
  • 1 lime
  • Ice (optional)

Directions:

Nutrition Information per serving (one-fourth of recipe):

Calories: 20 Total Fat: 0g Sodium: 6mg Total Carbohydrate: 7g Fiber: 0g Sugars: 5g Protein: 0g Potassium: 17mg

Recipe adapted from @get.inspired.everyday by Kari.

*Commercially sold kombucha may have up to 0.5% alcohol.

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LWA Spotlight: Looking forward in 2020

We couldn’t have done it without you! 2019 was another great year for the Living Well Alliance. We started a new “Yoga at Work” wellness program, taught over 100 nutrition and wellness classes in 57 companies and hosted tables at 25 health fairs.

Our lead dietitian, Christy Goff, was also highlighted in the media! A quick sample: she performed a cooking demo on King5, was a guest speaker on two podcasts (WARM 106.9 and DASH radio) and was interviewed for articles at The Seattle Times and What’s Up NW.

Stay tuned for another busy 2020 year! We will host monthly webinars that any company can join, as well as continue offering our popular “Yoga at Work” classes. Our new nutrition classes include “Food and Mood” and “Build Up Your Bones.” Visit us online to learn more about Living Well Alliance classes, webinars, screenings and other services.

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PacMed Donates Specialty Care to Our Neighbors

While programs exist that help cover basic health needs, specialty care for more serious issues can be hard to access for people at financial risk.

Project Access Northwest aims to close that gap. PacMed is proud to be a long-time partner of Project Access Northwest. It’s one of many ways we support our community.

People who use Project Access Northwest are often un- or underinsured. It coordinates specialty care and provides other programs for people on the brink. Last year, PacMed physicians provided over 10% of all donated specialty care sought through Project Access Northwest.

We honor the people struggling to make ends meet and are grateful for our partners at Project Access Northwest and many other local nonprofits and programs. Together, we can help our neighbors find and maintain stability in these changing times.

To seek assistance or learn more, visit www.projectaccessnw.org.

Back to Top

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTHY TIPS – NOVEMBER/DECEMBER 2019


Topics This Issue:


Stay energized this winter!


Between short days, cool weather, holidays and visiting family, it is easy to feel dragged down. Make yourself a top priority! Explore these ideas on how to keep your energy up and fuel your best health.

Work it out. Physical activity boosts your brain chemistry, helps you sleep and primes your appetite for healthy eating! This winter, find ways to keep your exercise goals alive. Get up a little earlier to slip in a run. Walk to work, or climb stairs or hills at lunchtime. Meet a friend at the gym. Maybe you can help an elderly neighbor by raking their yard! Choose a weekly goal—say, 75 minutes of vigorous exercise or 150 minutes of moderate exercise—and then track your time and reward your success.

Lap it up! If you are not well hydrated, one of the first signs is fatigue. Water makes up about 60% of your body weight and is the main component of blood. It’s essential for carrying nutrients to your cells and removing waste products. So, how much should you drink? Watch the color of your urine. It should be a light lemonade color. Dark yellow? Drink a little more. And to keep up energy when you work out, drink 8 ounces of water before you begin, and another glass when you finish.

Don’t run on empty! Did you know that a smaller lunch can help you keep your energy up? A heavy lunch is often followed by a pronounced afternoon slump. Another energizing trick is to eat small meals and snacks every few hours. This can reduce feelings of fatigue because your brain needs a steady supply of nutrients. So what to snack on? Try protein- and magnesium-packed nuts like cashews, almonds and hazelnuts. Eggs and edamame have protein plus vitamin B, which helps convert food into the energy you feel. Finally, eat fresh fruit for a healthy source of fiber, vitamins, sugar and fluids!

Recharge at night. When you get enough sleep, you should feel refreshed in the morning and energized throughout the day. Sleep pretty much affects everything in your life: your heart health, metabolism, ability to ward off sickness and more. Not getting enough good-quality sleep can affect short-term memory, decision making, attention levels, logical reasoning, judgement, mood, and energy levels. Three good tips for healthy sleep hygiene? Go to bed and get up at the same time each day. Avoid all screens 90 minutes before you head to sleep. And slow your pace before bedtime: read a calm book, listen to quiet music or meditate.

Got a cold or the flu? Symptoms for both cold and flu include coughing, headaches and chest discomfort. When you have a cold, your nose and throat become inflamed, so you may experience a runny nose, sore throat, coughing and sneezing. Flu symptoms come on much more suddenly than with a cold, including a high fever, body aches, weakness and fatigue. Sleep, frequent hydration, daytime rest and good nutrition are important. Most over-the-counter medications can help temporarily relieve symptoms such as sore throat, congestion, cough and fever. If your symptoms persist or you have questions about which medications to take, consult your primary care provider.

PacMed Primary Care is a diverse team of providers! If you’re looking for a doctor to support your health goals, we invite you to learn more about our doctors.

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Winter blues got you down—again?


If you always experience depression that begins in fall and continues to spring, don't brush it off as simply a case of the "winter blues." You may suffer from Seasonal Affective Disorder (SAD). You don’t need to tough it out on your own! We have supportive help and steps you can take to keep your mood and motivation steady all year long.

Depression and SAD

Depression is a common and treatable condition that can affect anyone. Like other types of depression, SAD is a condition of the brain that leaves a person feeling down. It can sap your energy, erase your motivation and make you moody.

Symptoms specific to wintertime SAD include oversleeping, craving foods high in carbohydrates, weight gain and low energy. Other general signs of depression can include:

  • No longer enjoying the things you usually like to do
  • Feeling sad, down, hopeless or cranky most of the day, almost every day
  • Experiencing changes in your appetite, weight and sleep patterns
  • Feeling tired or having no energy
  • Having trouble concentrating
  • Feeling agitated
  • Thinking about death or suicide

Coping and treatments

Ongoing depression is never a normal part of life. We have safe and effective treatments to help you cope. These include seeing a psychotherapist, taking medications or a combination. With SAD, light therapy can also be a powerful treatment protocol. Read on for light therapy and other ideas you can discuss with your doctors.

Light therapy. With light therapy (also called phototherapy), you expose yourself to a special light box right after you wake up each day. Doing this appears to trigger a change in your brain chemistry and boost your mood. It’s a bit like getting some summer sunshine to start the day. Light therapy often offers relief from SAD in just a few days.

Vitamin D. Our bodies naturally synthesize vitamin D when exposed to sunlight. All you need for a week’s worth of this vitamin is 15 to 20 minutes in the sun—but that can be hard to come by during winter in the Northwest. Because vitamin D helps the body absorb calcium, it supports healthy bones. But recent research has also shown it may help alleviate symptoms of SAD.

Exercise. Physical activity is helpful for all types of depression because it increases the production of endorphins in the body. Endorphins are neurotransmitters that make you feel good.

Sleep. Sleep is a very important way to lessen symptoms. Good sleep hygiene includes getting up at the same time every day, following a bedtime routine to program your body to sleep and keeping your room dark at night. Also avoid all screen use for at least 30 minutes before bedtime.

When to get help

It's normal to have some days when you feel down. But if you feel down for days at a time and you can't get motivated to do activities you normally enjoy, see your doctor. This is especially important if you notice some of the symptoms listed above, you turn to alcohol for comfort or relaxation, or you feel hopeless or think about suicide.

With all types of depression, your primary care provider can help guide you to the support you need. Looking for a doctor? See our primary care team at one of our 9 PacMed clinics

ARE YOU OR SOMEONE YOU KNOW IN CRISIS?

If you are thinking about suicide or hurting yourself, help is available:

  • In an emergency, call 9-1-1 or go to the nearest ER
  • Call a 24-hour crisis line:
    King: 1.866.427.4747
    Snohomish: 1.800.584.3578
    Pierce: 1.800.576.7764
  • Call the National Suicide Prevention Lifeline: 1 (800) 273-8255

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Diabetes: Dr. Lisa Oswald talks with Northwest Military

An estimated 1.4 million new cases of diabetes are diagnosed in the United States annually, according to Healthline. With such staggering statistics, the importance of spreading awareness can help individuals with diabetes live full and productive lives, and in some cases, can help to prevent the onset of diabetes altogether. Here to provide a wealth of information on the topic is Pacific Medical Centers' Internist and Diabetes Champion Lisa Oswald, MD, whose insight provides perspective on diabetic symptoms, care techniques, and the differences of Type I and Type II diabetes.

Please explain the primary differences between Type I and Type II diabetes for our readers. What are the main causes of each?

Type 1 diabetes (five percent of patients) has onset in childhood or sometime in early-mid adulthood. It is caused by a loss of the insulin-producing part of the pancreas. It may be caused by the body attacking itself or may have other causes.

Type 2 diabetes (90-95 percent of patients with diabetes have this type) is caused by the body not being able to use the insulin that our body produces very well (this is called "insulin resistance"). Eventually, there may be a lack of insulin, but normally there is plenty of naturally produced insulin that the body just can't use properly. The causes are complicated, but genetics, being overweight, poor diet, and sometimes medications or medical conditions can all be factors of developing Type 2 diabetes.

What are some early signs and symptoms that may be indicators of diabetes?

Signs and symptoms of diabetes may include excessive thirst or urination; blurry vision; tingling in toes and/or fingers, usually of both sides; unexplained weight loss (especially in Type 1); and unexplained abdominal pain.

What advice can you offer individuals with diabetes to live the healthiest and happiest life possible?

My advice to those who are living with diabetes is to try and educate yourself as much as possible. Diabetes is a complicated and lifelong disease and you must be aware of many aspects of it. This can include talking to family/friends, taking classes (PacMed offers a series of three classes every month), reading about the topic, talking to your primary care doctor and nurse and certified diabetes educators. Additionally, you should have support to get you through this. This can include supportive people in your life, online group, medical team, etc. Lastly, it helps to know about your insurance. Sometimes diabetes medications are expensive, but you should know your options. Be sure to ask your pharmacist or primary care provider about the cost of different medications and if there are cheaper alternatives.

Military personnel are constantly on the go. What are the best practices for diabetics who are very busy?

My advice to military personnel would be to explain your average day to your primary care team and diabetes educator -- be realistic about schedules for eating and taking medications. I also encourage making plans with your primary care team for days that you cannot eat for long periods or take medications at the proper time, as this will happen on occasion.

Is there anything else you would like readers to know about diabetic health and wellness?

Additional health and wellness tips I have for those who have diabetes are centered around routine lifestyle changes. Schedule a routine hour or two per week to prepare food and snacks for the upcoming week that you can grab and take with you -- it doesn't have to be perfect! Exercise is also important, so try to make time in your day to be active. This can include short bursts of activity, such as walking, taking the stairs, dancing, playing with children, etc.

Lisa Oswald, MD works on the Internal Medicine team at Pacific Medical Centers. She is an internist and focuses on diabetes with her patients at the Beacon Hill clinic. Her medical interest is within geriatrics, end-of-life care and cross-cultural medicine. In her spare time, you can find her rowing, traveling and spending time with her family. She has been named one of Seattle’s best doctors by her peers for the last five years.

Read the article as published in NorwestMiliatry.com here

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NUTRITION CORNER: Healthy holiday hacks


Healthy eating during the holidays is not about deprivation, but about all things in moderation. We have some tips to help you put this crucial concept to work for you in the coming months.

Stay one step ahead when you’re head chef.

1) Delegate! 2) Shop early! 3) Prepare! Hosting doesn’t mean you have to do everything. Ask guests to bring whole-grain bread, a vegetable side, or a selection of no-sugar beverages. Next, study the recipes you have planned, and buy as many ingredients ahead of time as possible—like canned and frozen items and hardy vegetables like squash and carrots. Finally, one day ahead of the big meal, chop and peel vegetables, and make items like cranberry sauce and dessert.

Eat before you eat.

Dietitians swear by this hack! Heading to a holiday gathering? If you show up hungry, there’s a good chance you’ll overeat or fill up on high-fat appetizers. So before you head to auntie’s famous holiday potluck, eat a small, healthy snack like cheese on whole-wheat crackers or hummus with celery or tortilla chips. Take the edge off your hunger so you have more control at the party.

Contribute a healthy, savory dish.

If you’re heading to a shared meal, offer to bring a savory, nutritious dish. This way, you know for sure that your healthy eating habits won’t be forced to take a holiday! Explore interesting vegetable dishes, like this salad with roasted apples, squash and feta cheese. Keep it simple and use a bottled vinaigrette. Or maybe try fried rice with cauliflower. You might find a bag of cauliflower “rice” in the produce aisle.

Freeze the extras.

If you have lots of leftovers and are concerned about waste or overeating, try freezing them! Place cold portions in baggies, label them with name and date, and freeze. Leftover turkey, sweet potatoes and even mashed potatoes are healthy snacks—or interesting additions to new recipes. Explore ideas for leftover sweet potatoes. Or, as one foodie touts, “The Happiest Ending for Leftovers Is Quiche.” (Keep a frozen pie shell on hand!)

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Transformed Green Bean Casserole


If you want something different for your Thanksgiving table this year, try this new rendition of the traditional green bean casserole from Cooking Light. It provides a healthy serving of vegetables with less saturated fat and sodium than its classic counterpart.

Serves 4 Serving Size: 1 cup Prep: 15 minutes / Cook time: 15 minutes

Ingredients

  • 12 oz green beans
  • 2 tablespoons olive oil
  • 3 cups sliced mushrooms
  • ½ cup chopped onion
  • 1 tablespoon all-purpose flour
  • 1 cup stock, low sodium
  • 2 tablespoons whole milk
  • ½ teaspoon black pepper
  • ¼ teaspoon salt
  • ¼ cup whole-wheat panko (Japanese breadcrumbs)
  • 3 tablespoons grated Parmesan cheese

Directions:

Turn on boiler. On stovetop, place a medium pot of water over high heat and bring to a boil. Partly fill a medium bowl with ice cubes; add cold tap water to 2 inches below the rim.

Trim green beans and place in boiling water for 2-3 minutes until color becomes bright green. Remove from heat and let rest in ice water until cooled. Drain. Place beans in an 11x7-inch baking dish.

Heat oil in a large skillet over medium-high. Add sliced fresh mushrooms and chopped onion; cook until browned, 6 to 8 minutes.

Add all-purpose flour; cook, stirring constantly, 1 minute. Add stock, milk, black pepper, and salt; cook, stirring, until thick and smooth, 1 to 3 minutes. Spoon over green beans; sprinkle with whole-wheat panko and grated Parmesan cheese.

Broil until golden brown, 1 to 2 minutes.

Nutrition Information

Calories: 160, Total Fat: 9g, Saturated Fat: 9g, Cholesterol: 4mg, Sodium: 240mg, Total Carbohydrate: 17g, Fiber: 4g, Sugars: 5g, Protein: 6g

Recipe adapted from www.cookinglight.com/recipes/green-bean-casserole.

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Healthy Tips | September/October 2019 | Health Resources | Pacific Medical Centers
Health Resources

HEALTHY TIPS – SEPTEMBER/OCTOBER 2019


Topics This Issue:


Military Mindfulness


Strategies from working with vets facing PTSD

When introducing mindfulness to veterans living with PTSD, new PacMed physician Charles Falzon, MD, MBA, advises easing into it, rather than “jumping right into the deep end of that kind of work, because it can be emotionally provocative.”

“Meditation can be really intimidating,” observes Dr. Falzon, a former lieutenant in the US Navy Medical Corps and Integrative Medicine practitioner at Northwestern University. “The feelings people experience can be very uncomfortable because they’re not used to living in silence or stillness.... It can be very unsettling.”

Rather, Dr. Falzon recommends starting with small steps. “Focus for 30 seconds on what it feels like to take deep breaths,” he suggests. Or ease in with “yoga classes, going to a religious service or even simply putting your phone away during dinner and focusing on the people around you.”

This sort of “intentional action” also has tangible medical benefits. For example, taking time to chew intentionally, says Dr. Falzon, “gives your body a chance to process the food the way it’s meant to”—allowing salivary glands to perform the important first step of digestion. Mindfulness can recalibrate all four basics of health—defined by Dr. Falzon as diet, sleep, stress management and exercise—changing “how we feel and experience health.”

For processing new feelings, Dr. Falzon believes the most important building blocks are your social support system and engaging your medical team. That kind of outside help is necessary because we can lose our bearings, especially when overwhelmed by endless task lists.

Those of us who are task-oriented can learn from veterans in their approach to mindfulness. “The military people I’ve worked with are always extremely dedicated and excited to tackle challenges,” says Dr. Falzon. “Unfortunately, when it comes to mindfulness, trying too hard or looking for specific results can be counterproductive. It’s not going to get you there faster. How can we be ok with the path that we’re on and not necessarily try to build a new road?”

Luckily, mindfulness doesn’t require a goal—the journey can be a reward in itself. As Dr. Falzon describes, “Those new sensations can be a really fascinating experience. Hopefully, it’s something that patients find helpful— then we can keep building on it.”

Dr. Charles Falzon, practices family medicine at our Northgate clinic, listening closely and asking questions to focus on what will most help patients address their concerns.

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Leaving the Nest 101


PacMed provider offers some advice to parents with college-bound teens. (For younger children, check out the PacMed Back to School page for ideas on check-ups, healthy lunches and more.)

Stress abounds for former high schoolers as they prepare for college endeavors and begin to make the transition into adulthood. Parents have their hands (and hearts) full as well, making plans for their beloved offspring to flee the nest in pursuit of higher education. Though parting is such sweet sorrow, family medicine physician Ashu Verma, DO, is here with advice to help parents launch their teenagers off to college with care and confidence.

College students may have different back-to-school needs than their younger counterparts. What kinds of needs are those? Do they need health screenings and/or immunizations before arriving at college?

For patients in their adolescent or young adult stage (usually 12 to 18 years old), and parents of adolescents, we encourage openly addressing behaviors, associated questions, and the importance of regular health screenings. The five most common (and important) conversations for both adolescents, and their parents, include: Risky Health Behaviors (alcohol consumption, drugs, tobacco and e-cigarette devices, sexual activity); Physical Activity (engaging in 30-45 minutes of exercise most days of the week, exhibiting healthy eating and dietary habits); Mental Health (screening for depression and other mental health issues is also very important at this age); and Updated Immunizations (students and parents should keep all immunizations updated. It is also a good idea for the student to keep a copy of their immunization records for future references, as they transition out of the house. This can easily be kept on their phone and should include Tdap every 10 years, Menactra and MenB, HPV, Hepatitis A, Hepatitis B and Influenza yearly).

Are there any health concerns that are unique to college students? If a young person has a health concern while away at college, how should they proceed?

Parents and their college-aged children should become familiar with the health services available at their college, as most colleges and universities have university clinics on campus.

Keep in mind the following: Where is the clinic located? What are their hours? What’s the nearest clinic or doctor for after-hour needs? Do they offer mental health services at this specific university or college? It’s also important that the child know their insurance status and keep a card in their wallet.

How can parents help their children stay healthy from afar while they are enrolled in college?

Make sure your children are aware of their past medical history and the family’s medical history, such as autoimmune disorders, psychiatric, heart disease, or diabetes. They should be aware of any history of asthma, concussions, hospitalizations, surgeries, or allergies to medications. Ensure they know what medications they are taking, the names of these medications, details and the dosage. Also, it would be great for your child to have a small first aid kit that they can keep in their dorm room. This would include Band-Aids, triple antibiotic ointment, thermometer (make sure they know how to use it), sterile gauze/pads of different sizes, adhesive tape, antiseptic wipes, Tylenol or Motrin, and a list of emergency contact numbers and their primary care provider’s details.

Do you have any more healthful tips and suggestions for parents and college-bound kiddos?

Living in a dorm, your child will be exposed to lots of new people in a new and unfamiliar environment. They will probably be using the same showers, toilets, sinks, doorknobs/glasses -- and unfortunately, exposed to lots of germs. Be sure to share the importance of regularly washing your hands often, especially before eating or touching your face. The use of antibacterial gels works just as well as washing -- share that they can carry a small container in purse or pocket. College is a period filled with fun, excitement, nervousness, and change. However, there are many people available to the student to help in that transition to make sure it is filled with happiness and good health.

Dr. Ashu Verma is a family medicine physician at the PacMed Canyon Park clinic in Bothell. She earned her medical degree and completed her training in Texas.

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WOMEN’S HEALTH: Preventive care for menopause and cancers

Here is a quick primer on three health issues and how to get the care you need:

Menopause

Menopause marks the end of a woman’s fertility and occurs when the ovaries stop producing estrogen and progesterone. It becomes official when you’ve gone 12 months without a period. (The average age is 51, per Mayo Clinic.)

What should I expect? Everyone’s experience will be different. Symptoms can include weight gain, hot flashes, insomnia, night sweats, forgetfulness, dry skin, thinner hair, vaginal dryness and decreased libido. Menopause also increases your risk of heart disease, osteoporosis and urinary incontinence.

What can I do? Some women find menopause challenging. If you’re struggling with sleep or other symptoms, or simply have questions, make an appointment with your primary care doctor. You also may want to check your library for a resource like The Menopause Book (by Wingert, 2018) or Mayo Clinic, The Menopause Solution (by Faubion, 2016).

Breast cancer

About one in eight U.S. women will develop invasive breast cancer. When it is found in the early stages and treatment is initiated promptly, the chances for a positive outcome are improved.

What’s my risk? Risk factors include your family health history, earlier start of menstruation, fewer pregnancies, giving birth at a later age, working night shifts, using alcohol and, after menopause, hormone replacement, increased fat intake and weight gain.

Is treatment improving? Treatments have become less invasive and are tailored more accurately to the individual risk. This allows most women today to avoid mastectomy and chemotherapy.

What can I do? Address your breast cancer risk with a sense of importance and without fear. Ask your doctor about a mammogram and other screenings.

Cervical cancer

Cervical cancer is linked to infection with a virus called HPV (human papillomavirus). HPV is a common sexually transmitted virus. What’s important to know is that cervical cancer is highly preventable with regular screening, plus vaccination to help prevent HPV infection.

When should I get screened? Young women should get routine screenings starting at age 21. As long as the screenings are normal, women can expect repeat screenings every 3 to 5 years up to age 65.

Is there a vaccine? Do boys need it too? The HPV vaccine is recommended for boys and girls, starting at age 11-12. Getting vaccinated at these ages will ensure that, by the time a child becomes sexually active later in life, they will be at far less risk for the types of HPV that cause cervical cancer.

What else can I do? Cervical cancer affects different ages, communities and races of women differently, so encourage all friends and family to get screenings when they are due.

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Telemedicine adds cardiology services to PacMed south-end clinics

Ever wish you could be in more than one place at once? Now, at least your doctor can! With a local assistant by your side, our cardiologists can now evaluate your heart remotely. Visit our welcoming Puyallup clinic to chat with a cardiologist who can see your heart from a distance, saving you a stressful trip to downtown Seattle. Stay tuned as we add more telemedicine specialties and locations to bring the best care to you.

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Ask PacMed


Patients often ask...“I’m turning 65 next year. What do I need to know about Medicare?”

—answered by Linda Marzano, RN, MHA, Chief Executive Officer

Medicare is a great program, but it’s different from the commercial insurance you might be used to. You need to apply for Medicare within three months either side of turning 65—or you can’t join until the next enrollment period, and you’ll pay a penalty.

Basic Medicare includes Part A for hospital stays and Part B for outpatient services. Most people get Part A for free and pay a monthly premium for Part B. You can optionally add Part D for prescription drug coverage.

It’s important to remember, Medicare alone won’t cover all your health care costs. Medicare pays only 80% of items it covers, and it doesn’t cover long-term care, eyeglasses, dental care, hearing aids or extra perks.

To cover some of these extras, you have two options to add to Medicare:

  • A Medicare supplement known as Medigap. This pays the extra 20%—only for services that Medicare covers. You’ll pay an extra premium for a Medigap policy.
  • Medicare Advantage. These plans may cover vision, dental, hearing aids and long-term care, along with other perks like gym memberships, massage or acupuncture. However, you will likely still pay a portion of the extra 20% for covered services with Medicare Advantage. Some of these plans charge a premium and others do not.

You can’t have both Medigap and Medicare Advantage; you have to choose one or the other.

For help with your individual situation, PacMed offers free services, including Medicare information sessions and a hotline where you can ask questions or schedule a consultation. Just call 1.877.315.3279.

Health care decisions are important for your quality of life as you age. Please let us know if we can help.


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NUTRITION CORNER: Strategies for picky eaters


We’ve all seen a child crinkle their nose when served beets or stew! Helping a child become a happy, healthy eater takes patience and thoughtful attention. If you’re a parent or caregiver, keep in mind who is responsible for what:

  • The parent is responsible for what, when and where.
  • The child is responsible for how much and whether they eat.

This means that you choose and prepare foods, provide regular meals and snacks, and demonstrate how to behave when eating. You are in charge of making mealtimes pleasant, and letting your child grow into the body that’s right for them.

Children have a natural ability to eat as much as they need, and to stop when they’re full. So you can trust your child to eat the amount they need, and ease up on prodding them.

To help your child feel relaxed about meals and even confident in exploring new flavors, try these three tips:

Create a pre-meal routine
It can involve putting away toys, washing hands, a prayer or a song. Transitions may be hard for kids, and a routine helps everyone get ready for a meal in a calming and predictable way.

Involve your child in setting up meals
Help your child learn about preparing and cooking foods. You can offer simple tasks like tearing lettuce or mixing ingredients, or suggest something that avoids close contact with foods like setting the table, inviting sister and dad to the table or pouring water for everyone.

Eat as a family
Aim to make the dinner table the happiest spot in your house. Children will want to be there and feel privileged to be to participate in family meals. Eating with the family allows kids to model adult behavior around trying new foods and learning manners.

Finally, be considerate of your child’s preferences—but ultimately, remember the division of responsibility: you choose what is being offered, and the child decides if they want to eat it. Have the child help plan meals by requesting foods before grocery shopping or meal prep. Or ask them to choose between two items you were already planning to serve.

For more information on healthy, positive eating, visit The Ellyn Satter Institute. Looking for a pediatrician or dietitian who can give advice geared to your little one? Make an appointment with a PacMed pediatrician, family medicine doctor or dietitian. Happy eating!

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Baked Apple with Oat Crumble


Warm apples and a crispy topping make this a comforting fall dessert. Leave the skin on the apples for a dose of fiber, and serve with a small scoop of vanilla yogurt, if desired.

Serves 4 Prep 15 minutes / Cook time 60 minutes

Ingredients

  • 2 medium apples (such as Gala, Fuji, Honey Crisp or Pink Lady)
  • 3 tablespoons finely chopped pecans
  • 2 tablespoons uncooked regular oats
  • 1 tablespoon brown sugar
  • 1 tablespoon cold butter, cut into small pieces
  • ¼ teaspoon ground pumpkin pie spice
  • Pinch of salt
  • 1 orange, juiced (use some orange zest to add brightness to the finish product)
  • Optional: Serve with a dollop of vanilla yogurt

Directions:

Preheat oven to 350°F.

Cut each apple in half horizontally (so stem is in one half and flower end is in the other). Use a spoon to remove most of the core from each half, leaving about a half-inch of apple in the floor of the rounded hole.

Use your fingers to combine nuts, oats, brown sugar, butter, spices and salt until mixture resembles coarse meal. Fill each apple half with about 2 tablespoons of the mixture.

Place apples in an 8-inch baking dish; pour orange juice in dish around apples. Cover with aluminum foil. Bake 30 minutes. Sprinkle a small amount of orange zest on top for color (optional).

Remove foil, and bake an additional 30 minutes or until apples are tender and easily pierced with a toothpick. (Baking time will vary depending on variety, size and ripeness of apples.)

Nutrition Information

Serving size 1/2 apple (without yogurt)

Calories 101, Total Fat 4g, Saturated Fat 2g, Cholesterol 8mg, Sodium 100mg, Total Carbohydrate 17g, Fiber 3g, Sugars 11g, Protein 1g

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LWA Spotlight


The Living Well Alliance has a new cooking video! Next time you need a fast, delicious and healthy meal, try our Vegetarian Peanut Bowl. It pairs colorful vegetables with buckwheat noodles and homemade peanut sauce.

Video and recipe for Vegetarian Peanut Bowl


The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

Welcome!

We look forward to keeping you informed with the latest on health tips and trends, curated by our doctors and dietitians. Whether you signed up for our Healthy Tips email every two months, or our mailed Healthy Today newsletter twice a year, we’ll be working hard to bring you sound medical perspectives on topics relevant to you.

You can get started now—by browsing our Health Resource links on this page

As always, if you have questions or would like to update your subscription preferences, you can email us at .(JavaScript must be enabled to view this email address). And if you need some more personalized advice from a health professional, we’re happy to set up a time with you—just visit our Appointments page.

We’re glad to have you with us. Here’s to your health!

Medicare Questions | Medicare Coverage | Seattle, WA | Pacific Medical Centers
Health Resources

Ask PacMed

Patients often ask...“I’m turning 65 next year. What do I need to know about Medicare?”
—answered by Linda Marzano, RN, MHA, Chief Executive Officer

Medicare is a great program, but it’s different from the commercial insurance you might be used to. You need to apply for Medicare within three months either side of turning 65—or you can’t join until the next enrollment period, and you’ll pay a penalty.

Basic Medicare includes Part A for hospital stays and Part B for outpatient services. Most people get Part A for free and pay a monthly premium for Part B. You can optionally add Part D for prescription drug coverage.

It’s important to remember, Medicare alone won’t cover all your health care costs. Medicare pays only 80% of items it covers, and it doesn’t cover long-term care, eyeglasses, dental care, hearing aids or extra perks.

To cover some of these extras, you have two options to add to Medicare. One is a Medicare supplement known as Medigap, which pays the extra 20%—only for services that Medicare covers. You’ll pay an extra premium for a Medigap policy.

The other option is Medicare Advantage. These plans may cover vision, dental, hearing aids and long-term care, along with other perks like gym memberships, massage or acupuncture. However, you will likely still pay a portion of the extra 20% for covered services with Medicare Advantage. Some of these plans charge a premium and others do not.

You can’t have both Medigap and Medicare Advantage; you have to choose one or the other.

For help with your individual situation, PacMed offers free services, including Medicare information sessions and a hotline where you can ask questions or schedule a consultation. Just call 1.877.315.3279.

Health care decisions are important for your quality of life as you age. Please let us know if we can help.

Submit your question to .(JavaScript must be enabled to view this email address), and you may see it answered by a PacMed expert in the next Healthy Today.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

Peach Caprese Salad

This simple and tasty recipe is a perfect summer side! Look for local fresh peaches from farm stands or Pence Orchards for the most flavor.

Serves 4.

Ingredients:

  • 2 ripe peaches or nectarines, sliced 1 pint cherry tomatoes, halved
  • ½ cup fresh corn kernels
  • 1/4 small sweet onion, thinly sliced
  • 8 oz fresh mozzarella, torn into pieces 2 tablespoons olive oil
  • Kosher salt Black pepper
  • 2 cups baby arugula
  • ½ cup fresh basil, torn into pieces

Preparation:
Wash and spin/air dry greens. In a large bowl, toss peaches, tomatoes, corn, onion and cheese with olive oil. Season with salt and pepper to taste. Let sit at least 5 minutes. Fold in arugula and basil and transfer to a serving platter.

Nutrition Information: Serving Size: One-fourth of recipe Total Calories 280, Total Fat 17g, Saturated Fat 7g, Cholesterol 46mg, Sodium 350mg, Carbohydrate 19g, Dietary Fiber 3g, Sugars 12g, Protein 13g, Potassium 475mg

Recipe from Woman’s Day online magazine. Find more recipes at PacMed.org/recipes.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

Military Mindfulness

Strategies from working with vets facing PTSD


When introducing mindfulness to veterans living with PTSD, new PacMed physician Charles Falzon, MD, MBA, advises easing into it, rather than “jumping right into the deep end of that kind of work, because it can be emotionally provocative.”

“Meditation can be really intimidating,” observes Dr. Falzon, a former lieutenant in the US Navy Medical Corps and Integrative Medicine practitioner at Northwestern University. “The feelings people experience can be very uncomfortable because they’re not used to living in silence or stillness... It can be very unsettling.”

Rather, Dr. Falzon recommends starting with small steps. “Focus for 30 seconds on what it feels like to take deep breaths,” he suggests. Or ease in with “yoga classes, going to a religious service or even simply putting your phone away during dinner and focusing on the people around you.”

This sort of “intentional action” also has tangible medical benefits. For example, taking time to chew intentionally, says Dr. Falzon, “gives your body a chance to process the food the way it’s meant to”—allowing salivary glands to perform the important first step of digestion.

Mindfulness can recalibrate all four basics of health—defined by Dr. Falzon as diet, sleep, stress management and exercise—changing “how we feel and experience health.”

For processing new feelings, Dr. Falzon believes the most important building blocks are your social support system and engaging your medical team. That kind of outside help is necessary because we can lose our bearings, especially when overwhelmed by endless task lists.

Those of us who are task-oriented can learn from veterans in their approach to mindfulness. “The military people I’ve worked with are always extremely dedicated and excited to tackle challenges,” says Dr. Falzon. “Unfortunately, when it comes to mindfulness, trying too hard or looking for specific results can be counterproductive. It’s not going to get you there faster. How can we be ok with the path that we’re on and not necessarily try to build a new road?”

Luckily, mindfulness doesn’t require a goal—the journey can be a reward in itself. As Dr. Falzon describes, “Those new sensations can be a really fascinating experience. Hopefully, it’s something that patients find helpful— then we can keep building on it.”

Dr. Falzon practices primary care at our Northgate clinic, listening closely and asking questions to focus on what will most help patients address their concerns

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

Climbing to New Heights

At age 56, competitive stair climber Mark Henderson is just hitting his stride


Some people are born to be true competitors; others just want to be fit and healthy for life. Mark Henderson, a PacMed™ patient, happens to be both. Racing up stairs was not Mark’s first choice of physical activity. For many years, the retired Navy commander competed multiple times per week at racquetball and road and trail running. Nagging injuries led him to seek the cause of some pain that rest and recuperation would not heal.

An X-ray revealed Mark had arthritis, both in his back and hip.

“I wish I would have known earlier that it was arthritis,” says Mark. “I blame myself... I would just ignore the pain and think rest would make it better.”

Mark’s arthritis diagnosis led him to Aysha Morgan, a physical therapist at PacMed Canyon Park in Bothell.

“When Mark first came to see me, I could tell he was an incredibly fit yet frustrated individual because he was in so much pain,” recalls Aysha. “He was told he needed a total hip replacement, but we decided together to first try targeted physical therapy for specific muscle groups that would allow Mark to continue to function at a competitive level.”

Their agreed-upon plan worked incredibly well. Today, Mark is the #2 ranked amateur stair climber in the nation—placing second in Seattle’s recent Big Climb, winning the 50+ national championship in Las Vegas two years running and placing ninth among international climbers in the Empire State Building Run Up.

Mark says he worked with Aysha for six months, “primarily to improve my flexibility and strength so I could retain as much mobility in my hip as possible...I kept doing the basic stretching and specific exercises she taught me, along with working in some yoga.”

“Stair climbing is remarkably easy on the joints,” adds Mark. “You’re really not running; you just take a couple of steps and use the handrails to propel you up each flight of stairs.”

What’s Mark’s advice for staying active in spite of a physical challenge?

“Find an exercise or activity that’s right for you, whether it be hiking, stair climbing, tennis or swimming. It’s also a good idea to have a workout buddy. I’ve found a couple of training partners who are as crazy about climbing stairs as I am!

“As far as working through injuries, don’t ever give up. Listen to your body and seek quality medical care if you need it. I’m confident that when I do need to get my hip replaced, PacMed’s access to top orthopedic surgeons in the area will enable me to get back to being as competitive as I can in whatever sport I am able to pursue.”

Healthy Tips | July 2019 | Health Resources | Pacific Medical Centers
Health Resources

HEALTHY TIPS – JULY 2019


Topics This Issue:


Happy, safe and healthy summer fun


Summer is here and travel season is officially in full swing. Dr. Ari Gilmore shares these tips for fun and safe adventures.

Outdoor Safety:

  • Apply sunblock that’s SPF 30 or higher every two hours or after swimming in saltwater.
  • Avoid alcohol while boating or have a designated boat driver.
  • Know your capacity with waves and ocean currents. If caught in a riptide, face into the waves and swim out diagonally about 100 feet; then try to return to shore again.
  • Wear the right shoes for the activity. Don’t hike in flip-flops; wear sturdy shoes that cover your feet.
  • Keep an eye on the ground when you’re walking. It’s easy to get distracted by the sights and trip!

Food Safety:

  • If eating from a food truck, observe it first to see if they have clean meal preparation surfaces and whether it’s busy and popular.
  • Avoid fresh fruit that has been prepared out of your sight. Cooked vegetables are generally all right to eat, but it’s a good idea to avoid the lettuce/cabbage on tacos.
  • Always wash your hands with soap and water before eating.

Travel vaccines:

  • Avoiding Zika virus: Zika is endemic near the equator, in warm humid climates. Physicians recommend women wait eight weeks after departing a location where Zika might be present before attempting to get pregnant. Likewise, we recommend men wait six months after visiting, because they have the ability to transmit the disease for some time, even after symptoms have subsided.
  • Make sure you have the proper vaccines if you’re travelling abroad. Visit www.CDC.gov/travel or consult at least one month before you depart with a travel-clinic physician regarding malaria, typhoid and yellow fever.

Long flights:

  • Jet lag has less to do with time changes and more to do with the low pressure and low oxygen levels on the aircraft. Increase your oxygen intake by drinking more water in-flight and being properly hydrated in the days before your flight. Also, avoid alcohol (which causes dehydration).
  • Get up from your seat every few hours to stretch your legs and do a few calf squeezes to increase blood flow.

Trips with children:

  • On a long car trip, take breaks and walk with your kids for 5-10 minutes. This blows off steam and helps circulation.
  • If your child is in diapers, pack individual diapers in plastic baggies—easy to grab and a bag for disposal, too.
  • Expect some acting out and fussiness—travel is stressful for everyone! Come prepared with snacks (such as nuts, granola bars, dried fruit and crackers) and activities (books, finger puppets, drawing materials, a new toy).

Food allergies:

  • Research your dining options in advance. At a restaurant, ask open-ended questions, like “What kinds of oil is in the salad dressing?” instead of “Does this contain walnut oil?”
  • Avoid buffets. It’s easy for foods to be cross-contaminated when serving utensils are shared across containers.
  • Take the medications you need for an allergic reaction, and know where the nearest hospital is that can treat you or your child.

Ari Gilmore, MD, practices family medicine at the PacMed Beacon Hill clinic. You’ll also find comprehensive travel services for adults and children at The PacMed Travel Clinic—like country-specific health advice and immunizations. Bon voyage!

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Our Back-to-School List—Check! Check!


Parents, get a jump on September with our back-to-school checklist for immunizations, checkups and communicating with your child’s school. You’ll also find inspiring ideas for healthy lunches and tips on which vaccines are recommended for your child.

Check out PacMed Back to School

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PacMed is smart, wired and fun

Smart. Our doctors regularly share their expertise in interviews with our local media. Here’s how to catch that latest PacMed provider videos of their interviews.

Wired. Through our secular partnership with Providence Health & Services, PacMed has some great partners—like Swedish Medical Center! By joining together, we have access to excellent tools, like our new MyChart. With MyChart, you can schedule appointments, see test results and message your doctor—all online. If you’re a PacMed patient, learn more and get started with the new MyChart.

FUN! Yes, it’s that time of year again—time for the popular PacMed Back-to-School Bash in Federal Way on August 14, 5:30-7:30 PM! This free event offers cooking demos, a scavenger hunt, face painting, healthy snacks, prizes and more. Visit www.PacMed.org/BackToSchool for all the details.

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NUTRITION CORNER: Get more fruits and vegetables into your day


Summer is such an easy time to add an extra serving of fresh fruits and vegetables to your day. Produce is plentiful in grocery stores and local gardens. For maximum health benefits, medical experts recommend 5-7 servings of fruits and vegetables each day. Eating more produce has been linked to a lower risk of cancer, diabetes and heart disease. Along with exercise, make this a high priority for your health!

Here are a few tips:

  1. Make it convenient. Y Have a mixture of fresh, frozen and canned fruit and vegetables on hand. This makes it easy to add them to sandwiches, soups, stir-fries, pizzas, yogurt or salads.
  2. Shop locally. There’s nothing like the local farmer’s market or fruit stand to get out of your produce comfort zone! Signing up for a produce box is another good way to experiment with new flavors. Need a recipe? Search the USDA What’s Cooking site.
  3. Sign up for a cooking class. Learning new ways to cook produce can help you discover what appeals most to you and inspire you to cook more fruits and vegetables after the class. Try a local cooking class through Living Well Alliance, YMCA, PCC or Cancer lifeline.
  4. Swap vegetables in place of grains. Have you heard about zoodles (zucchini noodles) or spaghetti squash taking the place of pasta? You can also try using cauliflower for rice. Another trick? Hiding vegetables in plain sight: shredded carrots in muffins, frozen spinach in smoothies, pureed canned beans in brownies.
  5. Fire up the grill. Grilling produce adds flare to a summer meal. Try vegetable kababs or experiment with grilled fruit like pineapple, pluots or peaches.

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Savory zucchini-egg breakfast muffins


Summertime means a plethora of fresh vegetables from the store, farmer’s market or your own garden. Zucchini is affordable and delicious, and it compliments most meals. Try it in these breakfast muffins!

Yield 12 Muffins Total Time: 45 minutes (Cooking Time: 30 minutes)

Ingredients

  • Cooking spray, such as canola or coconut oil
  • 3 cups grated zucchini (2 medium zucchini)
  • ⅛ teaspoon salt
  • ½ cup chopped onion
  • 1 teaspoon extra-virgin olive oil
  • 7 eggs, beaten
  • ¼ cup milk (or milk alternative)
  • 2 tablespoons fresh rosemary or other herb
  • ½ cup rolled oats
  • ½ cup grated manchego or cheddar cheese (optional)
  • Salt and pepper, to taste

Directions:

Preheat oven to 350°F. Coat muffin tin with spray oil.

Place grated zucchini in a strainer and sprinkle with ⅛ teaspoon salt and let sit 5 to 10 minutes. Squeeze excess water out of zucchini; this prevents the muffins from being soggy.

Sauté onion in olive oil for 2 minutes over medium heat. Then allow to cool.

In a medium bowl, whisk eggs and milk. Add zucchini, onion, rosemary, oats, optional cheese, and salt and pepper to taste. Stir until combined.

Pour mix into muffin cups. Bake for 25 to 30 minutes or until lightly golden.

Note: These muffins can be stored in the fridge in an airtight container for up to 4 days. Just pop a muffin in the microwave for 20 seconds to reheat.

Nutrition Information

Serving Size: Two muffins

Calories 230, Total Fat 12g, Saturated fat 5g, Cholesterol 230mg, Sodium 565mg, Potassium 400mg, Total Carbohydrates 16g, Dietary fiber 2g, Sugars 5g, Protein 14g

Recipe from Nutrition.org by Macha Davis, MPH, RDN.

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LWA Spotlight: Mingle, Network and Make a Difference in your worksite wellness program


This year the Living Well Alliance is hosting its 4th annual Workplace Wellness Symposium – a free event that is designed to help Puget Sound-area wellness coordinators promote and grow their wellness programs. This year, network with others in the field, hear from a panel of experts about organizing a wellness team, health fairs and negotiating with insurance brokers. Full lunch provided.

Save the Date: September 11, 2019 from 10-2:30pm in the Pacific Tower, 8th floor panoramic room
1200 12th Ave S Seattle, WA 98144

RSVP to .(JavaScript must be enabled to view this email address) by August 30. Bring a friend not already connected with LWA and receive a gift card

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The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

Healthy Tips | May 2019 | Health Resources | Pacific Medical Centers
Health Resources

HEALTHY TIPS – MAY 2019


Topics This Issue:


Bone Up on Bone Health


Sitting around—which many of us do too much of during the cold months—is a major risk factor of osteoporosis and low bone mass. The aging process also affects bone density, and women are far more prone to osteoporosis than men (an estimated 80% versus 20%). The good news is that stress on bones—such as walking or weightlifting—stimulates bone growth.

As you ease into physical activity again or have any concerns about bone density, we can help! The best way to detect osteoporosis accurately is a low-radiation form of X-ray technology called dual-energy X-ray absorptiometry or DXA (pronounced “dexa”). DXA is a quick, painless procedure for measuring bone loss. The DXA test can also assess your risk for developing fractures. If your bone density is found to be low, you and your physician can work together on a treatment plan to help prevent fractures before they occur.

As you get moving again, ease back into weight-bearing activities, ask your PacMed doctor about DXA if you have bone concerns—and if you drink milk, save up your cartons for a team or your own boat at July’s Milk Carton Derby at Green Lake!

The best place to start your journey to improved bones is with your primary care doctor. If you are looking for a new doctor, explore the nine PacMed clinics and our primary care services. We also offer DXA scans and nutrition counseling with our registered dietitians .

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We Take Pride...Seriously


When Megan first came to the PacMed First Hill clinic, she was worried about her chronic health issues. She also had concerns talking about her gender transition. Happily, her first visit—with Dr. Julia Becke, a PacMed physician of seven years—calmed all her fears.

“Dr. Becke was awesome,” says Megan. “She understands me. She works with me. I’m transgender, and finding a doctor who’s willing to work with the medications I’m on, and to really hear the story of a transgender patient, is just amazing.”

“I believe the job of a doctor is to meet people where they are,” says Dr. Becke. “Every person is unique; that’s what makes this job so amazing. You get a glimpse into the lives of people very different from yourself. That’s an awesome responsibility—and a joy—to be able to do that every day.”

“Certainly, Megan has had a journey that not many people have a chance to experience,” says Dr. Becke. “She’s gone through it with grace and dignity, and I’ve had the pleasure to support her along the way. Not only did I want to make certain to address her ongoing health issues, but I also strove to figure out how we can meld those issues with her plan to continue gender transition over time.”

At PacMed, we believe each of our 100,000 patients deserves the best possible care. We respect every individual and do not exclude people or treat them differently because of race, color, national origin, age, disability, gender or sexual identity or orientation. Wherever you get your care, we encourage you to find a doctor who helps you relate and feel safe.

Julia Becke, MD practices internal medicine at our First Hill clinic. Learn more about her at our website, or call 206.505.1101 to schedule an appointment.

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Find Peace with the Sun

When his new barber got too popular, Seattle patient Russ tried trimming his own hair back at home. That’s when he noticed a new spot on the back of his neck.

“My first thought was to shrug it off,” says Russ. “But after thinking it over, I took out my cellphone and snapped a photo to send to the doctor.”

It’s a good thing he did. Soon after delivering the photo, he was asked to come in for a series of appointments, which led to a diagnosis: melanoma.

“I went through some initial scary moments when I saw the report, but the doctor was able to explain it was just stage zero,” says Russ. Having caught the skin cancer early, treatment was simple and complete within weeks, and now he wears sunscreen daily.

Many Northwest residents flock outside in April to soak in the vitamin D as soon as the sun appears. Our many cloudy days can make the sun feel like an old forgotten friend, bringing mixed feelings when it reappears. It can help us feel better—and take better care of ourselves—to remember the sun shines through all the time, even when we don’t see it.

“It’s obvious you need to wear sunglasses when the sun is intense,” says Tony Huynh, MD, an ophthalmologist at PacMed’s Canyon Park and First Hill clinics. “But it’s important to protect your eyes year-round, even when it’s cloudy. Those damaging rays can still get through the clouds.”

One sign of the Seattle area’s mixed relationship with the sun is our high rate of sunglasses purchases—50% higher per capita than the national average by one measure, possibly because we forget where our shades are stored over long cloudy periods.

If you forgot where your last pair of sunglasses was stored, it’s good to pick up a new pair, according to Dr. Huynh: “Your eyes can get sunburned, just like the rest of your skin, which can be painful. But without protecting your eyes, the damage can be much worse, ranging from abnormal growths to cataracts to macular degeneration.”

Dr. Huynh emphasizes the importance of choosing wraparound sunglasses with 100% UV protection. He also recommends brown and orange-amber tints, which are better than gray or blue tints at blocking the low-wavelength light that can cause serious damage over time.

While Russ had a close call with melanoma, the wake-up call helped him improve his relationship with the sun. “I’m a rower, and a lot of times I’d get on the water and realize I forgot the sunscreen. Now I know which sunscreen is best, and stocked up on the zinc oxide and a few hats. I definitely feel more empowered now going out in the sun.”

Tony Huynh, MD, practices ophthalmology at our Canyon Park (Bothell) and First Hill clinics. Learn more about him at our website, or call 206.329.3937 to schedule an appointment.

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NUTRITION CORNER: Planning Meals for Strong Bones and Good Vision


May is Osteoporosis Month and June is Cataract Awareness Month. So in this edition, we are sharing nutrition information tied to bone and vision health. Then, to help you take action, we have included some powerful tips on meal planning. As always, work closely with your medical provider to create a care plan that’s right for you.

Nutrition for Healthy Bones and Eyes

Calcium, vitamin D and magnesium all help to maintain strong, resilient bones. fortified juices, canned salmon and tofu. Other excellent sources are figs, cooked bok choy, sardines, almonds, sesame seeds and cooked white beans. Dietary sources of vitamin D include milk, some yogurt, eggs, mushroom and some fortified foods. You can get magnesium from leafy green vegetables, whole grains, beans and nuts.

When it comes to vision, studies have shown that some nutrients may help prevent age-related macular degeneration, a common eye condition and the leading cause of vision loss in people over 50. Supplements are one approach, but experts agree that the best method is to consume a varied diet that’s rich in antioxidants, lutein and zeaxanthin . Recommended sources are egg yolks, dark green vegetables and some yellow-orange fruits and vegetables such as corn, nectarines, oranges, papaya, squash and sweet potatoes.

Meal Planning 101

A weekly menu is the most important step to consistently eating healthy meals! Try these tips to make your meal planning a success for strong bones, good vision and overall health.

  1. Make a weekly menu in advance. Your menu doesn’t need to be fancy. Just aim for a basic framework of meals. Choose a regular time each week to make your plan. Overwhelmed? Start with planning one or two meals in advance.
  2. Choose meals that have leftovers. Leftovers are perfectly legitimate for another day’s lunch or dinner! For example, baked salmon on Monday can top a salad or go in a tortilla wrap on Tuesday.
  3. Use ingredients that are versatile. Select a few ingredients that work across various dishes. Sautéed kale can be eaten with olive oil and seasoning at dinnertime, or added to scrambled eggs. Hardboiled eggs are an easy breakfast item or can be part of a Cobb salad for dinner.
  4. Keep it simple. You don’t need exotic or elaborate dishes each night. Instead, imagine a plate that is half vegetables/fruits, one-quarter grains and one-quarter protein. Example: Swiss chard, sweet potatoes, brown rice and chicken.
  5. Cook in bulk. Put that freezer to work! When buying and cooking, double the recipe and then put half in the freezer for when life gets busy. Try making two quiches and freeze one. You can also freeze cooked grains and marinated meats.
  6. Keep your plan visible. Whether on the counter or hanging on the fridge, having your plan accessible will keep you focused on upcoming meals.
  7. Chop and cut once. Cleaning and prepping ingredients can take up precious time. Consider chopping all your veggie and meats at the start of the week. Store each recipe’s portions in separate containers in the fridge, ready to go.
  8. Keep a list of successes. Was one meal easy to prepare and enjoyed by your family? Maybe it worked well for leftovers? Keep a list of those meals for easy repeats!

PacMed has dietitians who can help you meet your nutritional needs. Learn about the dietitian services at PacMed. Or call to make an appointment: 206.505.1300.

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Strawberry Goat Cheese Bruschetta


Late May and June are the true season of strawberries in the Pacific Northwest! Enjoy them at their sweetest and cheapest—and paired with savory and creamy goat cheese on toast. Feeling adventurous? Find a local farm where you can pick your own at www.pickyourown.org.

Serves 4 Time: 15 minutes

Ingredients

  • 1 French baguette, cut in 1/2-inch slices
  • 1 cup chopped strawberries
  • 2 tablespoons chopped fresh basil
  • 1 tablespoon olive oil
  • 1 tablespoon balsamic vinegar
  • 5 ounces goat cheese (one small log)

(See alternative ingredient ideas below nutrition information.)

Directions:

Preheat oven to 375 degrees. Place baguettes slices on baking sheet and bake for 5 minutes. Meanwhile, stir together strawberries, fresh basil, olive oil and vinegar.

Spread goat cheese on baguette slices. Spoon strawberry mixture on top. Serve immediately.

Nutrition Information

Calories 166, Total Fat 11g, Saturated Fat 6g, Cholesterol 16mg, Sodium 204mg, Total Carbohydrate 9g, Dietary Fiber 1g, Sugars 3g, Protein 3g

Recipe from Gather for Bread by Melanie Kathryn.

Alternative ingredients:

  • Instead of baguette, use gluten-free bread or cucumber slices
  • Swap out strawberries for blueberries as they come into season
  • Use mozzarella or brie instead of goat cheese

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LWA Spotlight


On-Site Yoga—Coming This June!

Living Well Alliance is excited to announce that Christy Goff, the registered dietitian who leads Living Well Alliance, will soon be able to offer on-site yoga at your company! Christy finished her 200-hour yoga teacher training program in February and is excited to share her theme-based classes with all ages and abilities. Her philosophy is to provide yoga for all levels and abilities, making students feel comfortable and empowered. Help your employees increase mindfulness, think outside the box and improve posture and flexibility. For more information, email .(JavaScript must be enabled to view this email address).

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTHY TIPS – MARCH/APRIL 2019


Topics This Issue:


Spring forward… Fall back down?


Spring is here, the birds are chirping—but you just want to go back to bed. You may think it’s an illness coming on but don’t notice any other symptoms right away. “People can just feel wiped out… just this general malaise and fatigue,” says PacMed allergist John Knutson, MD.

According to Dr. Knutson, even if you don’t notice sneezing or sniffles, this could be allergies. “One thing that really surprises people is the fatigue that can develop. A lot of my patients start dragging in the spring. Fatigue is an important symptom that’s sometimes overlooked.”

Allergic fatigue can easily be confused with catching a late winter virus—because sometimes it leads to that.

“Allergic rhinitis and allergies in general can make you more prone to catching an illness,” says Dr. Knutson. “Because you have this allergic response, you have a lot of inflammation going on in your upper airway. That creates a non-healthy mucosa, and it gives viruses more access to take hold in the upper airway.”

However, if you treat the allergies as soon as you feel fatigue, you can likely avoid getting sick at all. Dr. Knutson recommends a few do-it-yourself treatment approaches.

“One thing that really helps, that I recommend to almost every patient, is nasal saline rinsing—like a neti pot— because that helps restore the mucosa back to a better healthy state,” he explains. “It flushes out allergens; it liquefies any thick secretions and removes them. It’s a mild decongestant, and it helps to heal that upper airway. So that’s a really good thing to do.” Dr. Knutson recommends over-the-counter antihistamines and topical steroids as well.

While the feeling of malaise or fatigue can sometimes last for days or weeks, says Dr. Knutson, “Once patients get treated, they feel so much better.”

For more interesting effects of allergies, including pollen food syndrome, see the full article at www.PacMed.org/allergic-fatigue. PacMed Allergy and Immunology are here to help with hay fever and whatever else tickles your nose.

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Eat, savor and be mindful


Every April 22, communities around the world celebrate Earth Day, a focused time to honor our planet and renew efforts to safeguard its health. This year, on the forty-ninth Earth Day, we suggest combining mindfulness with eating as a path toward greater public health—supporting healthier families and communities, right here at home.

If we think of the environment as everything in the world surrounding us, then it seems fair to say that the condition of our environment plays a pretty big role in our ability to live safe, healthy and satisfying lives. Our minds and physical health are deeply affected by the quality of our air, soil and water. The quality of our environment can speed or slow healing. And in turn, our dietary choices have an impact on the environment.

One small step we each can take to both value and preserve our natural resources is to cultivate mindfulness about how and what we eat. Jon Kabat-Zinn, who founded a center for mindfulness within the University of Massachusetts Medical School, defines mindfulness as, “paying attention in a particular way: on purpose, in the present moment and non-judgmentally.”

Mindfulness is a powerful concept. Like any change, it takes time to integrate it into your life. Learn more about the power of creating a mindfulness practice below.

With dining, eating mindfully means, on one level, the act of slowing down to savor each bite. When you eat mindfully, you are engaged in the present moment. Dining becomes a conscious and deliberate and enjoyable act. A mindful approach to the table also means eating because you are hungry and stopping because you are full. Some simple mindful eating habits include setting a place at the table, consciously choosing to eat slower and putting your mobile phone off and in another room. (For more ideas, explore Nutrition by Carrie, by Carrie Dennett, MPH, RDN, CD.)

On another level, mindful eating means paying attention to the environmental aspect of food. Consider where a food item came from and the impact of its transportation on the environment. How much energy did it take to process a food item? You might also take a thoughtful look at packaging: is there another product with less plastic or a simpler container?

In our busy lives, it can be easy to rush through a meal and move on to the activity. When you intentionally take time for a meal, focus on the ingredients and savor the flavors, you can also support and celebrate our wonderful planet.

How do I create a mindfulness practice?
A mindfulness practice can solidify a fleeting sense of contentment into a deeper sense of unity and presence. There are fabulous, sometimes-free resources available to help you develop a mindfulness practice. To learn more about the benefits of mindfulness, explore the 10% Happier podcast. The popular Headspace app at www.headspace.com offers guided meditations, practice on breath awareness and basic tips. The entry level is free. A good book to start with is Kabat-Zinn’s Mindfulness for Beginners. Sharon Salzburg offers a 28-day plan in her book Real Happiness.

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Spring clean your heart habits

By Ameet Parikh, MD, Cardiologist at Pacific Medical Centers

Spring’s glorious colors and sunshine often inspire us to get our lives in order—declutter, organize and clean. Suddenly, we can’t wait to tackle that patch of weeds or the bulging tool drawer in the kitchen! Why not take that same energy and refresh your heart-healthy habits? I encourage everyone to take control of their cardiac health.

Explore these four heart-healthy projects and make a “SMART” goal or two—Specific, Measurable, Achievable, Realistic and Time-bound.

Project 1: Eat healthier

Diet is a key factor to overall heart health. While it’s okay to indulge every now and then, the bulk of your meals should be made up of whole grains, fruits and vegetables. In general, you should minimize sodium, unhealthy saturated and trans fats, and refined grain products (such as white bread, pasta and pastries). To spring clean your diet, try swapping in oils made from olive, fish, avocado, nut and seeds, which are healthier monosaturated or polyunsaturated fats. Eat a freshly prepared meal at home, since restaurants tend to have a heavy hand with the saltshaker. Finally, control portion sizes by using a small plate or bowl. It will help you avoid the temptation to overeat.

Sample SMART goal:
“For two meals this week, I will replace white bread or pasta with whole-grain tortillas, brown rice or a yam.”

Project 2: Get regular exercise

The American Heart Association recommends a total of 150 minutes of exercise per week, including muscle-building activities like resistance or weight training at least two days per week. Let’s break this down into more realistic, achievable tasks. First, remember that any amount of exercise is better than none. If you spend most of your day sitting, set a timer a few times a day to remind yourself to get up and move. This can be as simple as a walk around the office, up and down the stairs, a sanity speed walk in the neighborhood, or even a few stretches on the floor.

Sample SMART goals:
“At every lunchtime this week, I will walk for 15 minutes before or after my meal.”
“By Thursday, I will contact my primary care provider for help crafting a suitable exercise routine.”

Project 3: Sleep more and better.

A lack of sleep can lead to a number of long-term health issues, including an increased risk of cardiovascular and coronary heart disease. It’s vital to try and achieve at least eight hours of sleep per night by establishing a sleep schedule. Also, avoiding caffeine and alcohol late in the day can help you get more hours at night.

Sample SMART goal:
“I will shut off all screens and do something quiet for 30 minutes before bedtime for the next week.”

Project 4: Stop smoking

Tobacco and nicotine in all forms is dangerous for overall cardiovascular health and should be avoided entirely. Even one cigarette a day can be detrimental to your health, as can e-cigarettes. The good news is that it’s never too late to stop, and your doctor can provide tips and resources to help you along the way.

Sample SMART goal:
“Before Friday, I will set up an appointment with my primary care provider to design a good tobacco-cessation plan for me.”

Get support for your heart-healthy life

Be sure to evaluate and reset your goal as needed. It’s also helpful to identify personal roadblocks—maybe lunchtime is your weakness, or a coworker is sabotaging your tobacco-free efforts.

Your medical team can give you vital information and support. Schedule a visit with your primary care provider or cardiologist to review your medical history, check your cholesterol and blood sugar levels, and determine your risk. I believe everyone can make healthy lifestyle changes that will help build a strong heart for years to come.

Be sure to evaluate and reset your goal as needed. It’s also helpful to identify personal roadblocks—maybe lunchtime is your weakness, or a coworker is sabotaging your tobacco-free efforts.

Your medical team can give you vital information and support. Schedule a visit with your primary care provider or cardiologist to review your medical history, check your cholesterol and blood sugar levels, and determine your risk. I believe everyone can make healthy lifestyle changes that will help build a strong heart for years to come.

Dr. Parikh is a Cardiologist at Pacific Medical Centers. Meet our full Cardiology team and learn about our primary care services.

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NUTRITION CORNER: Got a crush on a crash diet? Check the research


A new diet seems to hit the headlines every week: the Nordic! HMR! Alkaline! 5:2! The promises can sound great, but be sure to slow down and check with the experts. Your health is on the line! Let’s take a deeper look at what the research says about three diets that are hot today—especially since it’s March, National Nutrition Month.

Intermittent fasting

With intermittent fasting, you follow various patterns of fasting through the day or week. The three main patterns are alternate-day fasting (alternating a day with no food with a day of unrestricted eating), modified fasting (days of partial fasting, meaning 25% fewer calories on those days, and then other days with unrestricted eating) and time-restricted feeding (no eating between certain hours). Other names for this diet trend include the Fast Diet, 5:2 or 8/16 diet.

Research shows some promise, with rat and mice studies demonstrating weight loss while preserving lean muscle. However, more studies are needed in human populations for weight loss, as well as to determine how and if intermittent fasting differs in general from daily caloric restriction.

Should I try it? There are several valid concerns about this diet. For starters intermittent fasting was ranked 33 out of 41 by 2019 US News & World Report for 2019 Best Overall Diet. Second, be wary of long-term bouts of fasting to make sure you are meeting your nutrient requirements. Lastly, fasting is not recommended for those with diabetes or a history of eating disorders, pregnant or breastfeeding women, or if you have a health condition where medications are taken only with food.

Ketogenic diet

The ketogenic or keto (“KEY-toe”) diet is a calorie-restrictive program that mandates a high fat intake and a low carbohydrate intake to put the body in a state of ketosis. Ketosis occurs when your body does not have enough glucose (or sugars) available to fuel the brain and maintain cellular function, and so it starts to break down fatty acids into ketones. Maintaining a state of ketosis requires you to eat no more than 20-50g of carbohydrates per day, depending on your total calorie intake.

Research shows that like most calorie-restrictive diets, this one works temporarily. Studies also found that keto dieters have improved satiety (the sense of fullness) levels because of the high fat recommendations, and because the appetite-stimulating hormone is reduced during ketosis. Another study showed that those on the keto diet improved insulin sensitivity; however, it also noticed that they are more fatigued than their counterparts and that both their cholesterol (both LDL and HDL) and certain inflammatory markers increased. Additionally, there are risks for developing kidney stones, bone fractures and constipation because of micronutrient deficiencies and limited fiber intake. Often, it is recommended to supplement the keto diet with vitamins and minerals to get the proper amounts of nutrients in ketosis.

Should I try it? The keto diet was ranked 38 out of 41 by US News & World Reports, which demonstrates that it isn’t the most favorable eating plan for most. If you do try it, it’s important to work with a physician and dietitian to make sure you are meeting your micronutrient needs or managing any medication interactions. This diet plan can also be socially isolating due to its strict nature, so it is important to be on the watch for mental health effects.

Whole30 diet

The Whole30 diet is a popular eating plan to “reset” digestion and potentially provide some weight loss benefits. For 30 days, dieters follow a plan that promotes fresh foods while eliminating many processed options like salty snacks and desserts. It also eliminates dairy; grains; legumes; alcohol; additives like MSG, carrageenan or sulfites; and peanut butter—all for claims of better digestion, skin health, metabolism and overall sense of well-being. Snacking is frowned upon and exercise is promoted. At day 30, dieters reintroduce all foods slowly to determine how the body responds to each addition.

Should I try it? This diet comes with lots of promises but little research to back it up, so more study is needed. Whole30 is ranked 38 out of 41 in best overall diet, showing again the limited benefits for embarking on this journey. However, this plan does take people back to the kitchen to cook whole foods, which is helpful for consuming the recommended fruits and vegetables. If starting this plan, make sure to have a strong support system, good meal planning skills and the dedication to complete it.

Crash diets vs. healthy lifestyle changes

With any eating plan, it’s important to tell your health care team if you are dieting for longer than a month or two to ensure nutrient deficiencies are minimized and, in extreme cases, lab work is monitored. Diets rarely lead to long-term health or even weight loss, yet they often promote food restriction, are inflexible and almost seem a punishment for one’s weight and body size.

So, what works better? Aim for lifestyle changes that switch your mindset to eating for health not size. This approach includes supporting and acknowledging your relationship with food, being flexible with eating, and accepting and welcoming all foods that support our physical health and emotional health. We can all be healthy in our own way and time, especially with the individualized help of our health care team. Think long term!

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Parmesan Roasted Snap Peas


This simple and tasty recipe is the perfect introduction to spring! Whether you grow your own peas or buy them at the store, roasted snap peas are a great side dish or healthy snack. They taste good hot or cold.

Serves 4 Time: 20 minutes

Ingredients

  • 1 pound sugar snap peas
  • 1 tablespoon olive oil
  • 1/4 cup shredded Parmesan cheese
  • 1/8 to 1/4 teaspoon salt, to taste
  • 1/4 teaspoon pepper

Directions:

Preheat oven to 350 degrees F.

In a large bowl, combine the snap peas, oil, cheese, salt and pepper. Toss to combine.

Spread the snap peas on a baking sheet and bake for 15 minutes.

Nutrition Information

Serving Size: One-fourth of recipe
Total Calories 105, Total Fat 5g, Saturated Fat 2g, Cholesterol 8mg, Sodium 280mg, Carbohydrate 5g, Dietary Fiber 3g, Natural Sugars 6g, Protein 6g, Potassium 213mg

Recipe from Food and Nutrition Blog by Natalie Rizzo, RDN, 2018.

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LWA Spotlight


The Living Well Alliance has an exciting, new cooking video to share! Watch Christy prepare a Fiesta Shrimp Grain Bowl—an easy meal for a busy weeknight. Stay tuned throughout the year as the LWA team shares different variations on this grain bowl.

Want to host a cooking demo at your office or apartment, or for an event? LWA can do this easily! Just pick a theme and reserve a conference room. We’ll do the rest. Email LWA for more information or to book your next LWA class.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address)

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
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HEALTHY TIPS – JANUARY/FEBRUARY 2019


Topics This Issue:


Put Your Heart First This Valentine’s Season 


What’s on your Valentine’s Day list this year? A dozen red roses? A box of gourmet chocolates? A romantic getaway or tickets to the big game? These excellent choices may cause hearts to flitter—a great reminder that with all the love going around, our hearts need love, too!

As one in four deaths are caused by heart disease, American Heart Month in February is a great time for some uplifting activities that our hearts can fall in love with.

Ask your heart to dance

It’s not always easy to exercise in winter, so why not get creative? Bust a move and clean your house to music. Try your hand at an indoor climbing wall. Play laser tag with the kids. Go ice skating, or try yoga, Pilates or water aerobics. As you dance about, remember that signs of heart attack vary for men and women; if you don’t feel quite right, be sure to seek care.

Take your heart to dinner

Love with every “fiber” of your being—by keeping fiber and whole grains in your meals! High-fiber diets have been shown to lower blood pressure and encourage a healthy weight. (While we’re on the topic of fiber, February is a great time to schedule your colonoscopy!)

Find a partner your heart can trust

Every heart has a story to tell. When it comes to choosing health care providers, let your heart in on the decision. PacMed’s team features some of the longest-serving doctors in the region, who invest in doing right by patients over the long haul.

If you’re looking for someone new, drop in for a visit—including our state-of-the art Nuclear Cardiology department at our First Hill clinic, led by Dr. Philip Massey and assisted by Dr. Keiko Aikawa. Just call 206.505.1300 or use our online appointment request form.

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Don’t Try This Alone: Teamwork Can Boost New Year’s Resolutions


January is over, and those resolutions are fading. It’s amazing how quickly our resolve dissolves. The problem, according to two PacMed physical therapists (PTs)—who have decades of experience walking people back from devastating setbacks—could be trying to change all on your own.

When PacMed’s Aysha Morgan, PT, DPT, first met Sandy,* she’d “had a very severe stroke a few years ago and was only being pushed around in a wheelchair…. She felt the only thing she could do was move one arm. She couldn’t stand, she couldn’t transfer, she definitely couldn’t walk.”

“I took one look at her, and I thought, ‘No, no, no—there’s potential in this woman!’” says Aysha. “Let’s see what kind of potential you have that’s going to make your life easier.” Over the course of the year, Aysha worked with Sandy, helping her stand, then take a step, then two steps and finally walk with a cane.

When our beliefs keep us from changing, it helps to connect with someone else who sees our potential—like Aysha did for Sandy. Stephanie Clements, PT, who manages PacMed’s team of 15 physical therapists, encourages the team to see potential by keeping the whole person in mind. “Once you find out more about them, then they start to tell you more about what they’re capable of doing, or what their dream is to do.... You’re more than your diagnosis,” she says.

Stephanie sees the best outcomes among people who make social connections part of their health routine: “The ones that do very well are the ones that go to the community center three times a week. So they’ve got a group… it’s socializing. They are in the same boat; they are all wanting the same thing.”

To read more about this approach to change, visit www.PacMed.org/resolutions.

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Nutrition Corner: Get that Blood Pressure in a Healthy Range


February is heart health month! You can do a lot to prevent heart disease, and one of the best ways is to get control over your blood pressure. High blood pressure is diagnosed when the force of the blood flowing through your blood vessels is consistently too high, meaning over 140/90 mmHg. These two numbers demonstrate the pressure of blood flowing through your blood vessels. Unfortunately, a high amount of pressure over a long time can cause damage or changes to the important vessels, increasing the risk for heart attack or stroke.

If you have high blood pressure, here are three ways to start:

  1. Ask for help. First, talk to your doctor about possible medications to control blood pressure. There are many different kinds depending on your unique body. While most of us don’t like taking medications, they do have their place in bringing your blood pressure numbers into a normal range fairly quickly. The benefits far outweigh the damage that can accumulate in your body without this swift control. Of course, medication isn’t the only thing you should focus on; nutrition and exercise are close second and third steps.
  2. Eat smart. You also need to review any dietary habits that can contribute to high blood pressure. The first two places to focus on are reducing excess sodium and eating more vegetables. Sodium is directly linked to increasing blood pressure over time. Aim for less than 2400mg of sodium per day (or about 1 teaspoon). Foods with high sodium include fast foods, soups, pizza and cheesy foods. Second, increasing vegetables in your diet to 5-7 servings per day means your body gets more potassium and other nutrients that help manage blood pressure. Some good choices are sweet potatoes, kale and avocados. Additionally, foods that have high amounts of nitric oxide (beets, spinach, celery) help lower blood pressure by improving vascular function and blood flow. How do you start? Track your salt and vegetable intake on paper or with an app like myfitnesspal.com to meet these recommendations. Want more information? Read about the DASH diet.
  3. Exercise. Exercise is critical to keeping your blood pressure in range. Aim for 150 minutes per week of moderate-intensity movement, paired with some strength exercises. At a loss for ideas? Try walking during your lunch break, stretching at your workstation, walking your dog (or a neighbor’s!) or trying an exercise class at your local gym or community center.

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Caramelized Beet and Sweet Onion Soup


Beets are rich in nutrients, including folate and potassium. They also have a high nitrate content, which has been studied for its heart-healthy benefits and ability to lower blood pressure.

Recipe by Jackie Newgent, RDN, from www.foodandnutrition.org.

Serves 4 Time: 40 minutes

Ingredients

  • 1 1/2 tablespoons extra-virgin olive oil
  • 2 large sweet onions, very thinly sliced
  • 1 large beet, peeled and cut into 1/4-inch cubes
  • 2 large garlic cloves, minced, plus 1 garlic clove, halved
  • 2 teaspoons fresh thyme leaves
  • 4 cups low-sodium vegetable or chicken broth
  • 1 tablespoon aged red wine vinegar
  • 3/4 teaspoon sea salt, or to taste
  • 3/4 teaspoon freshly ground black pepper
  • 4 half-inch-thick slices of whole-grain baguette, cut on a diagonal
  • 1 1/2 ounces goat cheese, room temperature

Directions:

Heat oil in a stockpot over medium heat. Add onions and beets, and cook 15-20 minutes, stirring occasionally, until onions are fully softened, richly colored and have a distinct caramelized aroma.

Add minced garlic and thyme, and sauté for 1 minute or until fragrant.

Add broth, vinegar, salt and pepper. Increase heat to high and bring to a boil. Reduce heat to medium-low and simmer, partially covered, until flavors have fully developed and beets are cooked through, about 20 minutes.

Preheat oven to 475°F. Place baguette slices on a baking sheet and bake until lightly toasted, 6 to 7 minutes. Remove from oven and rub toast slices with halved garlic clove. Spread goat cheese on one side of each toast slice. Ladle soup into bowls, and top each bowl with a piece of goat cheese toast. If desired, sprinkle with additional fresh thyme.

Nutrition Information

Serving Size: 1 rounded cup of soup and 1 goat-cheese toast

Calories 200, Total Fat 8g, Saturated Fat 2g, Cholesterol 5mg, Sodium 680mg, Carbohydrate 32g, Dietary Fiber 5g, Natural Sugars 13g, Protein 6g, Potassium 281mg

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Mediterranean Diet Rated “Best Diet” for 2019


On January 2, US News and World Report unveiled the Mediterranean diet as its Best Overall Diet for 2019. In addition, the Mediterranean diet also came in first for easiest diet to follow, best diet for healthy eating, best diet for plant-based eating and best diet for diabetes. Learn more in this CNN article.

The health of Mediterranean nutrition is no surprise. Numerous studies have shown that Greeks, Italians, French and Spaniards along the Mediterranean coast often live long, healthy lives. Meals from the sunny region have been linked to reduced risk for high cholesterol, diabetes, dementia, depression, memory loss and breast cancer. The diet has also been found to support weight loss, strong bones and a healthy heart.

The Mediterranean diet is a pattern of eating, not a structured diet. It has no rigid rules and offers lots of choice and variety. It even promotes a glass of red wine and the occasional treat! Many call it a lifestyle, with frequent socializing over meals, mindful eating and daily exercise such as walking.

Meals emphasize simple cooking and include lots of vegetables, fruits, whole grains, seeds, beans and legumes. Dishes lean heavily on olive oil and flavorful herbs and spices, and fish and seafood are eaten at least twice a week. Poultry, eggs, cheese and yogurt are enjoyed in moderation. Sweets and red meat are saved for special occasions. Finally, red wine and plenty of water round out the diet.

Check out this sample one-day menu to whet your appetite. “Buon appetito! Kalí órexi! ¡Buen provecho! Bon appétit!”


The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address)

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*Some patient names in this publication have been changed for privacy.

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
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Spring forward… Fall back down?

Do you feel tired as the weather improves? Read on!


Spring is here, the birds are chirping—but you just want to go back to bed. You may think it’s an illness coming on but don’t notice any other symptoms right away. “People can just feel wiped out… just this general malaise and fatigue,” says PacMed allergist John Knutson, MD.

According to Dr. Knutson, even if you don’t notice sneezing or sniffles, this could be allergies. “One thing that really surprises people is the fatigue that can develop.

A lot of my patients start dragging in the spring. Fatigue is an important symptom that’s sometimes overlooked.”

Allergic fatigue can easily be confused with catching a late winter virus—because sometimes it leads to that.

“Allergic rhinitis and allergies in general can make you more prone to catching an illness,” says Dr. Knutson. “Because you have this allergic response, you have a lot of inflammation going on in your upper airway. That creates a non-healthy mucosa, and it gives viruses more access to take hold in the upper airway.”

However, if you treat the allergies as soon as you feel fatigue, you can likely avoid getting sick at all. Dr. Knutson recommends a few do-it-yourself treatment approaches.

“One thing that really helps, that I recommend to almost every patient, is nasal saline rinsing—like a neti pot— because that helps restore the mucosa back to a better healthy state,” he explains. “It flushes out allergens; it liquefies any thick secretions and removes them. It’s a mild decongestant, and it helps to heal that upper airway. So that’s a really good thing to do.” Dr. Knutson recommends over-the-counter antihistamines and topical steroids as well.

While the feeling of malaise or fatigue can sometimes last for days or weeks, says Dr. Knutson, “Once patients get treated, they feel so much better.”While the feeling of malaise or fatigue can sometimes last for days or weeks, says Dr. Knutson, “Once patients get treated, they feel so much better.”

Allergic fatigue “can sometimes fool people,” says Dr. Knutson—and that’s not the only misunderstood allergic effect. Another is pollen food syndrome.

“You’re eating a banana, and your mouth thinks you’re trying to eat ragweed, and it kind of goes crazy,” Dr. Knutson describes. That’s because “the proteins [in a fruit or vegetable] are similar to proteins that are in pollens.” He goes on to explain that the immune system in the mouth senses the banana’s proteins, but it “may think that, ‘Oh, that’s ragweed in our mouth.’”

If you’re confused by an allergic reaction to a fruit or vegetable, try cooking it—like making banana bread or applesauce. “The cooked versions of those proteins are denatured, and you don’t react to it,” he explains.

Like many allergies, food pollen syndrome tends to be seasonal. Dr. Knutson shares, “I can’t eat cantaloupe during the weed pollen season—my mouth goes crazy—and the rest of the year, I eat it fine.”

Also on the horizon of interesting allergy news might be the effects of allergies in patients living with autoimmune diseases, as being studied by the Benaroya Research Institute. As summed up by Dr. Knutson, the article “talks about autoimmune problems and allergy problems as essentially dysregulation of the immune system.”

There is not much data yet to allow us to draw conclusions, but our understanding of some lesser-known manifestations of allergies may be growing in the near future.

For more interesting effects of allergies, including pollen food syndrome, see the full article at http://www.PacMed.org/allergic- fatigue. PacMed Allergy and Immunology are here to help with hay fever and whatever else tickles your nose.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
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Don’t Try This Alone

Teamwork can boost New Year’s Resolutions


January is over, and those resolutions are fading. It’s amazing how quickly our resolve dissolves. The problem, according to two PacMed physical therapists (PTs)—who have decades of experience walking people back from devastating setbacks—could be trying to change all on your own.

When PacMed’s Aysha Morgan, PT, DPT, first met Sandy, she’d “had a very severe stroke a few years ago and was only being pushed around in a wheelchair…. She felt the only thing she could do was move one arm. She couldn’t stand, she couldn’t transfer, she definitely couldn’t walk.”

“I took one look at her, and I thought, ‘No, no, no—there’s potential in this woman!’” says Aysha. “Let’s see what kind of potential you have that’s going to make your life easier.” Over the course of the year, Aysha worked with Sandy, helping her stand, then take a step, then two steps and finally walk with a cane.

When our beliefs keep us from changing, it helps to connect with someone else who sees our potential—like Aysha did for Sandy. Stephanie Clements, PT, who manages PacMed’s team of 15 physical therapists, encourages the team to see potential by keeping the whole person in mind. “Once you find out more about them, then they start to tell you more about what they’re capable of doing, or what their dream is to do. You’re more than your diagnosis,” she says.

Stephanie sees the best outcomes among people who make social connections part of their health routine: “The ones that do very well are the ones that go to the community center three times a week. So they’ve got a group…. It’s socializing. They are in the same boat; they are all wanting the same thing.”

The right environment can foster long-term investments in each other that make change possible. As Aysha says about Sandy, “It’s taken her a year to come this far, and I’m grateful that PacMed has allowed me to work with them for this time.” The kind of environment that fosters caring for patients starts with caring for each other. As Aysha describes,

“I love my coworkers—I love the people who work under me, over me, beside me. Patients are just so wonderful. Honestly—I’m so, so pleased, I couldn’t be more pleased. And I’ve always loved my job, always done the best wherever I can, but I’m especially happy here, which is so nice. Really.”

That kind of supportive environment empowers caregivers to invest in others through the sometimes-long process of change. Aysha reflects on her ongoing work with Sandy, who suffered the stroke. “In the beginning, we worked on just standing, just standing, which was hard,” says Aysha. “And then we got her standing and moving from one place to the next. And standing and taking a step, and then taking two steps, and taking steps on a walker with a platform, and then a front-wheel walker. And just recently, we got her walking indoors with a cane.”

This investment, in turn, can inspire patients to invest in themselves. Sandy, accompanied by her husband, a Korean War and Vietnam vet, has “come in, diligently, every single week. Really, to be honest, it’s her hard work, and his hard work. They’re incredible people,” says Aysha.

Stephanie witnessed this transformation firsthand. “Sandy was glowing. And her husband was so happy.”

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
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A doctor who knows you

How primary care can save your life


“Before the headaches started, he wasn’t himself on the basketball court,” Michelle Tibbs, mother of 16-year-old Dorian, recently told us. “He started playing kind of sloppy.… He was lobbing the ball and had a lot of turnovers.” That night, Dorian was shivering in bed and throwing up.

The emergency room diagnosed him with a sinus infection and sent him home. At urgent care the next day, Michelle told the doctor, “I’ve had sinus infections, I didn’t throw up from them, this is not normal.” Still, the doctor just increased his sinus medications and also sent him home.

Luckily, the Tibbs family had a primary care doctor who had cared for Dorian since birth. “When I walked into the room, I could tell Dorian was extremely sick,” said Dr. Mary Weiss, according to an article in the Seattle Medium. “The difference in what I have with Dorian is I knew him.”

Michelle told us that the family saw their primary care doctor on a Monday afternoon. At 6:00 the next morning, Dorian underwent his first brain surgery. It turns out he was suffering from an infected abscess that was leaking into his brain.

Michelle would meet others on Facebook with the same condition as her son. One slipped into a coma and had 70% of his brain removed, resulting in permanent mental impairment. Another, a 13-year- old, was also turned away with a misdiagnosis eight times and died shortly thereafter.

“‘If you would have been one more day, Michelle, we would have been having a whole different conversation,’” she reports Dr. Weiss told her.

Dorian spent eight days in the Intensive Care Unit, eventually undergoing a total of five brain surgeries.

Today, Dorian is playing basketball again, point guard for Garfield High School’s varsity squad, and he’s on track to attend a Division I college. It’s been a long road back, but it all started with a doctor who knew Dorian’s personality and history, and used that background to find the right diagnosis.

In the US, primary care doctor-patient relationships are on the decline.

According to a 2018 study by the Health Care Cost Institute, primary care office visits dropped by a full 18% in the short period from 2012 to 2016. While a shifting health care market may introduce convenient options like urgent care and direct access to specialists, as the Tibbs family knows, these can’t take the place of a doctor who knows you.

That’s what new PacMed patient Sara had in mind when she visited for the first time this fall. “I’ve had cancer before, and while I’m healthy now,” she says, “I want someone who can follow me in case anything comes up again.”

As a lifelong artist who had just landed a teaching job, Sara also decided to upgrade her health care. PacMed’s connection to the Swedish hospital system was key to her decision: “It’s a good way to get good health care while having access to a top hospital.”

Sara’s first visit to PacMed’s Beacon Hill campus to meet her new doctor didn’t require her to sacrifice any convenience. “Everyone’s been so nice,” she adds. “They were able to schedule me for my labs and scans here on the same day—it’s kind of amazing.”

Sara is on her way to building relationships with doctors who know her and who, as PacMed’s Dr. Andrew Dym puts it, practice medicine in “a deep and persistent culture, with our roots as a Public Health Service hospital.” Whether you’re starting in middle age or have known a doctor from birth, we encourage you to invest in a relationship with a doctor who can get to know you over time.

Michelle Tibbs recommends it: “100 percent—110 percent, yes.”

PacMed’s network of 150+ physicians around Puget Sound includes 72 primary care doctors, with 30 who have been in practice with us over 10 years. Our commitment to establishing long-term doctor-patient relationships hearkens back to the days when family doctors and house calls were the norm.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
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HEALTHY TIPS – NOVEMBER 2018


Topics This Issue:


Best Tactic for Diabetes? Find and Treat It Early


Over 30 million Americans have diabetes, but 7 million of those people are not yet diagnosed!* Are you one of them? Getting tested is a smart step for your long-term health.

Diabetes is a life-altering disease, and it’s important to catch it early. The earlier you detect diabetes, the better your chances of avoiding future health problems, including heart attack, kidney disease, limb amputation and blindness.

With diabetes, there is too much glucose (sugar) in the blood. This occurs when a person’s body is unable to produce or use insulin, a hormone that regulates blood sugar levels in our bodies. There are two types of diabetes:

  • Type 1 diabetes is typically diagnosed in children and young adults. It occurs when the pancreas produces little to no insulin. Type 1 can be managed with daily insulin injections.
  • Type 2 diabetes accounts for 90 percent of cases. It occurs when your body resists the effects of insulin or doesn’t produce enough.

If left untreated, either form of diabetes can increase the risk of serious health complications.

Learn Your Risk Factors and Get Screened

Risk factors for type 2 diabetes include a family history of diabetes, age 45+, being overweight, infrequent/irregular physical activity and certain races/ethnicities (including Pacific Islander, Asian-American, Mexican-American and African-American). Also, women who had diabetes during pregnancy are at higher risk.

If you have one or more risk factors for diabetes or notice any of the above symptoms, talk with your doctor about being screened as soon as possible. If you receive a diabetes diagnosis, you are not alone. Ask your doctor about diabetes education and nutrition support.

Think of Exercise as Diabetes “Medicine”

It’s important to make physical activity a part of your life. If you don’t have diabetes, regular exercise can help prevent the disease. If you do have diabetes and you exercise regularly, it can lower your blood pressure and blood sugars—and can even prevent the need for diabetes medication for a long period of time.

You don’t need to run a marathon to reap the benefits of exercise! Walking between 6,000 and 10,000 steps daily is an attainable goal for most people. Use a step counter—or simply count your steps for 5 minutes and do some math. If you have mobility problems, water aerobics is a great alternative. Whatever you do, aim for 150 minutes of exercise per week, or 20-30 minutes every day.

If you are looking for a primary care provider, we invite you to meet the PacMed Primary Care team. If you are already living with diabetes or have recently been diagnosed, the PacMed Diabetes Management Program offers comprehensive medical care, health education and support.

*Statistics as reported in the 2017 National Diabetes Statistics Report by the Centers for Disease Control (CDC).

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Help Your Immune System Fight Winter Illness


Does it seem like you always get sick at this time of year? There are powerful things you can do to help you and your family avoid colds and flus. Your best bet is to avoid getting sick in the first place! Try this two-pronged approach.

Eat Smart to Boost Immunity!

The immune system is your body’s defense against infectious organisms and other invaders. Many nutrients from food specifically “feed” the immune system, thus strengthening your body’s protective response.

  • Remember your cruciferous. Cruciferous vegetables—such as cabbage, Brussels sprouts, broccoli, cauliflower, bok choy—strengthen the liver so it’s better able to flush the body of harmful substances.
  • Skip the sugar. Want a sweet? Reach for whole, fresh fruit! The simple sugars in cookies, soda and pastries can weaken your white blood cells’ ability to fend off foreign invaders … like viruses.
  • Add some zing. Garlic and ginger have antiviral and active molecules that help the body fight off viruses and bacteria. (Worried about garlic breath? Ask your provider about high-quality garlic supplements.)
  • Feed your gut. Fermented foods contain good bacteria, or probiotics, that help the digestive tract fight off foreign invaders. Try sauerkraut or kimchi (cabbage), or yogurt, kefir and sour cream (dairy).
  • Talk with your doc about vitamin D. Vitamin D plays a big role in regulating your immune system. With our dark Northwest winter, your doctor may recommend a daily dose of D for you.
  • Devour fish. Cold-water, fatty fish like salmon and sardines are the highest in omega-3 fatty acids, which enhance the function of certain immune cells. Fish is also a rare source of vitamin D.

Take Preventive Steps!

You can do a lot of things to help prevent you and your family from catching a cold or flu this season.

  • Wash your hands: Good handwashing is the number one way to protect yourself from getting sick. Scrub for at least 20 seconds with soap.
  • Get the flu vaccine: Everyone over the age of 6 months should get a flu shot. While it won’t keep you from getting a common cold, it will help protect you and others around you from the flu.
  • Avoid people who are sick: Keep your distance! Sick children/adults should stay home from school/work.
  • Sleep well: Your body needs good sleep for a healthy immune system. Go to bed earlier so your body can get the nightly sleep it needs: adults, 7-8 hours; teens 8-9 hours; “tweens” 9-10 hours; young school-age kids 10-12 hours; toddlers/preschoolers, 11-13 hours.
  • Eat well: Maintain a well-balanced diet of healthy protein, whole grains, healthy fat like olive oil and avocado, limit added sugar, and eat plenty of fruits and vegetables. Read more below!

Eat well, sleep well and be well this winter!

Are you looking for a primary care provider? PacMed offers preventive, primary care through our Family Medicine and Internal Medicine teams. Therapists in our Behavioral Medicine department are also available for counseling.

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Nutrition Corner: Six Ways to Stick to Healthy Eating This Holiday Season


With forethought and a few tricks, you can stick to your health goals this holiday season! Try these six tools this year.

  1. Be mindful. Aim for a healthy relationship with food this year by practicing mindful eating—an exercise that builds awareness of our actions, thoughts, feelings and motivations behind eating. This practice focuses on listening to your body, acknowledging your hunger and satiety cues, and keeping tabs on how certain foods make you feel. Mindful eating can also help you create a better eating environment by slowing down at mealtimes and focusing on cherishing food. Mindfulness can remove the guilt around food intake and help you experience the joy of eating again.
  2. Continue your exercise routines. Maintaining your exercise routine in the midst of parties, travel and winter darkness will keep your stress down and your immune system at its best. Set realistic expectations for the holiday season. Create a new routine if it means you are more likely to stick with it. Often, success is best achieved when you include your favorite spin or yoga class in your weekly schedule—or find an activity that offers more flexibility.
  3. Prepare yourself with a plan. Come up with a realistic plan for parties, office treats or temptations when out shopping. Some people benefit from eating a light, healthy meal before attending a party to reduce their potential to binge on higher-calorie foods. This trick also will ensure you get your servings of fruits or vegetables beforehand, while boosting your willpower by not being hungry. When you head out shopping or to work, pack healthy snacks to avoid impulse purchases or grabbing an extra dessert from the workplace cafeteria. Some easy ideas are roasted chickpeas, apple or orange slices, or whole-grain crackers.
  4. Know your stressors. Take a few minutes before the holidays to write a list of your main stressors. Is it your family, the business of events, your kids during their sugar highs? Make a plan for handling these stressors to lessen the burden on your body. For example, if planning for guests is your stressor, try to delegate tasks instead of doing it all yourself or schedule some self-care activities before or after the event.
  5. Plan for indulgences. Let’s get real—holidays are delicious especially when all your favorite traditional foods come back, like grandma’s apple pie, uncle’s pepperoni rolls or, mm-mm, auntie’s artichoke dip. How about being a little pickier with your food choices this year? Try focusing on just your favorites while forgetting the empty-calorie or high-calorie fillers. Feel good about the foods you choose to indulge in and really savor every bite.
  6. Rethink your drink. Cutting out sweetened beverages is one way to stick to your health goals while still enjoying favorite traditions. Many drinks are full of calories yet have no or little nutritional benefit. In particular, alcoholic drinks not only are caloric, but also tend to loosen our decision-making skills around food intake (hello, late-night munchies). Turn to infused, sparkling or regular water as an alternative and practice moderation when drinking alcohol, which is defined as up to one drink per day for women and up to two drinks per day for men.
  7. Sticking with these suggestions can help you to alleviate stress and enjoy a healthy holiday season with family and friends. Don’t beat yourself up over the occasional splurge. Just keep your focus and continue to set goals that keep you on track.

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    Keeping Holiday Stress at Bay (or under Control)


    For most of us, our lives are already busy, and with the holidays come additional burdens and stressors, from social obligations and cooking, to juggling out-of-town guests and kids on vacation. Stress drains us physically and mentally, making it that much harder to get enough sleep and maintain our exercise routines. Overeating is also common, especially when stress is combined with the many temptations of special foods and beverages. By thinking through your personal approach to stress, you can call on internal and external resources to help you enjoy the winter holiday season.

    Your Personal Stress Response

    When you feel stressed, your body undergoes a physiological change—your “fight or flight” response has been activated. Your heart rate increases, your muscles feel tense, you feel on alert. In essence, your body is giving you extra energy so you can deal with a perceived challenge.

    Take a minute to consider how you personally tend to respond to stress. If you have a sweet tooth, think ahead about how you can limit your access to sweets. If you tend to stop moving and become sedentary, can you find an exercise buddy and schedule weekly walks? Even short bursts of activity, like walking around the block or taking the stairs, can make a difference. If your weak spot is not getting enough sleep, try setting a go-to-sleep alarm on your smart phone. When it goes off, begin to ready your brain for sleep by turning from brain-busy activities to calmer ones.

    Setting Expectations and Limits

    Our outlook and expectations also can play a central role in how we manage the holidays. Picture this: Your neighbors are throwing a party, and they’ve asked you to bring all the appetizers. But you have gifts to wrap and want to spend time with your family baking. While you feel extremely overwhelmed and prefer to relax at home with your family, you feel a sense of obligation to please others.

    In this and other stressful holiday situations, try these stress-busters:

    • Think about your expectations. Be honest about what you want, and be realistic about what is possible. Then, try these two rules: Keep it simple. Don’t overcommit. Remember that you are not superman or superwoman; scale back your commitments. Don’t let “supposed to do” take the place of what you would like to do or what brings you enjoyment.
    • Accept people as they are. Don’t expect others to behave as you would like them to. This is a recipe for disappointment, if not misery. Recognize that the people in your life will celebrate the holidays as they want to and not the way you want them to. So don’t try to change or control them.
    • Remember, even the best-laid plans can go awry. This goes back to expectations. Expect that some problems are possible or even likely—inclement weather, delayed guests, an overcooked dinner. Try to approach unexpected challenges with an open mind, patience, creativity or a sense of humor.
    • Take a few slow breaths. Deliberately slowing your breathing for a minute or two calms your body a bit so that you can pause, think more clearly and choose an effective response to the situation.
    • Talk to someone. Discussing how you feel with a trusted supporter can increase your resilience. You will often find you are not the only one experiencing a particular problem.

    For some people and situations, stress levels can be too high to manage alone. If you are experiencing insomnia, chronic anxiety, panic attacks, or two weeks or more of low mood or lack of interest in activities you previously enjoyed, talk with your primary care. They can refer you to a specialist to help manage your stress.

    Remember, the holidays are short, as is life. Make the most of them!

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    Sage and Pecan Stuffing


    This recipe from Serious Eats is my new holiday tradition. The stuffing stays moist, provides grand flavor and best of all, keeps your vegetarian guests happy! To get the most out of this recipe, I highly recommend using the homemade stock available in the link below. It takes a bit of time but can be made in advance and adds so much to this recipe.

    Serves 10-14 Total Time: 2 hours (active time: 45 minutes)

    Ingredients

    • 2 1/2 pounds’ hearty rye bread (about 2 loaves), crusts removed, cut into 3/4-inch pieces
    • 1-pound button, cremini or shiitake mushrooms (or a mix), roughly chopped
    • 6 ounces’ pecan halves, toasted
    • 1/2 cup olive oil
    • 1/2 cup minced fresh sage leaves, or 1 tablespoon dried sage leaves
    • 1 large yellow onion, finely chopped
    • 1 large leek, white part only, finely chopped
    • 4 large ribs celery, finely chopped
    • 2 cloves garlic, minced
    • 4 cups Hearty Vegetable Stock (see note below)
    • 1/4 cup minced fresh parsley leaves, divided
    • Kosher salt and freshly ground black pepper

    Directions

    Adjust two oven racks to lower-middle and upper-middle positions. Preheat oven to 275 F, spread bread evenly in two rimmed baking sheets. Stagger trays on oven racks and bake until bread is completely dried, about 50 minutes total, rotating trays and stirring bread cubes several times during baking. Remove from oven and allow to cool.

    Increase oven to 350 F.

    In two batches, pulse mushrooms in food processor until roughly chopped, about 8 short pulses. Transfer to a large bowl. Place pecan halves in food processor (do not wipe out bowl) and process until roughly chopped, about 12 short pulses. Set aside.

    Heat oil in a large pot over medium-high heat until shimmering but not smoking. Add chopped mushrooms and cook, stirring frequently, until all moisture has evaporated, about 8 minutes. Add half of sage and continue to cook, stirring, until mushrooms are well browned, about 5 minutes longer. Add onion, leek, celery, garlic, and remaining sage and cook, stirring frequently, until vegetables are softened, about 10 minutes. Add stock, half of parsley and chopped pecans and bring to a boil. Add bread cubes and gently fold in until evenly mixed. Season to taste with salt and pepper.

    Transfer mixture to a greased 9x13-inch rectangular baking dish (or 10x14-inch oval dish), cover tightly with aluminum foil, and bake until hot throughout, about 30 minutes. Remove foil and continue baking until golden brown and crisp on top, about 10 minutes longer. Remove from oven, let cool for 5 minutes, sprinkle with remaining parsley and serve.

    Note

    This recipe includes a Hearty Vegetable Stock, which you must prepare beforehand. I strongly recommend using the stock recipe instead of store-bought vegetable stock, which I feel is universally inferior stuff. When making your own stock, add any extra vegetable or mushroom trimmings for extra flavor. If keeping the dish vegan is not of concern to you, feel free to substitute homemade or store-bought low-sodium chicken stock for the vegetable stock.

    Nutrition Information

    Serving Size: 1/10 of recipe

    Calories 550, Total Fat 25g, Saturated Fat 3g, Cholesterol 0mg, Sodium 500mg, Total Carbohydrate 60g, Dietary Fiber 11g, Sugars 3g, Protein 13g

    Recipe lightly adapted from J. Kenji Lopez-Alt from SeriousEats.com.

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Healthy Tips | Seattle Medical Clinic | Seattle Dietitian | Seattle Nutrition
Health Resources

HEALTHY TIPS – SEPTEMBER/OCTOBER 2018


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Breast Cancer: What’s the Risk?


Breast cancer remains the second-deadliest cancer in women (after lung cancer). It is important to know your personal risk factors, so you can reduce your risk through lifestyle changes and receive a breast-cancer screening that is tailored to you.

Learn Your Risk Factors

How often should you have a screening? What should your prevention strategy be? It all depends on your personal risk factors. Talk with your primary care provider about your situation.

Being female and getting older are your biggest risk factors. You are at higher risk if there’s a history of breast cancer in your family or if you have a BRCA1 or BRCA2 genetic mutation. But keep in mind: approximately 85 percent of breast cancers occur in women who have no family history of breast cancer. Other risk factors include starting periods at a young age, having your first baby after the age of 30 or never having children, being obese, and having dense breasts.

Make Lifestyle Changes

You can take positive steps to reduce your risk for many cancers. Some areas to explore: Are you getting enough exercise? Are you at a good weight? Do you smoke? Finally, how healthy is your diet? Are you eating more vegetables, fruits, beans and whole grains? How much your red meat, sugar and alcohol do you consume?

Your health care team can help you with all these lifestyle factors. For dietary inspiration, explore the recipes and ideas offered by the American Institute for Cancer Research.

Get Screened

Despite the value of knowing your risks, many breast-cancer cases develop without obvious risk factors. This is why age-appropriate breast-cancer screenings are essential for all women. The best approach to breast cancer detection is regular mammograms.

  • Mammograms should be performed every 1-2 years beginning at age 40, based upon discussion with your health care provider.
  • If you’re over age 75, the benefits of mammograms are less certain.
  • Knowing how your breasts normally look and feel can help you be aware of changes, which you can share with your provider.

Not Sure Where to Start? Ask the Right Questions

Here are some questions to ask your primary care provider at your next visit:

  • What testing should I get at my age?
  • What do I need to know about my family history that could put me at higher risk for breast cancer?
  • What can I do to prevent breast cancer or decrease my risk?

PacMed offers several options for primary care providers, an excellent place to begin a conversation about breast cancer prevention. Learn about our Primary Care team. We also invite you to explore our Women’s Health offerings and our Oncology department.

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Breast Cancer in Men


Yes, it’s much rarer for a man to get breast cancer. For US men, there’s a lifetime risk of about 1 in 1,000. Breast cancer in men is often diagnosed at a later stage. One reason for this may be that men are less likely than women to recognize or report symptoms to their doctor.

The Susan G. Komen Foundation offers these warning signs for men:

  • Lump, hard knot or thickening in the breast, chest or underarm area
  • Change in the size or shape of the breast
  • Puckering, dimpling or redness
  • Itchy, scaly sore or rash on the nipple
  • Inverted nipple or pulling in of other parts of the breast

If you have any concerns, contact your health care provider for a consultation.

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All About Flu Shots—Get Yours Soon!


Here comes flu season! Autumn is the best time to get your flu shot if you haven’t already. It takes about two weeks for the flu vaccine to give you protection. Make sure you understand what the flu is and how the flu vaccine works.

What is the flu?

The flu, also known as influenza, is an acute respiratory illness caused by influenza A or B viruses. These are found worldwide and are spread through sneezing and coughing. Typically, it takes one to four days from the time of exposure to the viruses to the onset of illness.

Symptoms include a fever higher than 100⁰ F, headache, muscle aches and weakness. Usually, flu symptoms come on abruptly. By comparison, with a cold you can often feel the symptoms coming on before you start feeling really lousy.

How does the flu vaccine work?

The flu vaccine introduces inactivated strains of the flu virus, which prompts your body to make antibodies to fight it. This means that when you are exposed to the live flu virus, your immune system recognizes it as an invader and goes to work on eliminating it from your body.

Who should get the flu vaccine?

Everyone older than 6 months should get the flu shot, especially those who have chronic illnesses like asthma, COPD, diabetes, heart disease or weakened immune systems.

Some people, however, should not get the flu vaccine. If you have any severe allergies to any part of the vaccine or have a history of Guillain-Barré syndrome, speak with your primary care provider before getting the shot.

Can I catch the flu from the flu vaccine?

The flu shot does not contain any live flu virus, so it cannot cause the flu. Some people do get a sore arm or redness where they got the shot. Sometimes, low-grade fever, headache or muscle aches can occur for a day or two.

Also, it takes about two weeks for the flu vaccine to give you protection. So, if you were exposed to the flu right before you got the vaccine, you may still get sick.

Learn about PacMed Flu Clinics in your area. Looking for a primary care provider? The PacMed primary care team offers a wide range of options, from pediatricians to family medicine and internal medicine providers

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PacMed Flu Shot Clinics


Our drop-in clinic for flu shots is the quick and easy way to get you and your family vaccinated. PacMed will bill your insurance company, or you can pay cash.

>>>>> Visit our Flu Clinic page to learn times, locations and other details. <<<<<

The flu shot helps protect you, your family and your community from getting the flu. It’s the smart thing to do! For more information, please call PacMed’s flu line at 206.621.4015

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Flu Prevention with Handwashing


We have all watched someone quickly rinse their hands in a restroom and rush out the door—or skip the sink altogether. Body fluids and viruses are invisible to the naked eye, but these germs are everywhere. They contaminate commonly touched surfaces like handles, doors, walls, counters and paper dispensers.

To help your family avoid the flu, there is no substitute for handwashing. Disposable hand wipes or gel sanitizers also work well, although they don’t remove dirt and grime.

Handwashing is one of the most effective ways to stop disease.

Wash your hands often: always before eating or preparing food, and always after using the bathroom or changing a diaper.

  1. Soap and water work well to kill germs. Rub your hands briskly.
  2. How long? At least 20 seconds—try humming “Happy Birthday” through twice.
  3. Most people miss the backs of the fingers and thumbs … fingertips … the creases in the palms.
  4. Use a paper towel to turn off faucets and to open the door.

With flu season here, give your hands the soapy wash they deserve. Take two minutes to safeguard your health—and wash your hands

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Nutrition for Cancer Prevention


By Kathleen Bradley, RD, CD, PacMed

Western countries have diets statistically high in fat, sugar and animal products—and also have high rates of colorectal, breast and prostate cancers, according to the National Institutes of Health. Being overweight also can increase the risk for several common cancers.

Fortunately, what you eat is one of the cancer risk factors you have the power to alter. Here are four dietary factors to prompt you to eat more healthily.

  1. Fiber and other cancer-fighting nutrients. Studies show that fiber may protect against cancer. Fiber is found in vegetables, fruits, whole grains and legumes. But the average US citizen consumes only half of the recommended 25-30 grams of fiber per day. To get more, aim to fill half your plate with fruits and vegetables, and make at least half your grains whole grains.
  2. Fat intake. Recent studies show that consuming too much fat affects cancer risks. The average US diet contains about 37 percent fat. The National Cancer Institute suggests lowering your intake to 30 percent—and other studies find that going well below 30 percent may have an anti-cancer effect. To make a change in fat intake, cut back on saturated fat sources like meats, processed snack foods and desserts. These foods have lots of calories from added sugars and solid fats, but few nutrients.
  3. Meat. Smoking, salting, adding nitrates and cooking at high temperatures can convert meats into cancer-causing compounds within the colon. Your best bet is to limit processed meats and instead eat a variety of fish, skinless poultry and lean cuts of pork and beef. Also consider eating plant-based sources of protein such as beans, nuts and soybeans more often.
  4. Alcohol. Excessive intake of alcohol raises one’s risks for cancers of the breast, mouth, pharynx and esophagus, as well as potential stomach, liver and colon cancers. Alcohol is considered more harmful when combined with smoking. The Academy of Nutrition and Dietetics recommends limiting alcoholic drinks—if consumed at all—to one serving daily for women and two for men. (A serving of alcohol is 1½ fluid ounces of hard liquor, 5 fluid ounces of wine or 12 fluid ounces of beer.)

Nutrition guidelines for cancer prevention are similar to those for preventing other diseases such as heart disease and diabetes. Work with your primary care provider or a dietitian to gage your overall dietary health or take this quick survey.

For more information about PacMed and our dietitian services, please visit our PacMed Dietitian page or call 206.505.1300

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Pomegranate Salsa with Salmon


This cancer-fighting recipe includes healthy fats, antioxidants and lots of flavor. Never had pomegranate molasses before? It’s a unique combination of sweet, sour and salty that can be used in other Mediterranean-style dishes like dips, salad dressings, cocktails and sauces.

Note: Prepare quick pickled onions and salsa 1 hour to 1 day in advance. This allows these condiments to get good flavor, and it makes dinner preparation go very quickly! If you’re short on time, use raw red onion in place of the quick pickled onions described below.

Ingredients

  • 1 lb. salmon filet
  • 1 lemon, thinly sliced

Quick pickled red onions:

  • 1 red onion
  • 2 cups very hot (but not boiling) water
  • ½ cup rice or white-wine vinegar
  • 1 cup cold water
  • 2-3 tablespoons white sugar
  • 5 peppercorns
  • ¼ teaspoon red pepper flakes
  • ¼ teaspoon salt

Pomegranate salsa

  • 1 cup pomegranate arils (seeds), fresh or frozen
  • ½ apple, finely chopped
  • 1 tablespoon pickled red onion (see below), chopped
  • 2 teaspoons jalapeno pepper, finely chopped
  • 2 teaspoons pomegranate molasses* or 2 tablespoon pomegranate juice
  • ¼ teaspoon salt
  • Freshly ground black pepper
  • ¼ cup chopped cilantro

Directions

  1. Prepare quick pickled onions 1 hour (or up to a few days) in advance. Cut onion in half, remove peel and slice into very thin half-moons. Place in a bowl, add hot water and let sit 1 minute. Drain onions. Add vinegar, cold water, sugar, peppercorns, pepper flakes and salt, and stir to dissolve sugar. Cover and chill for at least one hour.
  2. Preheat oven to 350 degrees F.
  3. Prepare salsa. In medium bowl, use fork to combine pomegranate arils, apple, onion, jalapeno, pomegranate molasses and 3-4 grinds pepper. Mix in cilantro. Let salsa sit for 10 minutes so flavors can meld. Here’s the easy way to remove pomegranate arils.
  4. Place salmon on a baking sheet and top with lemon slices. Bake fish for 10-15 minutes, depending on the filet’s thickness, until internal temperature reaches at least 145 degrees F.
  5. Serve salmon with salsa and pickled onions.

Salsa keeps for 2 days, tightly covered in refrigerator. It also goes well with chicken, turkey, pork chops or grilled shrimp. Sprinkle over green salad, combine with cooked quinoa or add a spoonful to garnish a bowl of butternut squash soup.

*You can buy pomegranate molasses online or in specialty stores like Whole Foods or PCC Markets.

Recipe adapted from the American Institute for Cancer Research; Dec. 30, 2014, Issue 537.

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From the Living Well Alliance—Don’t Let Autumn Stall You! Keep Moving at Work


Autumn exercise can seem like such a challenge because of the cooler weather and darkness outside. Children are heading back to school. Our schedules feel busier. And yet, physical activity helps not only the body, but also the mind. When we are active, we are better able to focus and be productive at work. We also feel happier and less stressed, and we tend to get more quality sleep at night.

So how can you stay active this fall? Try these tips for moving more at work.

Minimize the time you spend sitting. The average time sitting at work is 6.2 hours. Researchers say these long hours of sitting correlate to greater risk for heart disease and diabetes. And unfortunately you can’t undo these periods of sitting with one longer workout after work. So, it’s important to interrupt long periods of sitting with consistent movement.

Get up and move. To keep your muscles, joints and mind’s productivity at their best, sit for no more than 30 minutes at a time. Take a two-minute moving break at least twice an hour to stretch or walk around. Stand up, move about, try some stretches. Try these resources on Stretches and Walking Your Way to Health.

Find exercise you like to do! Whatever you choose, you have to enjoy it to keep up a routine. For example, if you hate squats, use the same muscles by taking a walk up a slight hill instead. Don’t want to get out your biking gear? Maybe a jump rope would be quicker and easier workout for you.

Get a friend or colleague to join you. Peer pressure isn’t always bad, especially around exercise. Have a friend join you on a morning walk for a chance to catch up on each other’s lives.

Work different muscles throughout the day. We often forget about our upper body (think T-Rex arms), so try some of these exercises using a resistance band. These bands are easy to store at work and are affordable.

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Healthy Tips | Seattle Medical Clinic | Seattle Dietitian | Seattle Nutrition
Health Resources

HEALTHY TIPS – JULY/AUGUST 2018


Topics This Issue:


A Leopard Isn’t the Only Animal with Spots…


We humans have them, too! How do we avoid skin spots—and which ones are cause for concern? Can nutrition help? What about collagen? Read our 4 newsy bursts below!.

1. Going outside?

We all know the sun is bad for our skin—but hey, we live in cloudy Seattle, right? Wrong! Even on drizzly summer days, 80 percent of the sun’s harmful ultraviolet rays still reach your skin. If you are going to be out for more than a few minutes:

  • Always wear a sunscreen with a sun protection factor (SPF) of at least 30 on all exposed skin.
  • Cover all the skin you can.
  • Avoid the sun between 11 a.m. and 3 p.m., when it is most intense.
  • Seek the shade when possible.

2. What’s that spot? When in doubt, check it out.

Many common growths occur on the skin, and it can be difficult to know which lesions may be suspicious. The best bet always is to see your physician when you have questions or concerns.

You also should examine your skin regularly, at least every three months—every square inch! Be proactive about your skin health and watch for new or enlarging pigmented (brown) spots, especially if they are irregular in shape or color. Any new pink or red bumps that persist and enlarge over several months are of concern, especially if they are crusty, bleed or scab easily.

3. Eat your vitamins!

These four antioxidant nutrients can help promote healthy, radiant skin. Try our tips to incorporate foods rich in these nutrients into your daily diet.

  • Vitamin A: decreases cell damage and helps the healing process of wounds. Increase your intake of sweet potatoes, carrots, spinach, apricots, cantaloupe and other yellow and orange fruits and vegetables.
  • Vitamin E: helps protect against skin damage and plays anti-inflammatory roles in the skin. Try grabbing some sunflower seeds and almonds for your afternoon snack.
  • Vitamin C: plays an important role in the synthesis of collagen, a major protein in the skin. Include broccoli, red peppers and green peppers in your favorite dishes, and enjoy oranges, strawberries or kiwi for dessert.
  • Omega-3 fatty acids: may include a protective effect against sunburn and premature aging. Your body can’t make them; you have to get them through food. So, make sardines, tuna or salmon for dinner tonight.

4. Instant youth with collagen?

You may be hearing lots of push in advertising for collagen peptide supplements and other skin products. Collagen is a protein in our bodies, particularly the skin, hair, joints and nails. As we age, we gradually lose collagen, and our skin begins to look less moist and full.

So, will using collagen change the effects of time and age? It’s hard to say. Research is tricky when it comes to skin products. It’s hard to isolate whether the product is making an improvement, or whether some other aspect has played a role—like a change in diet, humidity, sleep or hydration.

The jury is still out. Collagen is generally safe and tolerated by most people. In the long run, however, you might do better to save your hard-earned cash and follow the sun-smart tips above for long-term preventive care.

Meet the Dermatology team at PacMed. We also invite you to learn more about our dietitian services. Call 206.505.1300 for an appointment.

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Staying on Top of Back-to-Scholl Anxiety and Bullying


As summer slips away, children may experience a range of emotions for the coming school year—excitement, nervousness, anxiety. The new school year presents many unknowns for a child: Will my teacher be strict? Will I get picked on? Will I make the sports team? Here are proactive steps you can take to combat back-to-school anxiety, including knowing the signs of bullying.

Alleviating Anxiety

Parents can help alleviate young students’ concerns before school begins through consistent emotional and mental support. Some ideas include setting up a bedtime routine at least two weeks before school starts to help ease your student into the school season. Also, take advantage of any scheduled events to meet teachers, classmates and families before the first day; this can help to ease nerves. Finally, be attentive to your child’s concerns. Well before school begins, start having consistent one-on-one conversations about your child’s day. Listen and validate any worries they express. Let them know they can come to you with any issues.

Watching for Bullying

Once school starts, a common source of anxiety for children is bullying. A bully is someone who asserts his or her power by repeatedly being aggressive toward a weaker person. Some types of aggression include physical (such as hitting, stealing and threatening posturing); verbal (such as name calling, public humiliation and intimidation); and behavior focused on relationships (like spreading rumors, social rejection and ignoring).

Here are some signs that can appear in a child who is being bullied:

  • Unexplained bruises or other injuries
  • Lost or damaged clothing, books or electronics
  • Frequent headaches, stomach aches or “invented” illnesses to stay home from school
  • Severe anxiety, nightmares, depression
  • Bullying younger kids or siblings (bullied children may switch roles and become the bully)
  • Weight loss or weight gain
  • Inconsistent mood swings, secretive or sullen behavior, temper outbursts

If bullying becomes a recurring issue, don’t hesitate to address the issue directly with the school. Come to the meeting with specific examples, and remember to be respectful as you work together to determine a plan of action.

Keeping Track with a Well-Child Checkup

Now is a good time to get your child in for their annual checkup. Your child’s doctor will check their height and weight, look at other signs of healthy development, screen for childhood diseases, and check for needed vaccinations. If your child has been affected by bullying, you can also talk with their provider about healthy ways to support your child.

We wish you and your children a respectful, healthy and interesting school year.

If you and your family are looking for a primary care provider, please explore the PacMed Family Medicine and Pediatrics providers. We have 10 clinics in neighborhoods around Lake Washington and the south Puget Sound region.

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Fueling Your Student-Athlete


Participating in a school sports programs is a great way for adolescents to develop muscular strength, boost confidence and inspire camaraderie. When participating in sports on any level, eating the right balance of nutrients is essential.

For athletes looking to build muscle and strength, understanding caloric intake and proportions of different macronutrients (carbohydrates, fats and protein) is key. Young athletes, in general, need more calories than adult athletes because of their faster growth and metabolic rates. Eating regular, well-balanced meals each day helps the body get nutrition, balances blood sugar levels and provides the foundation for a strong, healthy body.

Carbs Fuel Explosive Power.

Carbohydrates are the main source of energy for an athletes’ explosive power. About 45-65% percent of the athlete diet should be whole forms of carbohydrates, such as whole grains, quinoa, legumes (beans and lentils), fruit, and starchy vegetables, such as sweet potatoes. Carbohydrates that come naturally with fiber, such as oats and winter squash, help control blood sugar for long-term energy.

Healthy Fats Are Critical to Endurance.

During the first two minutes of high-intensity exercises, all energy generated comes from carbohydrates. As exercise time increases, however, the calories the body burns start to transition from carbohydrate stores to the fat stores—meaning that it’s important for athletes to also include healthy fats in their diet. At most, 30 percent of total caloric intake should come from healthy fats such as nuts, salmon, avocado, omega-3 eggs and grass-fed meats. All of these also help with inflammation and are good for joint health.

Protein Builds and Repairs Muscle.

In our western diet, protein deficiency is generally not an issue; we eat plenty of protein. Also keep in mind that protein is not the main energy source for the body, unlike carbohydrates so young athletes should not overdo protein in hopes of gaining muscle faster. For young athletes up to age 18, protein should comprise 10–30% of total energy intake. Some good sources of protein are lean meat and poultry, fish, eggs, dairy products, and beans and nuts.

Healthy Fluids Oil the Machine.

For the most part, it is a myth that sports drinks keep athletes hydrated better than water. Generally, sports drinks should be considered only for high-endurance and high-intensity sports in which the participant is sweating heavily and exerting themselves for greater than 90 minutes. Otherwise, water is enough to hydrate … plus it’s cheap and readily available! And while some youth often think that sugary or caffeinated beverages will give them an energy boost, these in fact can cause a rapid rise in blood sugar, which can lead to a subsequent energy crash.

A good rule of thumb? Drink when you are thirsty. If properly hydrated, urine should be very light yellow to clear in color. If it’s yellow or dark yellow, you need more fluids.

Without proper fuel and nourishment, the body cannot attain its full athletic potential and is more susceptible to fatigue and injury. To learn more, the dietitians at PacMed are available to support your young athlete. Should any of the athletes in your family experience injury, the doctors in our Sports Medicine department can help diagnose and treat them.

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Back-to-School Lunch Nutrition Tips


When it comes to feeding your children, it can be stressful—especially once school starts. For starters, there’s the time it takes to prep and cook. Add to that the worry about whether they will even like what you prepare. Their preferred foods may be an easy, quick option, but they often aren’t the healthiest choices. Because children are still growing, they need nutritious foods to support the development of their bones, muscles and brains. What’s a parent to do?

A few things to consider for success:

Know your time-saving tips. Use the three Ps of meal planning: Plan, Purchase and Prepare. To save time and money, plan several meals before you head out to shop. When you go to purchase ingredients, be smart at the grocery store and use a list to stay on track. If possible, avoid going when you are stressed or hungry. Finally, set some time aside on the weekends or in the evenings to prepare ingredients: do some cutting, cooking and assembling for the week. Try cooking your grains and proteins for the week all at once or precutting vegetables and fruits so they are ready for lunches and snacks. Still strapped for time? Use frozen or pre-cut vegetables and fruits.

Get the kids involved. Children who help with meal prep tend to be better eaters and more willing to try new foods, so get them in the kitchen! If your child is 6 or older, give them more power to pick out healthy items at the store for their lunch and then to help pack their lunch bag. Try using the terms “growing foods” for foods that are nutrient rich and “fun foods” for those that taste good but are eaten less often or for special occasions. A challenge: can you and your kids find growing foods that are also fun?

Develop healthy eaters. To help children grow an open, healthy attitude to food, follow dietitian and therapist Ellyn Satter’s wisdom about the division of responsibility. In her approach, adults are responsible for choosing and preparing foods for their children, providing regular meals and snacks, and letting children grow into the bodies that are right for them. The children’s job is to eat the amount that is right for them, learn to behave well at mealtimes and grow predictably in the way that is right for them. When done consistently, children tend to be less picky and more willing to try new things. Read more stories about the division of responsibility in feeding to start a new mealtime strategy.

Use the healthy plate guideline. For a healthy plate, include at least three food groups in every meal to ensure balance. Children tend to need snacks between meals to keep themselves going, so make these snacks more like mini meals with veggies and fruits, proteins and fiber-rich grains. Avoid empty-calorie options like chips or cookies. For more meal ideas, use our helpful lunchtime planner!

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Recipe: Camping Quesadilla


Eating healthy while camping can be a challenge since most nutritious foods tend to need refrigeration. Being a regular camper myself, I’ve learned some tricks to packing a cooler with vitamin-rich foods. 1) Choose hardy vegetables that last longer such as carrots and dark leafy greens like kale, broccoli and collards. 2)Put all foods in sealed plastic baggies or water-tight containers, including precooked meats, cheeses and dips like hummus. 3) Avoid taking raw meats (or eat them at the beginning of your trip to avoid contamination). 4) Layer your drinks at the bottom making a flat shelf for the foods on top. 5) Be prepared to restock ice halfway through your trip to prevent food borne illness. —PacMed dietitian Christy Goff, RDN

Who wants to make a four-course, fresh meal in the woods?! Try this simple, vegetable-laden quesadilla, being sure to keep perishable ingredients chilled until dinnertime. For even simpler preparation, precut/prechop vegetables, measure and store together in a sealed container or baggie. Consider adding a salad or carrot sticks!

Serves 2. Prep Time: 20 minutes (includes marinating time). Cook Time: 15 minutes

Ingredients

  • 2 teaspoons olive oil
  • ¼ onion, finely chopped
  • ¼ cup broccoli, finely chopped
  • 3 button mushrooms, sliced thinly
  • 2 large whole wheat tortillas
  • 2 tablespoons refried black beans
  • ½ cup shredded cheese, perhaps a cheddar blend
  • ½ cup of precooked shredded chicken
  • ½ cup guacamole

Homemade guacamole:

  • 1 avocado
  • Juice of ½ lime
  • Salt and pepper to taste
  • Optional: red pepper flakes, diced tomato, garlic powder

Directions

On camping stove, place heavy frying pan over medium heat and add oil. Add onion, broccoli and mushroom and sauté until golden brown and starting to wilt, about 6 minutes. Remove vegetables to bowl and set aside. In frying pan, add one tortilla and spread with refried beans. Sprinkle half (¼ cup) of the cheese on top and add cooked vegetables, chicken and remaining ¼ cup of cheese on top. Place second tortilla on top and cook 3-4 minutes. To flip quesadilla and cook other side, place a plate over the quesadilla in the pan and flip the pan over, placing the quesadilla onto the plate. Now slide the quesadilla off the plate and into the pan. (This maneuver tends to keep the quesadilla from falling apart!) Cook another 3-4 minutes until cheese has melted and tortilla is lightly browned. Serve with guacamole.

Nutrition Information per Serving (1/2 recipe)

Calories: 398, Total Fat: 23g, Sat. Fat: 7g, Cholesterol: 48mg, Sodium: 680mg, Total Carbohydrate: 34g, Dietary Fiber: 7g, Sugars: 0g, Protein: 22g

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Events: PacMed Back-to-School Bash and Giveaway!


Come join us at our Federal Way clinic (Aug. 8) from 5:30-7:30pm or Canyon Park clinic (Aug. 25) from 12-2 pm. We have lots of free fun planned—like door prizes, face-painting, games and snacks. And while supplies last, we will give away school backpacks at Federal Way and lunch bags at Canyon Park to children. Come have fun and meet some of our providers!

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The Living Well Alliance—Summer Classes for Your Employees!


Happy summer! The Living Well Alliance™ (LWA) would like to remind you of our favorite wellness programs.

Our team continues to help local companies reach their employee wellness goals by providing complimentary services – including biometric screenings, health fairs and one wellness class each year. Don’t forget to schedule your LWA programming soon, as fall will be here before you know it!

With our 2018 webinar subscription program, you can offer your organization more wellness initiatives on a regular, monthly basis! Because we are now halfway through 2018, we’ve prorated our monthly subscription to just $200 for 6 webinars for your whole company to enjoy. What a deal!

Lastly, we’d like to share some of our most popular summer wellness topics:

  • Fight with Food: Nutrition for Cancer Prevention. Nearly 50% of most common cancers can be prevented! In this class, you will learn what cancer is and the common types, review risk factors to avoid, and gain positive lifestyle interventions that have been shown to lower your risk.
  • Brain Boost. With all the fresh produce available in our area, it’s easy to choose foods that energize and protect the brain. You can choose to include a cooking demo at no additional cost other than food supplies.
  • Food for Thought. This class reviews the importance of mindful eating in our busy summer lives and offers a good basis for thinking about long-term health goals.
  • Plant Forward Nutrition. Want to understand different plant-based diets? We will review the research on these diets and the different types out there. Want to taste some plant-focused foods? Add in a cooking demo at no additional cost other than food supplies.

Classes from the Living Well Alliance help you provide wellness programming to your employees. These 45-minute, in-person classes are interactive, fun and current—an easy fit for your worksite.

Learn more about scheduling Living Well Alliance events for employees by contacting Christy Goff, RD, by email or at 206.621.4419.

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Healthy Tips | Seattle Medical Clinic | Seattle Dietitian | Seattle Nutrition
Health Resources

HEALTHY TIPS – MAY/JUNE 2018


Topics This Issue:


Osteoporosis 101


This “silent disease” causes bone tissue and mass to deteriorate over time. As the bones thin, lose density and become frailer, there is a higher risk for serious fractures. Because osteoporosis takes place gradually over years, people may not know that they have an issue until a sudden strain or fall causes a fracture. This is why screening is so critical.

Older women are particularly susceptible to osteoporosis. Risk factors include:

  • Being female
  • Going through menopause
  • Male or female - being slim and less than 130 pounds
  • Smoking cigarettes
  • Drinking excess alcohol (more than three glasses daily)
  • Having a first-degree relative with osteoporosis
  • Age—the older you are, the greater your risk

Screening for osteoporosis involves a bone density scan.

This quick, painless procedure uses an enhanced, low-radiation form of X-ray technology called DXA (pronounced “dexa”). Generally, a DXA screening for women over age 65 is highly recommended. Men over 70 should discuss screening with their primary care doctor. Of course, if you have risk factors, ask your doctor for guidance at any time.

So, what preventive steps can you take?

Two key steps are to get the daily recommended amounts of calcium and vitamin D, and to consistently engage in weight-bearing, impact-based activity. See our related articles on walking and good bone nutrition! Talk with your primary care doctor for guidance.

Find a primary care provider at PacMed! Already diagnosed with osteoporosis? Learn more about our Rheumatology team.

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Cataracts 101


What is a cataract?

A cataract is a clouding of the lens in the eye. Just like a camera with a smudged lens, if the eye’s lens is cloudy, the quality of vision will be poor.

What are the symptoms of cataracts?

A person with a cataract may notice that their vision has become blurred or duller. They may have trouble reading or identifying colors, in particular blues and purples. Night vision may be compromised and light-sensitive; for example, headlights may seem too bright or have streaks radiating from them.

Who is at risk?

Although most cataracts occur in older people due simply to aging, cataracts also can be caused by surgery, steroid use, exposure to radiation or an eye injury. Some diseases such as diabetes can contribute to your chance of developing cataracts earlier.

Can I reduce my risk?

You may be able to reduce your risk of a cataract. Here are some tips:

  • Avoid UV exposure. Wear a brimmed hat and sunglasses or regular clear glasses with a UV coating.
  • Get good nutrition—in particular, green, leafy vegetables, fruit and other foods with antioxidants.
  • Receive regular, preventive eye care from an optometrist or ophthalmologist. A typical eye exam is painless. Your eye doctor will track your vision health over time and answer your questions.

How are cataracts treated?

Nonsurgical treatments aim to improve vision as much as possible. These include altering glasses prescription and adding a tint to cut glare. Reading in good light and choosing books with a larger font are other steps. Surgery may be recommended once the symptoms have progressed to a point that it interferes with your daily activities. In cataract surgery, the cloudy lens is replaced with a clear artificial lens called an intraocular lens.

The PacMed Optometry team can assess your eye health, and our Ophthalmology department offers cataract surgery.

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What's Cooking: Tofu Banh Mi


A traditional Vietnamese banh mi is typically made with pork, but this vegetarian makeover uses crispy tofu, vegetables and zesty sriracha mayonnaise. Tofu, an excellent source of protein, iron and calcium, will keep up your energy and bone health, and it’s a great, affordable option for your meatless Mondays.

Serves 5. Prep Time: 50 minutes (includes marinating time) Cook Time: 15 minutes

Ingredients

  • 12 ounces (1 package) extra-firm tofu
  • ½ cup low-sodium soy sauce
  • 1 teaspoon grated ginger
  • 1 clove garlic
  • 3 radishes, sliced thinly
  • 3 tablespoons rice vinegar
  • ¼ teaspoon ground black pepper
  • ¼ cup mayonnaise, or veganaise if avoiding animal products
  • 2 tablespoons sriracha hot chili sauce
  • ½ teaspoon lime zest
  • 1 tablespoon canola oil
  • 1 carrot, cut into matchsticks
  • ½ cucumber, peeled into ribbons
  • 1 avocado, mashed
  • 1 jalapeno, thinly sliced, seeds removed (optional)
  • ½ cup fresh cilantro leaves
  • 20-inch baguette

Directions

1. Cut tofu into five 1-inch thick slabs. Combine 1 tablespoon water, soy sauce, ginger and garlic in an 8"×8"baking dish. Arrange tofu in the marinade in a single layer and cover with plastic wrap. Refrigerate for 15 minutes, then turn tofu pieces and refrigerate another 15 minutes.

2. To quickly pickle, place radishes, vinegar, black pepper and 2 tablespoons water in a small bowl. Cover with plastic wrap and store in the refrigerator until ready to use.

3. Stir together mayonnaise, sriracha sauce and lime zest. Set aside.

4. Heat canola oil in a non-stick skillet over medium-high heat for 2 minutes. Arrange tofu in a single layer in the pan. Cook for 5 minutes on one side or until lightly browned. Flip tofu and cook another 5 minutes until browned. Transfer to a plate to cool slightly.

5. Prepare carrots, cucumber and avocado as described in ingredients list.

6. To assemble sandwiches, slice baguette in half lengthwise. Evenly spread 5 tablespoons sriracha mayo on bottom half of baguette and 5 tablespoons mashed avocado on the top half. Place tofu slabs on the bottom half. On top of tofu, evenly distribute cucumber ribbons, carrots, radishes, optional jalapeno and cilantro. Put upper half of baguette on top and cut into five 4-inch sandwiches.

Nutrition Information

Serving Size: 1 sandwich

Calories 362 Total fat 13g Sat. fat 2g Chol. 0mg Sodium 841mg Carb. 48g Fiber 6g Sugars 4g Protein 17g

Adapted from original recipe by Deborah Murphy, MS, RDN: https://foodandnutrition.org/blogs/stone-soup/kikkoman/vegetarian-banh-mi-sandwich/

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Nutrition Corner: Eat Right for Strong Bones and Good Vision


Bone Health: Increasing your intake of dietary sources that are rich in calcium, vitamin D and magnesium can support a personal health goal to maintain strong, resilient bones. As always, work closely with your medical provider to create a care plan that’s right for you.

Calcium

Calcium is found in dairy products (for example, milk, yogurts and cheese), fortified juices, canned salmon and some plant sources such as tofu. Try making “tuna melts” with salmon instead of tuna, or enjoy plain, low-fat yogurt with fresh fruit for a mid-morning snack. Other excellent sources are figs, cooked bok choy, sardines, almonds, sesame seeds and cooked white beans.

Vitamin D

Vitamin D is in milk and some yogurt and can also be found in eggs, mushrooms and some fortified foods. Starting your day with a hardboiled egg or having a glass of milk instead of your midday soda can help.

Magnesium

Foods rich in magnesium include green leafy vegetables, whole grains, beans and nuts. Fresh fruits and vegetables also provide a modest amount of magnesium.

Eye Health: Studies have shown that some nutrients may help prevent age-related macular degeneration (AMD), a common eye condition and the leading cause of vision loss in people over 50 years old. But are supplements the best path forward to ensuring you eat the right nutrients for good eye health?

While specific vitamins and supplements are promoted as beneficial, experts agree that the best method is to consume a varied diet that’s rich in antioxidants, lutein and zeaxanthin. Sounds easy enough. But what food items contain antioxidants, lutein and zeaxanthin?! Try these recommended sources:

  • Most fruits and vegetables, but especially dark green vegetables and yellow and orange vegetables and some yellow and orange ones such as: corn, nectarines, oranges, papaya, squash and sweet potatoes.
  • Egg yolks

In addition to diet, certain lifestyle factors can also affect eye health. Be sure to exercise regularly, avoid smoking, and maintain normal blood pressure, blood sugar and cholesterol levels. Check in with your eye care professional on a regular basis as well.

Learn about the dietitian services at PacMed. Or call to make an appointment: 206.505.1300.

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Walk Your Way to Health!


Walking is a simple and enjoyable activity that offers many health benefits. Just 30 minutes a day can improve your heart health and lower your risk for high blood pressure, high cholesterol and diabetes.

Because walking is a weight-bearing exercise, it helps maintain strong bones. Bone is living tissue, and it gets stronger when you exercise. Specifically, weight-bearing and muscle-strengthening exercise helps to increase bone density such as walking, climbing stairs, jogging, dancing, tennis and lifting weights.

It’s easy to get started with a regular walking routine. If you aren’t a walking enthusiast already, start small. Even if you begin with just 5 to 10 minutes each day, you can gradually work up to 30 minutes of brisk walking in no time! Just gradually increase your time each week as you get in better shape.

Too busy? Break your target walking time into smaller chunks and spread them out during the day. You will still get health benefits. Here are some ideas to fit more steps into your day:

  • Take your dog for a stroll.
  • Go to the store or post office—on foot!
  • Walk over to a colleague to ask a question instead of sending email.
  • Get off the bus one stop earlier to walk the rest.
  • Park farther away from your office, and use the stairs instead of the elevator.
  • Golf—without the cart!
  • Hike with a friend at a local park.
  • Window shop at the mall or downtown.

Before you know it, walking can be a part of your daily routine!

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June Wellness Symposium for HR Professionals


Attention HR employees—Save the date for our complimentary wellness symposium!PacMed’s Living Well Alliance team is hosting this event to share ideas on ways to enhance your company’s wellness initiatives.

Wellness Symposium

Thursday, June 14

10:00 a.m.–2:30 p.m.

(Lunch included)

PacMed Beacon Hill campus

1200 12th Ave S Seattle, WA 98144

This lively event will include speakers and roundtable sessions on how to get your employees engaged. Hear from local experts on heart health, behavioral health and a yoga expert for stress-reduction tools. Bring home resources and possible raffle prizes from Lululemon, Steven’s Pass ski lift tickets and more! Join us for this complimentary event. Lunch will be included.

Look for your invitation by email, or contact Christy Goff at PacMed for more details or to RSVP today.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 1.855.550.8799 for more information or email .(JavaScript must be enabled to view this email address).

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Healthy Tips | Seattle Medical Clinic | Seattle Dietitian | Seattle Nutrition
Health Resources

HEALTH TIPS – MARCH/APRIL 2018


Topics This Issue:


A Colonoscopy Can Save Your Life


When found early, colorectal cancer is easier to treat and highly curable. This is good news because colorectal cancer has some pretty dire statistics: it is the third leading cause of U.S. cancer deaths, and there is a 1 in 24 chance of developing it.*

So why take your chances and risk going undiagnosed? Proper screening can detect colorectal cancer early. It can also help eliminate pre-cancerous polyps that could become cancerous if left to grow.

Symptoms

Colorectal cancer—commonly called colon cancer—often has no symptoms. This is why screening is so important. These symptoms, however, might indicate colorectal cancer:

  • Change in bowel habits
  • Rectal bleeding or blood in your stool
  • Persistent abdominal discomfort
  • Nausea or vomiting
  • Unexplained weight loss
  • Chronic fatigue

Steps You Can Take

If you are over 50 or have a family history of colorectal cancer, talk to your doctor about getting screened today. The more you know, the better you can take care of your health.

A colonoscopy is one important screening test. The procedure takes just 15 to 30 minutes. During the test, a doctor looks inside the entire large intestine and into the rectum using a long, flexible, narrow tube that has a light and tiny lens on the end. The doctor can see things such as abnormal growths and inflamed tissue.

Other preventive steps include maintaining a healthy weight, being physically active and eating a healthy diet.

Learn more about colonoscopies at PacMed.You can make an appointment with one of our gastroenterologists** by calling 1.844.66.COLON (1.844.662.6566).

*Source: American Cancer Society.

**Always check with your insurance provider to find out if you need pre-authorization or to determine the level of coverage your insurance carrier provides for colonoscopy.

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Spring into Action


Thank goodness spring has sprung, yes? We can stop climbing the walls, wishing for warmth and daylight, and finally get outside and MOVE those limbs!

Be sure to ease into new activity, stretching before and after and increasing your activity level with each outing. You’ll want to hydrate and fuel your body with healthy proteins and fruits and vegetables. Feeling a bit out of shape or have other health concerns? Be sure to talk with your primary care provider.

Some ideas for spring activity:

  • Dig in—Now’s the perfect time to start preparing a vegetable garden. Weeding and pruning are excellent exercise too.
  • Dig out—It can be hard to garden when you can’t find your tools. Choose a sunny day to clear out your shed, reorganize your deck’s closet or sweep out the garage.
  • Connect—Outdoor time shouldn’t all be work, of course. Grab the family or some friends and pick a park for a walk or game of catch. Aren’t we lucky? Our region has some amazing green spaces to explore!
  • Tune out—Check community boards and neighborhood gyms for outdoor classes in yoga, tai chi or “boot camp.” It’s never too early to spread your toes in the grass.

Still working out the kinks? The PacMed Physical Therapy department can help. And if you are looking for a primary care provider, check out our Primary Care team. We have nine neighborhood clinics.

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Colon Health: Diverticulitis


Patients suffering from a bout of diverticulitis can usually point right to it: belly pain in the lower-left abdomen. Diverticulitis happens when the wall of the colon develops small weak places that turn into pouches. These pouches, about marble sized, are called diverticula. If the diverticula tear and become infected, you experience the symptoms of diverticulitis.

Symptoms of diverticulitis include:

  • Belly pain, usually in the lower left side—the most common symptom
  • Fever, chills
  • Bloating, gas
  • Diarrhea or constipation
  • Nausea, sometimes vomiting
  • Low appetite

If you think you have diverticulitis, call your provider, explain your symptoms and make an appointment.

Possible Role of Fiber

Medical researchers aren’t sure what causes diverticula to develop. Many adults have them, although they don’t always become a problem. A low-fiber diet may be one reason. Fiber adds bulk to your body’s stools; without that bulk, your body must work harder to push hard stools out. That pressure may cause the pouches to form.

You may be able to avoid diverticulitis by eating a high-fiber diet, drinking a healthy amount of water and exercising regularly. A diet high in fiber includes fresh fruits, vegetables, beans and whole grains. Please see our article—Nutrition Corner: Increasing Dietary Fiber.

If you have concerns about your digestive health, talk with your primary care provider, or make an appointment with a PacMed gastroenterologist. These highly trained specialists treat disorders of the digestive system.

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Nutrition Corner: Increasing Dietary Fiber


Did you know that increasing your dietary fiber has positive effects on the prevention of many health complications like high cholesterol, high blood sugars, colorectal cancers and poor digestive health? Additionally, a high-fiber diet is usually lower in calories and can increase feelings of fullness after meals, which can help promote a healthy weight.

Fiber is a type of indigestible carbohydrate found in plant foods such as fruits and vegetables, nuts and seeds, and whole-grain products. Fiber helps to bind dietary cholesterol before absorption and excrete it from the body, assisting in lowering overall cholesterol levels in the body. Also, in the large intestine, some fiber is fermented and transformed into a short-chain fatty acid, which then communicates with the liver to halt further production of cholesterol internally. A double win for your cholesterol numbers! Lastly, fiber feeds your gut’s beneficial bacteria that facilitate with proper digestion and immunity, thus reducing your risk for colon cancer and diverticulitis.

The recommended amount of fiber is 25 grams per day for women and 38 grams per day for men (or for those over the age of 51, 21 and 30 grams per day, respectively). Unfortunately, most Americans are falling far short of the recommended amount. Therefore, here are some simple substitutions that can easily add more fiber into your diet:

  • Have steel cut or rolled oats with nuts and berries for breakfast instead of cereal.
  • For lunch, use whole-grain bread products and add veggies such as tomatoes, cucumber and spinach to sandwiches or wraps.
  • Add more vegetables or beans to casseroles and stews.
  • Snack on fruits and vegetables during the day.
  • Add oat bran or flour to home-baked items such as cookies and muffins and to savory dishes like meatloaf.

When increasing your fiber intake, start slow and drink plenty of fluids, especially if taking any supplemental forms of fiber.

To know how many grams are in your food, look for Dietary Fiber content on the Nutrition Facts label. It’s listed under Total Carbohydrates. A great source of fiber provides typically 5 grams or more per serving, while a good source provides 2.5 to 4.9 grams per serving.

Healthy eating!

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Spring Peanut Pad Thai


Celebrate spring with this delicious variation of the favorite noodle dish Pad Thai. This recipe uses fresh herbs like scallions and cilantro with spring asparagus and peas. Pair this with the ginger-peanut sauce, and it will shortly be a go-to meal for the family.

Serves 6

Prep Time: 15 minutes

Cook Time: 6 minutes

Ingredients:

  • 8 ounces flat rice noodles (brown rice preferred)
  • 1 tablespoon canola oil
  • ⅓ cup scallions, chopped, including white and green parts
  • 2 cloves garlic, minced
  • 2 large eggs, lightly beaten
  • 8 ounces trimmed asparagus, cut into 1-inch pieces
  • 1 cup frozen peas (or fresh if available)
  • 2 tablespoons lime juice
  • ½ cup roasted peanuts, lightly salted, roughly chopped
  • ¼ cup cilantro, chopped

Sauce:

  • ¼ cup low-sodium creamy peanut butter
  • 1 tablespoon grated fresh ginger
  • 2 cloves garlic, minced
  • 1 tablespoon brown sugar
  • 3 tablespoons rice vinegar
  • 3 tablespoons reduced-sodium soy sauce
  • 1 tablespoon sesame oil
  • ¼ teaspoon crushed red pepper flakes
  • ¼ cup hot water

Directions:

  1. Prepare rice noodles according to package instructions. Pour noodles into a colander, rinse well and let drain.
  2. Meanwhile, make sauce by whisking peanut butter, ginger, garlic, brown sugar, rice vinegar, soy sauce, sesame oil and crushed red pepper flakes in a medium bowl.
  3. Slowly whisk in hot water and stir until sauce is blended. Set aside.
  4. In a large wok or frying pan with tall sides, heat canola oil over medium heat. Add scallions and cook until fragrant, 1 to 2 minutes. Add garlic and cook for 30 seconds. Pour in eggs and stir to scramble for about 2 minutes or until soft. Add asparagus and peas and cook for 3 to 5 minutes, stirring often, until asparagus is tender.
  5. Add drained noodles and sauce and cook for 1 to 2 minutes, tossing until the liquid has been absorbed. Stir in lime juice.
  6. Transfer cooked noodles and vegetables to a large platter or bowl and garnish with peanuts and cilantro. Serve immediately.

Recipe from Food and Nutrition Blog at https://foodandnutrition.org/march-april-2016/spring-peanut-pad-thai/©Feb 2016.

Nutritional information per serving (2 cups):

  • Calories 232
  • Total Fat 3 g
  • Sat Fat 1 g
  • Cholesterol 188 mg
  • Sodium 227 mg
  • Total Carbohydrate 24 g
  • Dietary Fiber 3 g
  • Protein 25 g

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address)

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Health Tips 2018 | Mental Health Tips | Seattle, WA | Pacific Medical Centers
Health Resources

HEALTH TIPS – JANUARY/FEBRUARY 2018


Topics This Issue:


Heart-Healthy Resolution: Go Big, Go Positive


Do you have high blood pressure or precursors to heart disease? This year, honor yourself and focus on good heart health. And your timing is perfect: February is National Heart Month!

Try our ideas to making a beneficial change in your heart health for 2018.

Go big—and SMART! Dream up your heart-healthy resolution. You’re aiming for a shift in focus, a new lens through which to view your lifestyle choices. Keep it SMART but flexible. The idea of SMART goals are that they have Specific, Measurable outcomes and are Attainable, Realistic and Timely. For example, the general goal of “I want to lower my blood pressure” becomes SMART when it expands to this: “By next month, I want to lower my blood pressure to less than 140/90 by increasing my exercise to 3 days per week and reducing my consumption of salty foods.”

Work with your doctor and dietitian. An excellent place to start for heart health is with your primary care provider or cardiologist, and a dietitian to sort out the details. Tell your provider that you are working on improved heart health in 2018. Ask what areas you might focus on for prevention or for treatment of a specific heart condition. Your provider can guide you in lifestyle changes to improve your heart health. The American Heart Association offers several guidelines for managing high blood pressure (also called hypertension)—eat a well-balanced, low-salt diet; quit smoking; enjoy regular physical activity; and more.

Stay positive with changes. When it comes to heart-smart eating in 2018, focus on your well-being, not the latest fad diet. One approach is to practice mindfulness as you eat. Take the time to check in with yourself: Am I really hungry? Which snacks give me good energy? Which foods make me feel good and inspire me to eat right? Once you’re sitting down to eat, slow down and appreciate the meal. Savor the colors … the flavors … the aroma. When you feel full, stop eating. Applying a positive attitude to your goal can be a rewarding path to success. It helps to lower stresses in your life and can assist you with feelings of failure.

If you have concerns about your heart health, our Cardiology department is available. To make an appointment, use our appointment tool or call 206.505.1300.

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Are You Struggling with Depression or SAD?


Like other types of depression, seasonal affective disorder, or SAD, is a condition of the brain that leaves a person feeling down. It can sap your energy, erase your motivation and make you feel moody.

SAD is cued by the low levels of light during winter’s shorter days. Its symptoms usually start in fall and end in spring. It can affect anyone, regardless of age, gender or health situation.

Ongoing depression is never a normal part of life. Read on to learn about the symptoms of depression and SAD, and how to seek treatment.

Signs and Symptoms

Signs and symptoms of depression and SAD may include:

  • No longer enjoying the things you usually like to do.
  • Feeling sad, down, hopeless or cranky most of the day, almost every day.
  • Experiencing changes in your appetite or weight.
  • Sleeping too much or too little.
  • Feeling tired or having no energy.
  • Feeling guilty or worthless.
  • Having trouble concentrating.
  • Feeling agitated.
  • Thinking about death or suicide.

These symptoms are specific to SAD:

  • Oversleeping
  • Appetite changes, especially a craving for foods high in carbohydrates
  • Weight gain
  • Tiredness or low energy

(SAD sometimes occurs in people in spring and summer. Summer-onset SAD has nearly the opposite symptoms, including insomnia, poor appetite, weight loss and agitation.)

Treatment Options

Safe and effective treatments for depression and SAD are available. They can include seeing a psychotherapist, taking medications or a combination.

Additionally, with SAD, light therapy can be a powerful treatment protocol. With light therapy (also called phototherapy), you use a special light box “aka happy lights” and expose yourself right after you wake up each day. Doing this appears to trigger a change in your brain chemistry and boost your mood. It’s a bit like getting some summer sunshine to start the day. Light therapy often offers relief from SAD in just a few days.

With all types of depression, a behavioral health therapist or your primary care provider can guide you to the support you need. Make an appointment today.

Learn more about our Behavioral Medicine team at PacMed. Our team of licensed therapists offer individual, couples and family therapy. They also can help with medication management and provide psychiatric evaluation. To make an appointment, use our appointment tool or call 206.621.4045.

ARE YOU OR SOMEONE YOU KNOW IN CRISIS?

If you are thinking about suicide or hurting yourself, help is available:

  • In an emergency, call 9-1-1
  • Go to the emergency room at your local hospital
  • Call the King County 24-Hour Crisis Line: 1 (866) 427-4747
  • Call the National Suicide Prevention Lifeline: 1 (800) 273-8255
  • Call your health care provider and tell them it is urgent

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Nutrition Corner:


Omega-3 Fatty Acids: A Star for Your Health?

Omega-3 fatty acids are a type of dietary fat that has been greatly studied over the years for its ability to improve health. This type of fatty acid is called an essential fatty acid because it is crucial for maintaining our heart and brain health and yet the body is unable to produce it. Therefore, we must ingest omega-3s from what we eat.

There are three types of omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are both found in marine sources, including seaweed; and alpha-linolenic acid (ALA), which is found in plant sources like flax seeds. EPA is known for reducing inflammation in our body, which keeps our blood vessels and heart healthy. DHA plays an integral role in brain function, especially for the developing fetus and young children, by protecting cell membranes. Lastly, ALA is converted to EPA and DHA in the body; however, it is highly dependent on a person’s current health status, genetics, gender and general eating habits so you may need to eat more for the same results as EPA and DHA directly.

So, what is best? Studies show that eating two to three servings of marine animals high in omega-3s each week can help reduce a person’s risk for heart disease because of a reduction in triglycerides and blood pressure. Studies also show promise that regular omega-3 consumption is protective against cognitive decline and depressive disorders, although more research is needed on specific amounts.

The best sources include salmon, mackerel, sardines (see recipe), rainbow trout, herring, halibut, cod liver oil and anchovies. You also get some omega-3s from tuna, oysters, flax and chia seeds, walnuts and soybeans.

And how much? The National Institutes of Health suggests a range of amounts that depend on age and sex (see chart below). Because there isn’t one size that fits all, your provider or registered dietitian can suggest a dose that’s right for you, specifically if it involves supplementation.

Adequate intake measurements for omega-3s

  Age  Male  Female  Pregnant  Breast-feeding
Birth–6 months* 0.5 g 0.5 g
7–12 months 0.5 g 0.5 g
1–3 years** 0.7 g 0.7 g
4–8 years** 0.9 g 0.9 g
9–13 years** 1.2 g 1.0 g
14–18 years** 1.6 g 1.1 g 1.4 g 1.3 g
19–50 years** 1.6 g 1.1 g 1.4 g 1.3 g
51+ years** 1.6 g 1.1 g

g=grams  *as total omega-3s   **as ALA

Source: NIH

For more information about our dietitian services, please visit www.PacMed.org. To make an appointment, use our appointment tool or call 206.505.1300.

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Good Mood Sardines


This dish will make even those who dislike sardines envious of your culinary talent. The mix of fresh herbs and lemon add freshness, while the sardines’ rich supply of omega-3 fatty acids helps lower inflammation in your body, including your heart and brain.

Video demo: Watch our registered dietitian Christy Goff demonstrates how to make this recipe.

Serves 2 Prep time: 10 minutes

Ingredients:

4 teaspoons freshly squeezed lemon juice
2 teaspoons grated lemon zest
1 tablespoon finely diced red onion
2 teaspoons finely chopped fresh parsley
2 teaspoons finely chopped fresh basil
2 teaspoons finely chopped fresh mint
1 teaspoon extra-virgin olive oil
1 teaspoon Dijon mustard
1/8 teaspoon sea salt
1 (4.35-ounce) can sardines, packed in water or olive oil

Preparation:

Put lemon juice, lemon zest, red onion, parsley, basil, mint, olive oil, mustard, and salt in a bowl and stir to combine. Add the sardines and flake them into chunky pieces with a fork. Stir gently to combine. Taste; you may want to add a pinch of salt or more lemon juice. Serve on crackers, in a sandwich or on top of a fresh salad.

Recipe from The Longevity Kitchen by Rebecca Katz with Mat Edelson.

Nutrition Information per Serving (1/2 recipe):

Calories: 102, Total Fat 11g, Sat Fat 0g, Cholesterol 0mg, Sodium: 111mg, Total Carbohydrate: 3g, Dietary Fiber 0g, Protein: 14g

More recipes online! Go to www.PacMed.org/recipes.

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The Living Well Alliance—Check Out Our Added Programs!


As we enter 2018, the Living Well Alliance™ would like to share some exciting additions to your favorite programs.

First off, a few reminders!

  • In 2018, the LWA team will again help you reach your company’s employee wellness goals by providing complimentary services for biometric screenings and health fairs!
  • Don’t forget to take advantage: LWA offers you one complimentary wellness class each year!
  • And here’s what’s new for 2018!

    With our new webinar subscription program, you can offer your organization more wellness initiatives monthly! More details by emailing below.

    Already preparing for February’s heart health awareness month at your site? Book a biometric health screening that directly helps participants know their health numbers like blood pressure and weight. A biometric health screening measures physical characteristics such as height, weight, body mass index, blood pressure, blood cholesterol and fitness. This screening evaluates an individual’s health status and provides a benchmark that can be used to track changes over time.

    Introducing NEW class topics for this quarter! Classes from the Living Well Alliance help you provide wellness programming to your employees. These 45-minute, in-person classes are interactive, fun, current—an easy fit for your worksite.

    • Participants in our new Understanding Vegetarian & Vegan Eating class will explore different types of vegetarianism, their health benefits and potential concerns. They will learn to use plant proteins to create healthful, delicious and satisfying meals, and discover it is more than just avoiding red meat!
    • In Preventing Cancer, participants will learn what cancer is and the common types, review risk factors, and gain positive lifestyle interventions that have been shown to lower your risk. Nearly 50% of most common cancers can be prevented so let’s start now!

    Learn more about scheduling a worksite biometric screening for employees with the Living Well Alliance, book a class or schedule PacMed into your health fairs by contacting Christy Goff, RD, by email or at 206.621.4419.

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – DECEMBER 2017


Topics This Issue:


Avoid Winter Illness, Boost Immunity


It’s that time of year again: we all know someone who is sick! Read on to learn ways to strengthen your immune system and avoid getting sick.

Both colds and flu are caused by viruses, not bacteria. This is why antibiotics won’t work to treat colds or flu because antibiotics kill bacteria, not viruses. The flu tends to hit harder, have higher fever and cause aches and nausea. Cold and flu viruses are easily spread between people in close contact, such as at school or work. They’re typically spread by contact with an infected surface such as a doorknob, or person-to-person by direct contact. Most viruses are not airborne.

Take Preventive Steps!

You can do a lot of things to help prevent you and your family from catching a cold or flu this season.

  • Wash your hands: Good handwashing is the number one way to protect yourself from getting sick. Scrub for at least 20 seconds with soap.
  • Get the flu vaccine: Everyone over the age of 6 months should get a flu shot. While it won’t keep you from getting a common cold, it will help protect you and others around you from the flu.
  • Avoid people who are sick: Keep your distance!Sick children/adults should stay home from school/work.
  • Sleep well: Your body needs good sleep for a healthy immune system. Make time for the nightly sleep your body needs: adults, 7-8 hours; teens 8-9 hours; “tweens” 9-10 hours; young school-age kids 10-12 hours; toddlers/preschoolers, 11-13 hours.
  • Eat well: Maintain a well-balanced diet of healthy protein, whole grains, healthy fat like olive oil and avocado, limit added sugar, and eat plenty of fruits and vegetables. Read more below!

Choose Foods to Boost Immunity!

Many nutrients from food specifically “feed” the immune system, thus strengthening your body’s protective response.

  • Choose whole foods. Whole foods are those you can picture growing or harvesting. They provide more nutrients like vitamins C, D and E and zinc. Cruciferous vegetables—such as cabbage, Brussels sprouts, broccoli, cauliflower, bok choy—strengthen the liver so it’s better able to flush the body of harmful substances.
  • Devour fish. Cold-water, fatty fish like salmon and sardines are the highest in omega-3 fatty acids, which enhance the function of certain immune cells. Fish is also a rare source of vitamin D, which has been shown to decrease the incidence of the common cold and flu.
  • Add fermented foods. They contain good bacteria, or probiotics, that help the digestive tract fight off foreign invaders. Try miso paste (a fermented soybean product), sauerkraut, kimchi (fermented cabbage) and cultured dairy products like yogurt, kefir and sour cream.
  • Add some zing. Garlic and ginger have antiviral and active molecules that help the body fight off viruses and bacteria.

Eat well, sleep well and be well this winter!

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A Healthy Approach to the Holidays


Scrumptious treats. Rich meals. Special beverages. Plus, parents, siblings, neighbors and friends! For many, the joys of the holidays are a source of stress … and weight gain. With some thoughtful planning and attitude adjustment, you can keep stress to a minimum—and maintain your weight come January!

  • Keep your appetite in check. With a sumptuous dinner party ahead, it’s tempting to skip meals or eat less before you go. Instead, eat as you typically do, so you arrive at the festivities with your usual appetite. Then, munch on a plate of vegetables or salad as an appetizer. Vegetables are low in calories, and filling up on them at the beginning of a meal will keep you from overdoing it with higher-calorie options later on.
  • Limit yourself to one plate with small portions. This will still allow you to get a taste of everything while not overdoing it. It takes about 20 minutes for our stomachs to realize we’re full, so wait at least 20 minutes after your first plate before deciding if you want seconds.
  • Are desserts your nemesis? Love salty snacks? If you know the desserts will be calling your name, make a deal with yourself before the event to have just your favorite one. If salty snacks are your Achilles’ heel, choose to skip any chips or crackers. These snacks are available throughout the year—so why waste calories on them when there are bacon-wrapped scallops to be eaten!

Our outlook and expectations may have as much to do with how we manage the holidays as our resources. As you get into the full swing of the holidays, try these three stress-busters:

  • Think about your expectations. Be honest about what you want, and be realistic about what is possible. Then, try these two rules: Keep it simple. Don’t over-commit. If you need to, scale back your plans. Remember, you’re not Superman or Superwoman.
  • Accept people as they are. Don’t expect others to behave as you would like them to. This is a recipe for disappointment, if not misery. Recognize that the people in your life will celebrate the holidays as they want to and not the way you want them to. So don’t try to change or control them.
  • Remember, even the best-laid plans can go awry. This goes back to expectations. Expect that some problems are possible or even likely—inclement weather, delayed guests, an overcooked dinner. Try to approach unexpected challenges with an open mind, patience, creativity or a sense of humor.

A final idea, for both stress and healthy eating: get everyone outdoors, walking, jumping puddles or kicking a ball around. Exercise is good for your emotional state and your waistline! Remember, the holidays are short, as is life. Make the most of them!

The dietitians at PacMed help patients support good health through better eating habits. The PacMed behavioral medicine team offers a variety of therapy to help patients cope with a wide range of problems.

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Give Back and Build Strong Communities


Giving back to those around you is a wonderful way to build community. Donating your time or providing supplies to those in need can also remind us of the power of doing good, sharing life’s burdens and spreading joy. It can also be a low-cost and powerful antidote to the pressures of consumerism.

Our local communities need your gifts of creativity, energy, support and caring. Make it a team effort! Pull together family and friends and pick a project, big or small.

Shop (or sew or craft!) for patients at Seattle Children’s hospital.
Your thoughtful gift helps young patients and their families when they need it most.The Toy & Items for Patients web page gives all the details. Can you sew a flannel blanket for an infant? Want to shop for preteens? Look for links under the “Our Greatest Needs” section. The web page also gives details about wrapping (don’t!), donation drop-off, and other ways to give. Short on time? Check out the holiday donation program.

Help your children learn the joys of giving, with Toys for Tots.
This is a wonderful way to teach generosity and help children get involved. Run by the US Marine Corp Reserve, Toys for Tots has several ways to donate toys. They ask for new, unwrapped toys and get them to families who can’t afford gifts. Find a local program or check out the Toys for Tots Native American Program.

Support youth in foster care—academic resources, clothing extracurricular fun.
Treehouse provides academic and other essential support for 7,000+foster kids throughout Washington State each year. Besides investing in their academic future, Treehouse helps them try to fit in and feel comfortable with clothing that suits them and resources to take part in extracurricular activities. You can donate time, money, supplies or host a drive – see the Take Action page!

Collect donations for a food bank—or help sort, label and prep food!
Food banks distribute food to people in need. Make it a group activity with family or friends. Either donate time on an afternoon, or do a group shopping and donate needed food. Check the food bank’s website for acceptable, needed items—including non-food items. Sample items include packaged whole-grain foods, canned vegetables, low-sodium broth and low-sodium canned meats or fish.

Search an online map for “food bank” and give them a call. Or try one of these:

Food Lifeline (numerous sponsored food banks throughout Puget Sound region) • Nourish Pierce County (formerly FISH Food Banks) • Kent Food BankRainer Valley Food BankNorth Helpline (NE Seattle) • HopeLink (Eastside, Shoreline, Sno-Valley) • Lynnwood Food BankMill Creek Food Bank

Thanks for sharing your energy and joy with others! Knowing you are giving helpful and even fun gifts to those who need them most can be very fulfilling.

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Revitalizing Spice Tea


This revitalizing tea is a unique blend of warming herbs that have invigorating properties while leaving the house smelling great while you cook it. Ginger helps improve digestion and reduce nausea, while cinnamon improves circulation and may comfort coughs. Cardamom helps aid digestion, and peppermint freshens the breath.

Serves 2. Prep and cook time: 15 minutes.

Ingredients:

2 cups of water
1 tablespoon fresh ginger (peeled and minced small)
½ teaspoon organic orange peel
1 cinnamon stick chopped into small pieces
1/2 teaspoon cardamom seeds
1 peppermint tea bag
1 slice of lemon

Preparation:

1. Place the water and the ginger into a small saucepan. Heat the water until it’s about to boil. Reduce heat and add remaining ingredients except lemon.

2. Steep the spices for 5-10 minutes.

3. Using a strainer, pour tea into two mugs, making sure to remove all the spices.

4. Finally, squeeze lemon into each mug and stir.

Recipe adapted by Christy Goff, RDN, CD.

More recipes online! Go to www.PacMed.org/recipes.

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“Thank You” to the Living Well Alliance Family


We wish to thank all the employees, organizations and community groups who invited the Living Well Alliance team to your worksite in 2017. With your help, we have continued to make great strides in our overarching goal of preventing chronic diseases in the Puget Sound area. We couldn’t have done it without your help and referrals. Thank you.

Some highlights! In 2017, the Living Well Alliance:

  • Worked with 70 companies and community groups
  • Conducted biometric screenings at 11 companies
  • Made 80+ wellness presentations
  • Supported 35 health fairs
  • Offered new nutrition counseling through the national Enhance Wellness program
  • Held our second annual Wellness Symposium for area HR professionals to share, learn and grow their company’s wellness offerings

For more information about our programs and current classes, visit our website or email .(JavaScript must be enabled to view this email address). Share any feedback with us as well! We appreciate your thoughts.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419.

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – NOVEMBER 2017


Topics This Issue:


Find and Treat Diabetes Early


Of the 30.3 million Americans who have diabetes, 7.2 million are not yet diagnosed*. Get tested today.

Nearly one in 10 American’s have diabetes—but many of us don’t know it. Diabetes is a life-altering disease, and it’s important to catch it early. The earlier you detect diabetes, the better your chances of avoiding future health problems.

The best medicine? Learn the basics of diabetes, know your risks and talk with your doctor.

Diabetes Basics

Diabetes is a disease in which there is too much glucose (sugar) in the blood. It occurs when a person’s body is unable to produce or use insulin, a hormone that regulates blood sugar levels in our bodies.There are two types of diabetes:

  • Type 1 diabetes is typically diagnosed in children and young adults. It occurs when the pancreas produces little to no insulin. This form of diabetes can be managed with daily insulin injections.
  • Type 2 diabetes accounts for 90 percent of cases. It occurs when your body resists the effects of insulin or doesn’t produce enough. This type is commonly linked to obesity, but not always.

If left untreated, either form of diabetes can increase the risk of serious health complications, including heart attack, kidney disease, limb amputation and blindness.

Diabetes Risk Factors and Symptoms

Risk factors for type 2 diabetes include:

  • Age—being over 45
  • Family history of diabetes
  • Being overweight
  • Infrequent or irregular physical activity
  • Women who had diabetes during pregnancy
  • Certain races/ethnicities, such as Pacific Islander, Asian-American, Mexican-American and African-American

Symptoms include frequent infections, extreme fatigue, frequent urination, or tingling and numbness in the hands and feet.

Ask Your Doctor about Screening

If you have one or more risk factors for diabetes or notice any of the above symptoms, talk with your doctor about being screened as soon as possible. If you receive a diabetes diagnosis, you are not alone. Ask your doctor about diabetes education and nutrition support.

If you are looking for a primary care provider, we invite you to meet the PacMed Primary Care team. If you are already living with diabetes or have recently been diagnosed, the PacMed Diabetes Management Program offers comprehensive medical care, health education and support.

*Statistics as reported in the 2017 National Diabetes Statistics Report by the Centers for Disease Control (CDC).

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Think of Exercise as Diabetes “Medicine”


There are millions people in the U.S. living with diabetes, and if Dr. Sonja Maddox had her way, they would all be doing one thing to prevent onset of the disease: exercise.

Dr. Maddox, a family medicine physician at PacMed Renton, says people should think about exercise as “medicine.” Here’s how she explains this idea: “If you exercise and you don’t have diabetes, it can help prevent the disease. If you have diabetes and exercise regularly, it will lower your blood pressure, lower blood sugars and can even prevent the need for medication for a long period of time.”

Patients with diabetes can control their weight and blood sugar with diet and exercise. Although a diabetic patient may eventually need oral medication or insulin, exercise can help delay that need. Delaying the progress of the disease also means delaying the ravaging effects of diabetes on the heart and vascular system.

“The reason to work hard—to eat properly and exercise—is that you may have diabetes for just 30 years as opposed to 40 or 50 years. The longer you have the disease, the greater the likelihood you’ll develop retinopathy [eye damage], nephropathy [kidney damage]or heart disease,” says Dr. Maddox.

So what counts as exercise?

You don’t need to run a marathon to reap the benefits of exercise. You don’t even need to jog! Walking between 6,000 and 10,000 steps daily is an attainable goal for most people. Plus, it’s available to everyone. Use a step counter—or simply count your steps for 5 minutes and do some math. If you have mobility problems, water aerobics is a great alternative.

The recommended amount of physical activity is 150 minutes per week. That’s 30 minutes of exercise on five days, or 20 minutes every day. Your routine could include anything from high-intensity exercise to walking or gardening. Any activity that gets the heart rate elevated can be counted as physical activity. So, find something you enjoy and will do, and stick with it! A partner in exercise can also be motivating.

One last point in favor of exercise...

Dr. Maddox points out that medicine works only so well for so long. The more weight a person gains, the less well the medicine will work over time. Getting daily exercise is a health strategy for everyone, but especially for people with diabetes.

Are you looking for a primary care provider? PacMed offers preventive, primary care through our Family Medicine and Internal Medicine teams. Dr. Sonja Maddox sees patients at our Renton clinic.

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Tips for Healthy Holiday Eating


Well, hello holidays! As we approach winter’s many holidays, now is a good time to think about how to savor those special meals—while saving our waistlines at the same time.

You know what November and December mean: winter holidays and festivities. And right alongside these activities come a plethora of delicious food traditions: festive parties, cookie exchanges, exquisite desserts, once-a-year beverages, family meals and homemade treats.

Eating healthily during the winter holidays can prove challenging for even the most disciplined among us. But you can still celebrate while eating better and having fun. Try these tips.

  • Choose pumpkin pie. Pumpkin contains beta carotene, a helpful antioxidant. Pumpkin is also technically a veggie, and one slice can count as a half-serving of your daily recommended amount of vegetables. Finally, a slice of pumpkin pie usually has about 200 fewer calories than other pies, such as apple. This is mostly thanks to pumpkin pie not having a top crust.
  • Cook stuffing separately. When baked inside the turkey, stuffing absorbs the turkey’s fat drippings. Cook it in a pan, and you save on calories and fat. Other ways to cut calories are to use low-fat, low-sodium chicken or vegetable broth instead of butter … swap the bread for a higher-fiber, higher-protein option like wild rice … and replace the giblets, bacon and pork sausage with chicken sausage, nuts, celery, diced carrots, apples or dried cranberries.
  • Eat popcorn—but keep it healthy. Yes, popcorn can be a good snack in a healthy diet! It’s whole grain and a good source of fiber. Roughly three cups of air-popped popcorn equal 100 calories. (That’s about equal to one and a half cheese strings or one-half of a sugar cookie.) To keep things interesting, add toppings such as drizzling olive or canola oil, parmesan cheese or herbs such as rosemary, garlic or dried basil. But avoid too many popcorn balls, kettle corn or caramel corn.
  • Baked potatoes. Potatoes are a good source of potassium and vitamin C. Instead of mashed or scalloped potato dishes, go for the baked potato; it contains fewer calories and fat. If you do have mashed potatoes, substitute skim milk for cream or butter or add in plain yogurt in exchange for sour cream. Then, limit the gravy and add extra vegetables like peppers and green onions to boost flavor.

Making these small changes can help you to alleviate stress and enjoy a healthy holiday season with family and friends. Don’t beat yourself up over the occasional splurge. Just keep your focus; instead of trying to lose weight during the holidays, aim to maintain and avoid seasonal weight gain.

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Stuffed Acorn Squash


Want a fun new recipe for your Thanksgiving spread? Try stuffed squash instead of stuffing to watch your carbohydrates and still get lots of flavor!

Serves 8. Prep time 20 minutes. Cook time 50-60 minutes.

Ingredients:

2 medium acorn squash (about 1 1/4 pounds each), halved width-wise and seeded
Cooking Spray
1 tablespoon Olive Oil
8 ounces Cremini mushrooms, sliced
2 3-ounce links apple chicken sausage, cooked and diced
8 ounces kale, stemmed and chopped
1/2 teaspoons salt (optional)
1/2 teaspoons ground black pepper
1/2 cup fat-free, reduced sodium chicken broth

1 cup dried cornbread stuffing

Optional: Top with dried cranberries

Preparation:

1. Preheat oven to 375 degrees.

2. Coat a baking pan with non-stick cooking spray and place squash cut-side down in the pan. Add about an inch of water and bake for 30 minutes.

3. While the squash is baking, add olive oil to a sauté pan over medium-high heat. Sauté mushrooms and chicken sausage until golden brown. Add kale, salt (optional) and pepper and sauté until kale is wilted, about 5-7 minutes.

4. Add the chicken broth and cornbread stuffing to the mushroom mixture and simmer until all of the liquid is absorbed.

5. Remove squash from the oven. Turn the squash over in the pan so the cut side is up. Fill each squash with ¼ of the mushroom mixture then return to the oven. Bake for 15 minutes.

6. Cut each squash in half and serve.

Optional: Sub spinach, collards or Brussels sprouts for kale

Recipe from the American Diabetes Association at diabetes.org.

Nutrition Information per Serving (1/2 sweet potato)

Calories: 150, Total Fat 5g, Cholesterol 20mg, Sodium: 280mg, Total Carbohydrate: 21g, Dietary Fiber 5g, Protein: 6g

More recipes online! Go to www.PacMed.org/recipes.

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Diabetes Screenings from The Living Well Alliance


Get diabetes health screens or educational classes for your employees today! We can help.

As of 2015, 30.3 million Americans have diabetes and an estimated 1.5 million Americans are diagnosed each year.* This is why it’s important to know your risk of developing this disease. At the Living Well Alliance, we have found that health screenings—such as for diabetes and prediabetes—are paramount to each employee’s ability to take charge of his or her ongoing health.

The Living Well Alliance offers a complimentary biometric health screening that measures the participant’s risk of developing diabetes. Our screenings, always conducted by our registered dietitian or registered nurse, are confidential and give participants the opportunity to ask other health-related questions. Participants will also gain an idea of their risk for other chronic diseases.

Our goal is to slow down the diabetes epidemic, while also helping individuals and companies control future health care costs. Small steps add up. If we each check our risk yearly, whether at our doctor’s office or at employer events, we can have a big impact in controlling this disease.

If you and your employees want to change behaviors to achieve better health, the best place to begin is with information delivered by trustworthy professionals. The Living Well Alliance is passionate about supporting your employees, so visit us for more information about booking a biometric screening today.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

*Statistics as reported in the 2017 National Diabetes Statistics Report by the Centers for Disease Control (CDC).

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – OCTOBER 2017


Topics This Issue:


Designing a Breast Cancer Prevention Strategy


How often should you have a screening? What should your prevention strategy be? October is Breast Cancer Awareness month—a perfect time to talk with your provider about a strategy for you.

About one in eight U.S. women will develop invasive breast cancer, but due to great medical advances, around 80 percent will survive it. Still, breast cancer remains the second-deadliest cancer in women (after lung cancer). It is important to know your personal risk factors so you can take steps to reduce your risk.

Fortunately, this cancer is highly preventable. Read on for two important prevention steps. And of course, if you have questions, make an appointment with your primary care doctor to learn more.

Risk Factors

When deciding on your breast-cancer prevention and screening strategy, consider the following risk factors:

  • Being female and older age
  • Personal or family history of breast cancer, especially among close relatives
  • Early onset of menstruation
  • Later onset of menopause
  • Dense breasts (as learned after a mammogram)
  • History of breast health problems found in biopsies

Lifestyle factors play a moderate role in the development of breast cancer. Weight gain after menopause, working night shifts, alcohol use and several hormone-replacement therapies are known to increase the risk. On the other hand, having a baby before age 30, breastfeeding, regular exercise and a Mediterranean-like diet—rich in fruits, vegetables, fish and olive oil—all seem to aid in reducing the risk of developing breast cancer.

Screening

Despite the value of knowing your risks, many breast-cancer cases develop without obvious risk factors. This is why age-appropriate breast-cancer screenings are essential for all women.

The best approach to breast cancer detection is regular mammograms.

  • Mammograms should be performed every 1-2 years beginning at age 40, based upon discussion with your provider.
  • If you’re over age 75, the benefits of mammograms are less certain.
  • Breast self-exams are a good practice. Knowing how your breasts normally look and feel can help you be aware of changes, which you can share with your healthcare provider. Finding a change doesn’t necessarily mean there is cancer.

If you have a family history, talk with your doctor about testing for hereditary cancer syndromes, such as BRCA gene mutations.

PacMed offers several options for primary care providers, an excellent place to begin a conversation about breast cancer prevention. Learn about our Primary Care team. We also invite you to explore our Women’s Health offerings and our Oncology department.

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Nutrition for Cancer Prevention


By Kathleen Bradley, RD, CD

According to the National Cancer Institute, dietary factors are thought to be the cause for about 30% of cancers in Western countries. Fortunately, diet is one of the cancer risk factors you have the power to alter. Read on to learn how foods in your daily diet can lower your potential risk of developing cancer.

Western countries have diets statistically high in animal products, fat and sugar—and also have high rates of colorectal, breast and prostate cancers, according to the National Institutes of Health. Being overweight or obese has also been seen to increase the risks of several common cancers. Nutrition guidelines for cancer prevention are similar to those for preventing other diseases such as heart disease and diabetes. Work with your primary care provider or a dietitian to gauge your overall dietary health.

Some nutrition and dietary factors to consider:

Fiber and other cancer-fighting nutrients. Studies show that fiber provides potential protective effects against cancer. While it is recommended to consume least 25-30 grams of fiber per day, the average U.S. citizen consumes only 10-15 grams. Fiber is found in vegetables, fruits, whole grains and legumes. Other cancer-fighting substances in fruits and vegetables include carotenoids; beta-carotene, vitamins C, E, K; folate; flavones and indoles.

Aim to fill half your plate with fruits and vegetables, and make at least half your grains whole grains. A diet rich in these plant-based foods can also help you stay at a healthy weight.

Fat intake. Recent studies show an excessive consumption of fat affects cancer risks. The average U.S. diet contains about 37 percent fat. While the National Cancer Institute suggests lowering your intake to 30 percent, other studies find that dropping fat consumption well below 30 percent may have an anti-cancer effect.

Reduce your intake of foods with added sugars and solid fats, which provide a lot of calories but few nutrients. These foods include sugar-sweetened beverages, processed snack foods and desserts.

Meat. Certain cooking and processing techniques of meats may lead to an increased cancer risk. The processes of smoking, salting, adding nitrates or related compounds, and cooking at high temperatures can convert meats into carcinogenic compounds within the colon.

Your best bet is to limit processed meats and instead include a variety of whole-food-based protein such as fish, skinless poultry and lean cuts of pork and beef. Consider eating plant-based sources of protein such as beans more often.

Alcohol. Excessive intake of alcohol raises one’s risks for cancers of the breast, mouth, pharynx and esophagus, as well as potential stomach, liver and colon cancers. It is considered more harmful when combined with smoking.

The Academy of Nutrition and Dietetics recommends limiting alcoholic drinks—if consumed at all—to one serving daily for women and two for men. (A serving of alcohol is considered 1½ fluid ounces of hard liquor, 5 fluid ounces of wine or 12 fluid ounces of beer.)

For more information about PacMed and our dietitian services, please visit www.PacMed.org. To make an appointment, use the PacMed appointment tool or call 206.505.1300.

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Safety on Halloween Night


It’s a dark night, and groups of frantically excited kids in costumes are darting along sidewalks, bouncing off the curbs. They are excited to be hauling in candy. What could possibly go wrong?

Forget about vampires. You should be worried about cars. The Seattle Police Department recommends on its website that kids take flashlights out trick-or-treating. Remind your kids how tough it is for drivers to see at night, especially at dusk. And, of course, tell them not to weave between parked cars to get across the street. The candy will wait!

Make sure costumes are visible and that your child can see well. Make sure masks and big hair are clear of the eyes—and stay that way when jumping and running. Have a Batman, witch or other black-clad character in your group? Add a flashlight, glow sticks, glow jewelry or reflective tape.

Rethink trailing hemlines and large swords. They can be tripping hazards … and as the evening wears on, they aren’t much fun if your child is having trouble keeping up with friends! Warn your child, too, about candles in jack-o-lanterns. If costumes get too close, they can catch fire.

Keep big plastic bags away from small children who are out trolling for candy. If pulled over the face or head, they are a suffocation hazard. For treats, use a plastic pumpkin container or a cloth bag.

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Halloween Tricks for Your Treats


By Christy Goff, Registered Dietitian

Halloween night is exciting and fun … but then comes the sugar hangover the next day, week or even month! Let me share with you some tips and tricks for navigating that large pot of candy so you can have a healthier start to the holidays this year.

1.  Make a plan. Creating a plan with structure for you and your children keeps everyone on track. Some parents plan to indulge on Halloween night and then throw or give the rest away, while others put the candy bounty into plastic bags to have better portion control over the days that follow. Make your plan clear to your children as soon as you start talking about costumes and then stick to the plan throughout the holiday.

2.  Always eat a balanced dinner before trick-or-treating. This will reduce the chance that hunger will dictate the amount of sweets you will indulge in later on.Teaching yourselves and children about balance while allowing room for treats is an important conversation to have throughout the whole year to maintain a positive relationship with food choices.

3.  Understand portion sizes.Typically children should have no more than 1-2 pieces of candy per day and they should be given the candy with a meal to ensure the intake of healthy nutrients in addition. Even better, let them pick the meal they get to eat it at. Keep the candy in a special place so the kids can see it, but is not accessible easily, such as the top of the fridge or high counter. If there is just too much candy to manage, try using the rest as an art design, a lesson in sharing with others or throw it away.

4.  Don’t deny treats or use them as a reward. Typically prohibiting treats or using them as a reward causes the desire for sweets to grow even more, especially if they are forced to do something they don’t want to do like clean, eat their veggies etc.Your child will to learn to manage sweets better if they are given in the same meal and treated the same as any other foods.Go back to your plan and decide what works best for your family to allow treats in moderation.

5.  Enjoy the night! Focus on celebrating the holiday and spending time with family and friends.Remember that a balanced diet is created over time and all foods can be enjoyed in moderation, including treats.

For more information about Halloween treats and good health, visit the Ellyn Satter Institute.

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Handwashing: Don't Swish and Go!


We have all watched someone quickly rinse their hands in a restroom and rush out the door—or skip the sink altogether. Body fluids and viruses are invisible to the naked eye, but these germs are everywhere. They contaminate commonly touched surfaces like handles, doors, walls, counters and paper dispensers.

To help your family avoid the flu, there is no substitute for handwashing. Disposable hand wipes or gel sanitizers also work well, although they don’t remove dirt and grime.

Handwashing is one of the most effective ways to stop disease.

Wash your hands often: always before eating or preparing food, and always after using the bathroom or changing a diaper.

  • Soap and water work well to kill germs. Rub your hands briskly.
  • How long? At least 20 seconds—try humming “Happy Birthday” through twice.
  • Most people miss the backs of the fingers and thumbs … fingertips … the creases in the palms.
  • Use a paper towel to turn off faucets and to open the door.

With flu season here, give your hands the soapy wash they deserve. Take two minutes to safeguard your health—and wash your hands!

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Simple Sweet Potato Fries


Baked sweet potato fries will be your new favorite side dish.The combination of crispy outside and tender inside will delight your taste buds.Sweet potatoes are loaded with healthy nutrients like beta-carotene (a precursor to vitamin A), vitamin C, potassium, fiber and B vitamins to help ward off winter illness.Eat up!

Serves 6. Prep time 10 minutes. Cook time 20 minutes.

Ingredients:

3 medium sweet potatoes (about 2 lbs)
2-3 tablespoons potato or corn starch
1 tablespoon chili powder
1/2 teaspoon cinnamon
1/4 teaspoon salt
1 tablespoon olive oil

Preparation:

1. Preheat oven to 425 degrees.

2. Wash sweet potatoes and cut into thin wedges.

3. In a large plastic bag, combine sweet potatoes, starch, spices and salt and mix together until evenly coated.Add oil slowly and toss vigorously to combine.(A large mixing bowl works fine, too.)

4. Spread fries in a single layer on a lined baking sheet.

5. Bake for 20 minutes or until crispy on one side.Turn fries and bake for another 20 minutes or until golden brown.Watch for burning edges.

Recipe adapted by PacMed’s registered dietitian Christy Goff, MS, RDN, CD

Nutrition Information per Serving (1/2 sweet potato)

Calories: 174, Total Fat 3g, Cholesterol 0mg, Sodium: 214mg, Total Carbohydrate: 37g, Dietary Fiber 6g, Sugar: 7g, Protein: 3g

More recipes online! Go to www.PacMed.org/recipes.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

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Healthy Tips | September 2017 | Pacific Medical Centers
Health Resources

HEALTH TIPS – SEPTEMBER 2017


Topics This Issue:


Raising Awareness of Cervical Cancer


PacMed is honoring September as National Cervical Cancer Awareness Month. When cervical cancer is found early, it is highly treatable and associated with long survival and good quality of life.

What is the cervix? The cervix is the lower end of the uterus. This is where a baby grows when a woman is pregnant. When cancer starts in the cervix, it is called cervical cancer.

Fortunately, this cancer is highly preventable. Read on for two important prevention steps. And of course, if you have questions, make an appointment with your primary care doctor to learn more.

PacMed offers several options for primary care providers. Learn about our Primary Care team.

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Two Steps to Help Prevent Cervical Cancer


Human papillomavirus, better known as HPV, is the main cause of cervical cancer. It is also the most common sexually transmitted virus in the United States. The HPV vaccine protects against the types of HPV that most often cause cervical cancer.

When detected early, cervical cancer is highly curable. But the cancer in its early stages may have no signs or symptoms. This is why regular screening is so important.

Get Vaccinated! The HPV Vaccine

HPV vaccination is recommended for:

  • Preteen girls and boys ages 11 and 12.
  • Women ages 13 through 26 who haven’t been vaccinated yet or have not completed the vaccine series.

Get Screened! The Pap Test

Regular screening, also called a Pap test, is recommended for:

  • All women aged 21 to 65 (including women who got the HPV vaccination)

For preteens, PacMed has a professional and approachable team of Pediatrics providers. Our Gynecology team is available to women.

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Four Health Issues That Embarrass Many Women


Some health topics can seem too embarrassing to talk about—even in the privacy of a doctor’s office. It’s understandable. Sharing personal information with a person you hardly know is bound to be unsettling.

Understand, however, that medical providers want to help you be healthy and happy. These are common issues, so you’re likely not the first person to raise them with your provider!

Urinary incontinence

Millions of women experience involuntary loss of urine. This is called urinary incontinence (UI). The severity of UI can vary anywhere from slightly bothersome to totally debilitating. Rather than avoid activities you love, speak with your medical provider! UI is a health problem that often can be helped through medication and muscle-strengthening exercises.

Urinary tract infections or UTIs

When bacteria get into your bladder or kidneys, it can cause a urinary tract infection. You may experience a burning sensation when urinating, frequent urges to urinate, pressure or pain, and discolored or odd-smelling urine. Your provider can treat you with antibiotics—and give you behavioral and dietary tips to help you avoid UTIs in the future.

Frequent urination

When frequent urination becomes a distraction in your life or prevents you from activities with family and friends, you should see your doctor. Many factors can contribute to this issue, such as too much caffeine, constipation, an unhealthy weight and smoking. But it’s wise to first begin with a visit to your health clinic; frequent urination can also be caused by a nerve signal or overactive bladder.

Contraception

A multitude of contraception methods is available today. Oral contraceptives, condoms, implants… All protect against pregnancy, but how do you know which one works best for you and your partner? By talking with your doctor, you can choose the method that’s right for you.

Talking about these things can be uncomfortable and difficult, but addressing them is important. Find a doctor you are comfortable with. PacMed invites you to explore our team of Family Medicine/Obstetrics and Gynecology providers.

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Broccoli Apple Salad


Broccoli is a popular vegetable for its versatility in main or side dishes and because it provides great health benefits for detoxifying the body. Try this version of broccoli salad with a healthy twist –a yogurt dressing!

Serves 4. Prep time 10 minutes.

Ingredients:

1-2 large crowns of broccoli
2 apples (any variety of your choice)

For dressing

1 tablespoon non-fat plain yogurt
1 teaspoon olive oil
1 teaspoon lemon juice
1 teaspoon fresh dill, chopped
Salt and pepper to taste

Optional toppings:

Raisins, sunflower seeds, walnuts or cheese

Preparation:

1. Separate the broccoli into its florets and then thinly slice. Place in a bowl.

2. Halve and core the apples. Slice apple into thin pieces and then mix with broccoli.

3. To prepare dressing, mix all ingredients in a small bowl. Taste and season with salt and pepper to your preference.

4. Pour dressing over the broccoli and apple mixture, and toss well to coat vegetables.

Tip: If you put salad in the fridge for 10 minutes before serving, it will stay crisp slightly longer.

Recipe adapted from Leanne Brown by Christy Goff, MS, RDN, CD

Nutrition Information per Serving (1/4 recipe)

Calories: 75, Total Fat 1g, Saturated Fat 0g, Cholesterol 1mg, Sodium: 14mg, Total Carbohydrate: 16g, Dietary Fiber 4g, Sugar: 9g, Protein: 2g

More recipes online! Go to www.PacMed.org/recipes.

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Back to School and Bullying


With back-to-school season just around the corner, children are watching the final days of summer vacation slip away as the first day of school looms ahead. This naturally calls for a mix of excitement, nervousness and - in most cases - anxiety. Students of all ages often struggle with anxiety when preparing for the school year ahead as fears of the unknown flood their mind.

Who will be their teacher? Will they have friends in their classes? Will they get picked on?

As a parent, friend or loved one, there are proactive steps you can take to combat back-to-school anxiety and give children the confidence they need to excel in school. Rene Czerwinski, Licensed Mental Health Counselor from Pacific Medical Centers, provides insight on how to identify signs of anxiety in children and tools to equip them for success throughout the school year.

Read the complete article here.

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Flu Shot Clinics at PacMed, 2017


Should I get the flu shot? Get your questions answered here. Get your flu shots today at PacMed!

Beacon Hill

  • Thursday, September 14, 8 a.m.–noon
  • Saturday, September 16, 8 a.m.–1 p.m.
  • Thursday, September 21, 1 p.m.–5 p.m.

Canyon Park

  • Saturday, September 30, 9 a.m.–1 p.m.
  • Saturday, October 14, 9 a.m.–1 p.m.

Federal Way

  • Saturday, September 16, 9 a.m.–1 p.m.
  • Thursday, September 28, 1 p.m.–5 p.m.

First Hill

  • Monday, September 11, 9 a.m.–1 p.m.
  • Friday, September 22, 1 p.m.–5 p.m.

Lacey

  • Saturday, September 9, 9 a.m.–1 p.m.

Lynnwood

  • Wednesday, October 4, 1 p.m.–5 p.m.
  • Wednesday, October 18, 1 p.m.–5 p.m.

Northgate

  • Saturday, September 9, 8 a.m.–1 p.m.
  • Wednesday, September 20, 1 p.m.–5 p.m.
  • Friday, October 6, 9 a.m.–1 p.m.

Puyallup

  • Thursday, September 14, 1 p.m.–5 p.m.
  • Monday, September 25, 9 a.m.–1 p.m.

Renton

  • Saturday, September 9, 9 a.m.–1 p.m.
  • Saturday, September 23, 9 a.m.–1 p.m.
  • Saturday, September 30, 9 a.m.–1 p.m.

Totem Lake

  • Thursday, October 12, 1 p.m.–5 p.m.
  • Thursday, October 26, 1 p.m.–5 p.m.

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Healthy Tips | August 2017 | Pacific Medical Centers
Health Resources

HEALTH TIPS – AUGUST 2017


Topics This Issue:


Back to School Already?!


Doesn’t summer break always go by faster than you think? Like most parents, you’re probably already thinking about all the steps to getting your children school-ready. Don’t forget about well-child checkups, sports physicals andimmunizations.

Beat the Rush!

Your child may be due for a well-child check-up if he or she has not been seen in the past 12 months. Well-child visits to your primary care provider (PCP) are an essential part of keeping your child healthy.These exams include immunization updates and various health and development screenings. You can also schedule a sports physical with us!

Avoid the last-minute rush and make an appointment soon. When you schedule the appointment, let your doctor’s office know if you need immunization and other records for school purposes. If you have a school form to submit, fill out as much of it in advance. This will leave more time for you, your child and your child’s primary care physician to focus on health.

Immunize the Whole Family

Adults also need immunizations to stay healthy and keep children healthy. By being vaccinated, adults help protect people around them, especially infants and people with chronic conditions or weakened immune systems.

At PacMed, our pediatric providers will become your partner in your child’s health. Call us at 1.888.4.PACMED (1.888.472.2633) to schedule your child’s appointment or visit us here. Please verify covered services with your insurance company prior to making an appointment.

Come to a PacMed Back-to-School Event!


Come meet our providers! We love doing these energetic, family-focused events, with snacks and games and fun activities. You also can pick up a well-child immunization card.

Federal Way clinic—Back-to-School Backpack Giveaway,* Aug. 9, 5-8pm

Canyon Park clinic—Back-to-School Event, Aug. 26, 10am-1pm

*While supplies last. 200 backpacks will be given away to first arrivers.

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Summertime and Your Kids


Parents, what fun activities are your kids doing this summer? Staying physically fit is as important as completing their summer reading list! Be sure to mix fun with safety for a successful summer.

Safety first! Avoid injury and promote safety:

  •  Stay hydrated. Always take water with you for outside activities.
  •  Be a smart hiker. Take a rain jacket and warm layers, plus water and snacks. Tell someone exactly where you will hike and when you should be back.
  •  Take care in the sun. Apply sunscreen at least 20 minutes before going outside.
  •  Stretch first. Do some simple stretches to loosen up before walking or hiking.
  •  Protect the head. Ensure kids wear helmets when riding a bike, skateboard, scooter or other toy. Ask an expert to help you properly fit your child’s helmet so that it’s snug, level and comfortable.
  •  Take care in the heat. Be cautious with vigorous outside activities during the midday heat.
  •  Water fun? Keep eyes on the kids. When around water, give children your full attention—kids aren’t safe just because they know how to swim. Even a bucket, fountain or shallow wading pool is a drowning hazard. Drain containers when play is done.
  •  Check pool for safety measures. Choose pools with high fences that lock, lifeguards on duty and safety/rescue equipment nearby.
  •  Wear life jackets. On boats or docks, make sure all children wear a well-fitted life jacket that’s Coast Guard approved.

Now—get those kids moving! Here are some ideas:

  • Run through a sprinkler.
  • Go to a beach and skip rocks, look for small critters in the sand and rocks, or count seagulls.
  • Take a walk along a river. Keep an eye out for fish, insects or other creatures using the water.
  • Fly a kite.
  • Shoot hoops at the local school playground.
  • Play “follow the leader” at a nearby park or through the neighborhood.
  • Learn to hula hoop.
  • Get together with friends and have relay races, keep a beach ball up in the air, do somersaults, roll down a small hill, play tug-o-war, etc.

Active, physical exercise helps children increase self-confidence, boost coordination and build strong muscles and bones—along with a healthy appetite!

Have questions about child safety and health? Our pediatricians can help.

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Foods to Promote Healthy Skin


Now that our sunny days are finally here, it’s important to consider consuming antioxidant-rich foods that have a protective effect for skin. Four nutrients that promote healthy, radiant skin are vitamins A, E and C and omega-3 fats. Here is some useful background, plus tips on how to incorporate foods rich in these nutrients into your daily diet. (Be sure to consult your doctor for advice regarding appropriate doses of these nutrients.)

Vitamin A: This vitamin has an essential role in skin health by decreasing cell damage and helping the healing process of bodily wounds. Low levels of vitamin A can lead to a dry, flaky complexion. The recommended daily allowance (RDA) to consume is 900 mcg for men and 700 mcg for women. Don’t hesitate to increase your intake of sweet potatoes, carrots, spinach, apricots, cantaloupe and other yellow and orange fruits and vegetables.

Vitamin E: This antioxidant nutrient also helps protect against skin damage. Research has shown vitamin E plays an important role in photoprotection, preventing ultraviolet (UV)-induced free-radical damage to skin, as well as having related anti-inflammatory roles in the skin. The RDA for men and women is 15 mg. Try grabbing some sunflower seeds and almonds for your afternoon snack.

Vitamin C: In addition to promoting a strong immune system, this water-soluble vitamin is vital for skin health. Vitamin C has an important role in the synthesis of collagen, a major protein of body tissues that include the skin. Dietary and topical ascorbic acid (a form of vitamin C) have beneficial effects on skin cells, and some studies have shown that vitamin C may also help prevent and treat UV-induced photodamage. The RDA for men is 90 mg and 75 mg for women. Include broccoli, red peppers and green peppers in your favorite dishes, or enjoy oranges, strawberries or kiwi for dessert.

Omega-3 fatty acids: These healthy fats are considered essential fatty acids. They are necessary for human health, but the body can’t make them; you have to get them through food. Research has shown that omega-3 anti-inflammatory properties include a protective effect against sunburn and helping prevent premature aging. One of the symptoms of omega-3 deficiency includes dry skin. An adequate intake (AI) for men and women is about 1 g daily. Try sardines, tuna or salmon for a quick and delicious dinner tonight.

Kathleen Bradley, RD, CD, is a registered dietitian at our Canyon Park, First Hill and Northgate clinics. Learn more about our dietitian services at PacMed, or call 206.505.1300 for an appointment.

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Grilled Fruit and Balsamic Kabobs


Older kids can help you put fruit on skewers. Adults and kids alike will love the tart-sweet balsamic glaze. You’ll need eight or more 9-12-inch skewers.

Serves 4. Serving size 2 skewers. Prep time 30 minutes; cook time 10 minutes.

Ingredients:

2 cups pineapple chunks

2 cups watermelon chunks

2 bananas, peeled and cut into large chunks

16-ounce package strawberries (stems discarded)

2 tablespoons balsamic vinegar

2 teaspoons honey

1 tablespoon canola oil

Preparation:

1. If your skewers are wood, soak them in water for at least 30 minutes.

2. Heat grill to medium-high heat.

3. Poke fruit onto the skewers. Try to fit 2 pieces of each kind of fruit on each skewer. Place onto a platter or a baking sheet.

4. In a small bowl, mix vinegar, honey and oil. Whisk together. Brush balsamic-honey mixture on fruit with a basting brush.

5. Place fruit kabobs on grill. Turning a two or three times and baste with remaining balsamic-honey mixture. Cook until fruit is caramelized about 8 to 10 minutes. Serve!

Recipe copyright © 2016 American Heart Association.

Nutrition Information per Serving (two 9-inch skewers)

Calories: 199, Total Fat 4.1g, Saturated Fat 0.3g, Cholesterol 0mg, Sodium: 5.2mg, Total Carbohydrate: 43.1g, Fiber 5.3g, Sugar: 29.9g, Protein: 2.4g

More recipes online! Go to www.PacMed.org/recipes.

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LWA Updates


To help your organization stay on track with health this summer, the Living Well Alliance is introducing two new classes! Our on-site classes are convenient and led by health professionals.

NEW CLASS: An in-depth look at sugar. In this class, we help your employees wade through all the hype to learn the truth about this molecule and what it does to their health. Participants will learn why humans evolved to crave sugar, the consequences of eating too much and how to read food labels to learn your sugar limit. Employees will leave with suggestions on how to reduce sugar intake and cravings. Is a sugar detox in your future?

NEW CLASS: Making successful behavioral changes. This class is an excellent companion to the nutrition counseling program the Living Well Alliance started in June. Many of us know what we need to change, but turning that knowledge into action is tricky. Class participants will discuss theories that evaluate approaches to change, learn effective methods for successfully changing lifelong habits and finally evaluate their own readiness to change while creating an individualized plan.

Still need a push in the right direction? Living Well Alliance can help! Sign up for individual nutrition counseling with a registered dietitian today. Read our flyer.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 1.206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – JULY 2017


Topics This Issue:


Better Awareness to Prevent Prostate Cancer


Prostate cancer is the most common cancer among men. In fact, some 2.5 million men currently live with prostate cancer. It is also the second leading cause of death from cancer for men. Take these steps to learn more and to identify your risk of prostate cancer.

Know the symptoms of prostate cancer. These can include urinary changes such as increased frequency, weak stream, urgency and pain with urinating; erectile issues; blood in the urine or semen; or hip or back pain. However, prostate cancer may also present no symptoms, so it is important to know your risk.

Know your risk factors. A family history of prostate cancer, diet, obesity and smoking can all affect your risk of prostate cancer. Also:

  • Risk for prostate cancer rises after age 50, but this cancer is extremely rare for men under 40.
  • African-American men are at higher risk.

Talk with your doctor about prostate cancer screening. A screening includes a complete health history, questionnaires about urinary and sexual function, and a physical exam to feel the prostate. It also includes urinalysis and PSA (prostate-specific antigen) tests. PSA is an enzyme made by the prostate and can be elevated with cancer, urinary symptoms, infection or enlarged prostate. A biopsy may be conducted if the prostate exam shows irregularities or your PSA is elevated.

According to the American Urological Association, screening is recommended once every two years for men ages 55 to 70. However, your health history and risk factors may require a screening earlier than age 55. Discuss with your doctor if screening is right for you, as there are risks associated with screening, especially if a biopsy is needed.

Meet our Urology team and the medical issues they treat. Or call 206.505.1300 for an appointment.

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Summertime and Your Kids


Parents, what fun activities are your kids doing this summer? Staying physically fit is as important as completing their summer reading list! Be sure to mix fun with safety for a successful summer.

Safety first! Avoid injury and promote safety:

  •  Stay hydrated. Always take water with you for outside activities.
  •  Be a smart hiker. Take a rain jacket and warm layers, plus water and snacks. Tell someone exactly where you will hike and when you should be back.
  •  Take care in the sun. Apply sunscreen at least 20 minutes before going outside.
  •  Stretch first. Do some simple stretches to loosen up before walking or hiking.
  •  Protect the head. Ensure kids wear helmets when riding a bike, skateboard, scooter or other toy. Ask an expert to help you properly fit your child’s helmet so that it’s snug, level and comfortable.
  •  Take care in the heat. Be cautious with vigorous outside activities during the midday heat.
  •  Water fun? Keep eyes on the kids. When around water, give children your full attention—kids aren’t safe just because they know how to swim. Even a bucket, fountain or shallow wading pool is a drowning hazard. Drain containers when play is done.
  •  Check pool for safety measures. Choose pools with high fences that lock, lifeguards on duty and safety/rescue equipment nearby.
  •  Wear life jackets. On boats or docks, make sure all children wear a well-fitted life jacket that’s Coast Guard approved.

Now—get those kids moving! Here are some ideas:

  • Run through a sprinkler.
  • Go to a beach and skip rocks, look for small critters in the sand and rocks, or count seagulls.
  • Take a walk along a river. Keep an eye out for fish, insects or other creatures using the water.
  • Fly a kite.
  • Shoot hoops at the local school playground.
  • Play “follow the leader” at a nearby park or through the neighborhood.
  • Learn to hula hoop.
  • Get together with friends and have relay races, keep a beach ball up in the air, do somersaults, roll down a small hill, play tug-o-war, etc.

Active, physical exercise helps children increase self-confidence, boost coordination and build strong muscles and bones—along with a healthy appetite!

Have questions about child safety and health? Our pediatricians can help.

Back to Top


Foods to Promote Healthy Skin


Now that our sunny days are finally here, it’s important to consider consuming antioxidant-rich foods that have a protective effect for skin. Four nutrients that promote healthy, radiant skin are vitamins A, E and C and omega-3 fats. Here is some useful background, plus tips on how to incorporate foods rich in these nutrients into your daily diet. (Be sure to consult your doctor for advice regarding appropriate doses of these nutrients.)

Vitamin A: This vitamin has an essential role in skin health by decreasing cell damage and helping the healing process of bodily wounds. Low levels of vitamin A can lead to a dry, flaky complexion. The recommended daily allowance (RDA) to consume is 900 mcg for men and 700 mcg for women. Don’t hesitate to increase your intake of sweet potatoes, carrots, spinach, apricots, cantaloupe and other yellow and orange fruits and vegetables.

Vitamin E: This antioxidant nutrient also helps protect against skin damage. Research has shown vitamin E plays an important role in photoprotection, preventing ultraviolet (UV)-induced free-radical damage to skin, as well as having related anti-inflammatory roles in the skin. The RDA for men and women is 15 mg. Try grabbing some sunflower seeds and almonds for your afternoon snack.

Vitamin C: In addition to promoting a strong immune system, this water-soluble vitamin is vital for skin health. Vitamin C has an important role in the synthesis of collagen, a major protein of body tissues that include the skin. Dietary and topical ascorbic acid (a form of vitamin C) have beneficial effects on skin cells, and some studies have shown that vitamin C may also help prevent and treat UV-induced photodamage. The RDA for men is 90 mg and 75 mg for women. Include broccoli, red peppers and green peppers in your favorite dishes, or enjoy oranges, strawberries or kiwi for dessert.

Omega-3 fatty acids: These healthy fats are considered essential fatty acids. They are necessary for human health, but the body can’t make them; you have to get them through food. Research has shown that omega-3 anti-inflammatory properties include a protective effect against sunburn and helping prevent premature aging. One of the symptoms of omega-3 deficiency includes dry skin. An adequate intake (AI) for men and women is about 1 g daily. Try sardines, tuna or salmon for a quick and delicious dinner tonight.

Kathleen Bradley, RD, CD, is a registered dietitian at our Canyon Park, First Hill and Northgate clinics. Learn more about our dietitian services at PacMed, or call 206.505.1300 for an appointment.

Back to Top

Grilled Fruit and Balsamic Kabobs


Older kids can help you put fruit on skewers. Adults and kids alike will love the tart-sweet balsamic glaze. You’ll need eight or more 9-12-inch skewers.

Serves 4. Serving size 2 skewers. Prep time 30 minutes; cook time 10 minutes.

Ingredients:

2 cups pineapple chunks

2 cups watermelon chunks

2 bananas, peeled and cut into large chunks

16-ounce package strawberries (stems discarded)

2 tablespoons balsamic vinegar

2 teaspoons honey

1 tablespoon canola oil

Preparation:

1. If your skewers are wood, soak them in water for at least 30 minutes.

2. Heat grill to medium-high heat.

3. Poke fruit onto the skewers. Try to fit 2 pieces of each kind of fruit on each skewer. Place onto a platter or a baking sheet.

4. In a small bowl, mix vinegar, honey and oil. Whisk together. Brush balsamic-honey mixture on fruit with a basting brush.

5. Place fruit kabobs on grill. Turning a two or three times and baste with remaining balsamic-honey mixture. Cook until fruit is caramelized about 8 to 10 minutes. Serve!

Recipe copyright © 2016 American Heart Association.

Nutrition Information per Serving (two 9-inch skewers)

Calories: 199, Total Fat 4.1g, Saturated Fat 0.3g, Cholesterol 0mg, Sodium: 5.2mg, Total Carbohydrate: 43.1g, Fiber 5.3g, Sugar: 29.9g, Protein: 2.4g

More recipes online! Go to www.PacMed.org/recipes.

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LWA Updates


To help your organization stay on track with health this summer, the Living Well Alliance is introducing two new classes! Our on-site classes are convenient and led by health professionals.

NEW CLASS: An in-depth look at sugar. In this class, we help your employees wade through all the hype to learn the truth about this molecule and what it does to their health. Participants will learn why humans evolved to crave sugar, the consequences of eating too much and how to read food labels to learn your sugar limit. Employees will leave with suggestions on how to reduce sugar intake and cravings. Is a sugar detox in your future?

NEW CLASS: Making successful behavioral changes. This class is an excellent companion to the nutrition counseling program the Living Well Alliance started in June. Many of us know what we need to change, but turning that knowledge into action is tricky. Class participants will discuss theories that evaluate approaches to change, learn effective methods for successfully changing lifelong habits and finally evaluate their own readiness to change while creating an individualized plan.

Still need a push in the right direction? Living Well Alliance can help! Sign up for individual nutrition counseling with a registered dietitian today. Read our flyer.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 1.206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – JUNE 2017


Topics This Issue:


Cataracts Prevention and Treatment


Almost everyone knows an older family member or friend who has had cataracts. But what are cataracts? Can you avoid them? How do you detect a cataract?

What is a cataract? What are the symptoms? A cataract is a clouding of the lens in the eye that impairs vision. It can occur in one eye or both. A person with a cataract may notice that their vision has become blurred or duller. They may have trouble reading or identifying colors, in particular blues and purples. Their night vision may become compromised and light-sensitive; headlights or lamps may seem too bright or to have a halo or streaks radiating from them.

What is the role of the eye’s lens? The lens in the eye is critical to seeing well. It focuses light that enters the eye onto the retina at the back of the eye, creating an image that is sent to the brain. It also focuses the eye so you can see things far away or close up. Just like a camera with a smudged lens, if the eye’s lens is cloudy, the image quality will be poor.

The lens is made of proteins and water. The proteins are precisely arranged to let light pass through. With a cataract, some of the proteins bunch together and cloud part of the lens. The cloudy area increases over time, making it more difficult to see.

Who gets cataracts? How do I reduce my risk? Although most cataracts occur in older people, others can also experience this. Some children are born with small cataracts. Cataracts also can be caused by surgery, steroid use, exposure to radiation or an eye injury. Finally, some diseases such as diabetes can contribute to your chance of cataracts developing earlier.

You may be able to reduce your risk of a cataract. Avoid UV exposure by wearing sunglasses or regular clear glasses with a UV coating. Outdoors, wear a brimmed hat. Also, get good nutrition—in particular, green, leafy vegetables, fruit and other foods with antioxidants.

It’s also very important to receive regular, preventive eye care from an optometrist or ophthalmologist. A typical eye exam is painless and measures several factors. Your eye doctor will track your vision health over time, record changes and answer your questions.

How are cataracts treated? Nonsurgical treatments aim to improve vision as much as possible. These include maximizing glasses prescription and possibly adding a tint to reduce glare; choosing reading materials with a larger font;ensuring good lighting; and wearing a hat to cut glare.

Surgery may be recommended once the symptoms have progressed to a point that it interferes with your daily activities. The cloudy lens is replaced with a clear artificial lens called an intraocular lens.

The PacMed Optometry team can assess your eye health, and our Ophthalmology department offers cataract surgery. To see which of our providers currently do cataract surgery, please visit our Cataract Surgery page.

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6 Tips to Keep You Lookin‘ Good


The signs and symptoms of many eye issues are so mild that you may not notice them. The best solution? Get routine eye exams. Plus, these six tips are good for eye health.

1. Take a “20-20-20” break. Do you get eye strain from computer work or doing close work? Follow the 20-20-20 rule: Look up every 20 minutes and focus on an object 20 feet away for 20 seconds.

2. Choose good sunglasses. UV-blocking sunglasses delay the development of cataracts, help prevent eye damage and help prevent wrinkles and cancer. Choose sunglasses that block 100% of UV-A and UV-B rays.

3. Get to know your family tree. Know your family’s history of eye disease. You may be at increased risk for those diseases and may need close monitoring.

4. Ouch! Use protective eyewear. The US has 2.5 million eye injuries each year. But many could be prevented! For home projects, choose ANSI-approved eyewear. Wear protective eyewear designed specifically for your sport.

5. Stub out that cigarette. Smokers are at increased risk of developing cataracts, macular degeneration and disorders of the blood vessels of the eyes.

6. Don’t abuse contact lenses. Follow the instructions about the care and use of contact lenses. Misusing them can result in serious eye conditions that can cause severe pain and vision loss.

Vitamin D.

The first step to good eye care? Make an appointment. We invite you to learn about our Optometry department.

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Smart Nutrition Choices for Eye Health


How does diet play into vision health?

Studies have shown that some nutrients may help prevent age-related macular degeneration (AMD). AMD is a common eye condition and the leading cause of vision loss in people over 50 years old. While specific vitamins and supplements are promoted as beneficial, experts agree that the best method is simply to consume a varied diet that’s rich in antioxidants, lutein and zeaxanthin.

Recommended sources of these specific nutrients include:

  • Dark green vegetables, especially kale, spinach and Swiss chard
  • Most vegetables, especially corn, squash, tomatoes and sweet potatoes
  • Most fruits, especially nectarines, oranges and papaya
  • Egg yolks

In addition to diet, certain lifestyle factors can also affect eye health. Be sure to exercise regularly, avoid smoking and maintain normal blood pressure, blood sugar and cholesterol levels. Check in with your eye care professional on a regular basis as well to receive prompt treatment for any macular issues.

Want to learn more about nutrition? Learn more about our team of dietitians.

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Open-Faced Baked-Egg Croque


Love egg sandwiches but hate the mess? Try baking the egg on top of a thick slice of bread in the oven! Egg yolks provide healthy nutrients like zinc, lutein and zeaxanthin—which protect the eyes—plus choline, which protects the brain.

Serves 2. Prep time 5 minutes; cook time 20 minutes.

Ingredients:

Bread, preferably whole grain, cut into 2 long, thick slices

4 eggs

1 tablespoon grated cheese such as parmesan, gorgonzola or cheddar

1 scallion, chopped

1 teaspoon chopped fresh parsley, cilantro or basil

Salt and pepper to taste

Preparation:

1. Preheat oven to 375 F degrees. Cover a pan with aluminum foil.

2. Tear a small hole in the center of each bread slice to accommodate two eggs. Crack two eggs into each slice of bread.

3. Top eggs with cheese and scallion.

4. Bake on a middle rack for 20 minutes (or enough to toast bread and set eggs).

5. Sprinkle fresh herb on top and season with salt and pepper.

Nutrition Information per Serving (1 serving = 1 slice bread with 2 eggs)

Calories: 246, Total Fat 13g, Saturated Fat 4g, Cholesterol 374mg, Sodium: 426mg, Total Carbohydrate: 16g, Dietary Fiber 1g, Sugar: 2g, Protein: 16g

Original recipe by Christy Goff, MS, RDN, CD

More recipes online! Go to www.PacMed.org/recipes.

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On-Site Nutrition Counseling from Living Well Alliance


Employees, it is time to take charge of your health! When you feel fit and well, morale improves and illnesses decreases.

Many chronic illnesses can be prevented or improved with a change in lifestyle supported by good nutrition. This is why Living Well Alliance (LWA) is introducing on-site, individualized nutrition counseling. This program is typically offered after a LWA class or screening event at the employer’s offices—so it’s easy for employees to participate. The counseling can support healthy meal planning and weight loss, ease of digestive issues, chronic disease management and other health and fitness goals.

For $200, the Nutrition Counseling program includes three visits:

  • Initial 30-minute, confidential consultation with a registered dietitian
  • Two 15- to 20-minute, individual follow-up visits with each employee, scheduled 2-4 weeks apart.

Additional sessions can be scheduled, or outside referrals can be made. Prior to meeting with the dietitian, participants will fill out a confidential form to gather personal goals and health and food history. The Living Well Alliance team will encourage the goals that employees want to focus on.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 1.206.621.4419 for more information or email .(JavaScript must be enabled to view this email address).

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – MAY 2017


Topics This Issue:


Bone Up on Osteoporosis


Understand your risk factors, when to get screened and ways to protect your bone health.

Osteoporosis, which means“porous bone,” is a silent disease that can have devastating effects. With this disease, bone tissue and mass deteriorate, which leads to frail bones and a higher risk for serious fractures.

“The kicker,” says Dr. Mary Wemple, a rheumatologist at PacMed, “is that this bone-loss condition occurs without symptoms. That’s why screening is so critical.”Because bones weaken gradually over time, people may not know that they have osteoporosis until a sudden strain, bump, or fall causes a fracture.

In the U.S. today, 10 million people already have osteoporosis. Although osteoporosis cannot be cured, it can be effectively treated. Most important, it can be prevented.

Who Is at Risk?

Older women are particularly susceptible. Risk factors for osteoporosis include:

  • Being female
  • Going through menopause
  • Male or female—being slim and less than 130 pounds
  • Smoking cigarettes
  • Drinking excess alcohol (more than three glasses daily)
  • Having a first-degree relative with osteoporosis
  • Age—the older you are, the greater your risk

Certain health conditions, medications and ethnicities can also play a factor.

Who Should Get Screened?

Screening for osteoporosis involves a bone density scan. This scan is a quick, painless procedure that uses an enhanced, low-radiation form of X-ray technology called DXA (pronounced “dexa”).

  • Women: If you are over age 65, screening is highly recommended. If you are younger than 65 but have risk factors, you may benefit from screening.
  • Men: If you are over age 70, you should discuss bone density screening with your primary care doctor. If you are younger than 70 but have risk factors, you may benefit from screening.

What Preventive Steps Can I Take?

Two of the most important steps are to get the daily recommended amounts of calcium and vitamin D, and to regularly engage in weight-bearing, muscle-strengthening exercise. Talk with your primary care doctor for guidance, and read the related articles in this month’s Healthy Tips on nutrition and exercise suggestions for good bone health.

The message Dr. Shailaja Reddy drives home with her patients is one of awareness and prevention. “Get your calcium and exercise, even if you’re in your forties,” she recommends. “If you do this consistently from a younger age it will help you down the road.” Dr. Reddy practices internal medicine at PacMed.

Already diagnosed with osteoporosis? Learn more about the Rheumatology team at PacMed.

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Important Nutrients for Bone Health


Three nutrients important for healthy bones are calcium, vitamin D and magnesium. Here is some useful background, plus some tips on incorporating foods that are rich in these nutrients into your daily diet.(Be sure to consult your doctor for advice regarding appropriate doses of these three nutrients.)

Besides regular weight-bearing exercise (see related article!), getting enough calcium in your diet is a key element to preventing osteoporosis. One general guideline for women who are past menopause is 1,200 mg of calcium each day.

Vitamin D and calcium go hand in hand: without vitamin D, calcium can’t be absorbed. While our bodies synthesize vitamin D through the exposure of our skin to sunlight, that can be tricky in the cloudy Northwest—and even in summer,when you block the sun’s rays with sunscreen. Vitamin D supplements are usually needed, with the recommended daily amount being 600–800 international units.

Magnesium is a mineral, and it plays a critical role in your body, including maintaining healthy bones and a healthy heart. Magnesium exists in your body in significant amounts, with the major portion contained in the skeleton. Deficiencies of this mineral can lead to your bones becoming brittle, which in time increases the risk of fractures. Most people on average need to consume 300–400 milligrams of magnesium a day.

Boosting Your Diet for Good Bone Health

Increasing your intake of dietary sources that are rich in calcium, vitamin D and magnesium can support a personal health goal to maintain strong, resilient bones. As always, work closely with your medical provider to create a care plan that’s right for you.

Calcium. Calcium is found in dairy products (for example, milk, yogurts and cheese), fortified juices, canned salmon and some plant sources such as tofu. Try making “tuna melts” with salmon instead of tuna, or enjoy plain, low-fat yogurt with fresh fruit for a mid-morning snack.

Vitamin D. Vitamin D is in milk and some yogurt and can also be found in eggs, mushrooms and some fortified foods. Starting your day with a hardboiled egg or having a glass of milk instead of your midday soda can help.

Magnesium. Foods rich in magnesium include green leafy vegetables, whole grains, beans and nuts. Fresh fruits and vegetables also provide a modest amount of magnesium.

For more information about PacMed and our dietitian services, please visit www.PacMed.org. To make an appointment, use our appointment tool or call 206.505.1300.

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Fitness 101 for Strong Bones


Bone is living tissue, and it gets stronger when you exercise. Specifically, weight-bearing and muscle-strengthening exercise helps to increase bone density and strength; walking, climbing stairs, jogging, dancing, tennis and lifting weights all fit the bill. These forms of activity also increase coordination and balance, both helpful in preventing falls.

Another term for bone-smart exercise is “resistance training.” Resistance training is any form of exercise that forces the body to overcome an externally applied force. Lifting weights or exercising with elastic bands are good examples: your body must work against the force of the weights or the bands. Over time, resistance training increases your strength, power and bone density.

Weights are a popular form of resistance training. If you’re new to weight lifting, consider working with a trainer to learn proper technique and to slowly build your strength. A few other tips:

  • Be sure to work all major muscle groups—chest, back, legs, shoulders, arms, core. Ideally, do two exercises per muscle group.
  • Stay focused and use your core to stabilize your body’s alignment.
  • Over time, aim for 1–3 sets of 10–15 repetitions.
  • Choose a resistance that heavy enough that the last 2–3 reps are challenging.
  • As you gain agility and strength, consider adding some simple devices to simultaneously improve your balance—like standing on a square of two-inch foam or an inflated rubber balance disc.
  • Be sure to rest for 48 hours between workouts. A good plan is three resistance training sessions per week.

If weights aren’t your love and joy … you might try yoga, martial arts and Tai Chi. These excellent exercise forms combine strength, balance and flexibility. Pilates—whether a mat class or using Pilates equipment with a Pilates trainer—offers a good workout for your core muscles.

Before starting any new exercise activity, consult your primary care provider to make sure it is a good fit for your health situation. Looking for a primary care provider? Explore PacMed Primary Care to learn about family medicine, internal medicine and others options.

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Black-Eyed Peas and Collards


Recipe adapted by Christy Goff, RD, CD

Spring is the perfect time for collards, a healthy green that’s delicious—and a classic dish—with black-eyed peas and bacon. Did you know that black-eyed peas and collard greens have a surprising amount of calcium in them? Just 1 cup of each is equivalent to 2 glasses of milk. And since May is osteoporosis prevention month, enjoy this recipe all month long! For a vegetarian dish, omit bacon and add sautéed tempeh for a crunch.

Serves 4. Prep time 20 minutes; cook time 30–120 minutes.

Ingredients:

1 cup black-eyed peas, dried

1 tablespoon olive oil

1 large onion, finely chopped

3 cloves garlic, finely chopped

3 strips bacon, cut into small pieces

1 bay leaf

1 bunch collards

Salt and pepper

Directions:

1. Soak the black-eyed peas overnight in 4 cups of water.

2. Heat olive oil in a large saucepan on medium heat. Add the onion, garlic, bacon, and bay leaf. Cover the pan with a lid and leave it for 2 minutes. Stir occasionally and cook until the onions are translucent and the bacon is starting to be crispy.

3. Drain black-eyed peas and add to saucepan. Cover peas with just enough water to submerge them and turn heat to medium-low. Cooking time will vary, from 30 minutes to 2 hours, depending on the peas. Peas are done when you can easily squish them on the countertop with the back of a spoon. Check on them every half hour or so, and if water becomes low, add more to cover peas.

4. Wash collards thoroughly and cut out the tough central stems. Chop leaves into bite-sized pieces or tear by hand into small pieces.

5. Once peas are cooked, drain water and put peas back in pan. Add collards to the pot and cover with lid; continue cooking on medium-low. Stir in 1 teaspoon salt and some freshly ground pepper. Cover and let sit for 10 to 15 minutes. Once collards are tender, turn off heat. Add onion and bacon mixture to serve.

6. Serve dish over rice or with some toast or flatbread.

Nutritional Information (without grain) (1 serving = 1/4 recipe):

Calories: 166, Total Fat 9g, Saturated Fat 2g, Cholesterol 14mg, Sodium: 370mg, Total Carbohydrate: 12g, Dietary Fiber 5g, Sugar: 2g, Fiber: 9g

Source http://www.leannebrown.com.

More recipes online! Go to www.PacMed.org/recipes.

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June Wellness Symposium for HR Professionals


Attention HR employees—Save the date for our FREE wellness symposium! PacMed’s Living Well Alliance team is hosting this event to provide you with ideas on ways to enhance your company’s wellness initiatives.

Wellness Symposium
June 22, 10:00 a.m.–2:30 p.m.

PacMed Beacon Hill campus,
1200 12th Ave S
Seattle, WA 98144

This lively half-day event will include speakers and roundtable sessions on how to get your employees engaged, making your program effective while still watching your budget, helping your workforce prevent injuries and diseases and more!

Look for an official invite in May! You may also email Christy Goff, MS, RDN, CD, for more details.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 1.855.550.8799 for more information or email .(JavaScript must be enabled to view this email address).

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Health Tips 2017 | Mental Wellness | Seattle, WA | Pacific Medical Centers
Health Resources

HEALTH TIPS – APRIL 2017


Topics This Issue:


Know the Signs and Symptoms of Depression


Depression is a common and treatable condition. This brain condition leaves a person feeling sad—but it’s different from normal sadness.

Depression can make it hard to work, concentrate or do everyday tasks. Depression can affect anyone, regardless of age, gender or health situation. It can affect people of any race or ethnic group.

What Are the Symptoms of Depression?

People with depression feel down most of the time for periods lasting at least two weeks. They also have at least one of these symptoms:

  • No longer enjoy or care about doing the things they used to like to do
  • Feel sad, down, irritable, hopeless or cranky most of the day, almost every day

Depression can also make people:

  • Lose or gain weight.
  • Sleep too much or too little.
  • Feel tired or have no energy.
  • Feel guilty or worthless.
  • Forget things or feel confused.
  • Think about death or suicide.

Are There Treatment Options?

Safe and effective treatments for depression are available. They include seeing a psychotherapist, taking medications or a combination. Talk with your primary care provider to decide what options are right for you.

As you recover, remember that taking good care of yourself can also help boost your emotional state. Specifically, get regular exercise, like walking briskly or cycling three to five times each week. Be sure to eat a healthy and balanced diet. Avoid drugs and alcohol; they can worsen depression symptoms.

Finally, reach out to friends and family whom you are comfortable with. Talking openly and surrounding yourself with supportive, understanding people is important for recovery.

Learn more about our Behavioral Medicine team at PacMed. Our team of licensed therapists offers individual, couples and family therapy. They also can help with medication management and provide psychiatric evaluation. To make an appointment, use our appointment tool or call 206.621.4045.

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Are You or Someone You Know in Crisis?


If you are thinking about suicide or hurting yourself, help is available:

  • In an emergency, call 9-1-1
  • Go to the emergency room at your local hospital
  • Call the King County 24-Hour Crisis Line: 1 (866) 427-4747
  • Call the National Suicide Prevention Lifeline: 1 (800) 273-8255
  • Call your health care provider and tell them it is urgent

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Is My Son Depressed, or Just Lazy?


By Jack Shriner, LICSW, CMHS

I have been asked this question by many parents with sons in middle and high school. In fact, this question often brings a family in for an initial appointment with a psychotherapist. Although I mostly hear from mothers worried about their sons, my thoughts apply well to fathers and daughters, too.

A mother will express concern that her son has been withdrawn, holed up in his room, eyes glued to his Xbox. He seems more irritable. Also, his grades may be lower than last year, he doesn’t spend as much time with friends, and it’s like pulling teeth to get him to do his household chores—let alone get ready for school in the morning.

So, does the son have a psychiatric condition that needs treatment? Or is he just pulling a fast one to get out of doing work? For parents, this often leads to another question: do I respond with concern or with discipline?

First, be sure to review the typical signs of clinical depression in the accompanying article.

It is important to remember that—aside from statements about suicide or evidence of self-harm—it’s perfectly normal for anyone to experience one or two of these things from time to time. We start talking about depression only when the symptoms are ongoing and excessive, and they cause clear problems with a child’s functioning at home or school.

So, let’s say your child is showing some signs of depression. You can be a positive influence. For starters, drop the word lazy from your vocabulary. The best way to change a child’s behavior is to encourage the behavior you want, not to criticize the behavior you don’t want. Using negative labels like “lazy” is more likely to discourage your son and may even confirm thoughts that he’s not living up to your expectations.

The bottom line is that good parenting involves a constant dance between concern and discipline. This dance is challenging, and no parent is always going to get it right. If you suspect your pre-teen or teenage son is depressed, consider the following responses:

  • Think of discipline as teaching, not punishment. Keep a calm, neutral tone when setting and enforcing rules.
  • Help your son make a plan for coping positively with sadness or stress. For example, consider using art, writing, music, exercise, relaxation, or outings.
  • Share how you deal with feelings that arise in your life, such as frustration after a hard day at work.
  • Limit factors in your son’s environment that seem to trigger negative feelings. For example, if you feel the Xbox is not helping, relocate it to the living room and limit his use.

Other circumstances such as grief, drug use or a condition called hypothyroidism can cause symptoms similar to depression. These should be ruled out by a health professional and treated appropriately.

Seek out a psychotherapist for additional help if needed. Don’t be afraid to ask lots of questions!

Jack Shriner, LICSW, CMHS, is a licensed clinical social worker at Pacific Medical Centers at Beacon Hill. For more information about Jack and our other Behavioral Medicine providers, please visit www.PacMed.org. To make an appointment, use our appointment tool or call 206.621.4045.

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How Vitamin D May Affect Depression


It’s no secret that vitamin D contributes to the development and maintenance of healthy, strong bones. But did you know that it is also being researched for its effects on depression?

Here Comes the Sun!

Our bodies naturally synthesize vitamin D when exposed to sunlight. All you need for a week’s worth of vitamin D is 15 to 20 minutes in the sun. Vitamin D helps the body absorb calcium, which supports the development and maintenance of healthy bones. This is critical in children as they grow. Adults also need vitamin D and calcium to prevent osteoporosis, or brittle bones, as they age.

While we’ve known about the connection between vitamin D and calcium for some time, more recent research is looking into the connection of vitamin D to depression. It is possible that this vitamin may play a role in improving symptoms of depression and seasonal affective disorder (SAD). Other research has shown that vitamin D may also improve muscle recovery, help prevent soreness and aching, and help with immune function.

You can get small amounts of vitamin D from foods including fish, eggs and fortified milk, but for people living in the Seattle area, it’s hard to get enough vitamin D without taking a supplement, particularly during winter.

Balancing Vitamins and Sunshine

The Institute of Medicine recommends a minimum daily allowance of 600 international units (IU) of vitamin D per day and 800 IU per day for people over age 70. People living in the Pacific Northwest may need more than this due to our limited exposure to the sun, particularly during winter.

Lisa Sieberson, DNP, ARNP, recommends to her patients that they take a daily vitamin D supplement with 1000 to 2000 IU to ensure sufficient vitamin D levels.

During the summer months, when the sun does come out in Seattle, it is easier to get those 15 to 20 minutes of sunshine per week. However, keep in mind that sunscreen blocks the UV light that allows our skin to synthesize vitamin D.

She doesn’t advise going into direct sunlight for extended periods of time without sunscreen, especially for those who are fair skinned or have other risk factors for skin cancer. For this reason, it may be worthwhile to take vitamin D supplements all year round.

Some people are more susceptible to low vitamin D than others. People with darker skin tones need more sunlight to synthesize enough vitamin D. Breast-fed infants are also prone to vitamin D deficiency because breast milk does not usually contain a sufficient amount of vitamin D and infants should not be exposed to direct sunlight.

Seattle’s latitude and propensity for cloudy days make it hard for all of us to get enough vitamin D, so if you’ve got the rainy-day blues and aren’t already taking vitamin D, you might want to consider a supplement to boost your vitamin D. Talk with your doctor!

Learn more about the author, Lisa Sieberson, DNP, ARNP or call 206.505.1300 for an appointment.

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Lemon-Garlic Salmon Foil Pack with Green Beans and New Potatoes


Salmon has never been easier to cook, wrapped up in a packet to bake in the oven. As a bonus, crunchy green beans and garlicky potato slices are added for a complete meal.

Serves 4. Serving size one filet. Prep time 30 minutes; cook time 20 minutes.

Ingredients:

  • 1 pound new potatoes
  • 2 teaspoons garlic, minced
  • 1 pound green beans, ends trimmed
  • 2 tablespoons canola oil
  • 1/4 teaspoon salt
  • 1/4 teaspoon black pepper
  • 4 six-ounce skinless salmon filets
  • 1 to 2 lemons, sliced into wheels

Directions:

1. Preheat the oven to 400 degrees. Make four sheets of aluminum foil about 30 inches long. Fold the foil in half widthwise (into almost a square) so it's extra sturdy.

2. Cut each potato into half lengthwise. Thinly cut each half into ?-inch slices and place into a heatproof container. Stir in the minced garlic, cover and cook the potatoes in the microwave until halfway tender, around 90 seconds to 3 minutes, depending on microwave’s power. Transfer mixture to a bowl, along with green beans, oil, salt and pepper. Mix to combine.

3. Divide potato mixture into 4 equal portions and place in the center of each foil square. If possible, nudge green beans to face the same direction. Top each portion with a salmon fillet, aligning with green beans for easier folding. Top with 2 lemon wheels.

4. Securely seal the top and sides of each foil packet. Place each packet onto a large baking sheet and put in oven. Cook until salmon is cooked through, about 20 minutes.

5. Remove from oven and place each foil packet onto a plate. Carefully open each packet to serve.

Nutritional Information (1 serving = 1 packet, or 1/4 of recipe):

Calories: 394, Total Fat: 15g, Saturated Fat: 2g, Cholesterol: 79.5mg, Sodium: 286mg, Total Carbohydrates: 23.1g, Sugars: 4.4g, Dietary Fiber: 5.1g, Protein: 40.4g

Recipe © 2016 American Heart Association.

More recipes online! Go to www.PacMed.org/recipes.

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New Spring Classes from the Living Well Alliance


Classes from the Living Well Alliance help local organizations provide wellness programming to their employees. Their 45- to 60-minute classes are interactive, fun, current—an easy fit for your worksite.

This spring, we are rolling out a two new Take a Break to Educate classes:

  • Participants in our new Quick, Healthy Meals class will gain skills to help them pull together nutritious meals when there is no time to spare. Together, we will discuss how to plan a meal, be efficient in the grocery store and cut corners in the kitchen to save time, dirty dishes and sanity.
  • In Brain Boost, participants will learn ways to help protect their brain against memory decline as they age. The class will touch on various nutrition and lifestyle factors.

Our up-to-date, research-based topics can help you promote health and disease prevention among your employees. All classes are taught by qualified health professionals.

Learn more at the Living Well Alliance website. For the latest class information, click the Take a Break to Educate button for class descriptions and the Program and Services button for pricing.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 1.855.550.8799 for more information or send us an email.

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – MARCH 2017


Topics This Issue:


Colorectal Cancer Risks and Prevention


In 2017, the American Cancer Society predicts some 135,000 new cases of colorectal cancer and about 50,000 deaths. But this doesn’t have to be the case! The disease is largely preventable with regular screening and is treatable with early detection.

If you are over 50 or have a family history of colorectal cancer, talk to your doctor about getting screened today. The more you know, the better you can take care of your health.

Colorectal Cancer Signs & Symptoms

Colorectal cancer—also commonly called colon cancer—often has no symptoms. This is why screening is so important. These symptoms, however, might indicate colorectal cancer:

  • Blood in your stools
  • Unexplained abdominal pain
  • Unexplained change in bowel habits
  • Unexplained anemia
  • Unexplained weight loss

Screening/Early Detection

Colon cancer is mostly preventable with regular screening. Screening can help catch colon cancer at an early, curable stage. It also gives your care team the ability to find and remove precancerous polyps.

Beginning at age 50, both men and women who are at average risk for developing colorectal cancer should have a screening colonoscopy and then repeat the procedure every 10 years. All men and women are at risk for colorectal cancer. However, African Americans, Hispanics and Ashkenazi Jews (people of Eastern European descent) are at a higher risk for the disease than other populations.

Understand Your Insurance Coverage

Before you get your screening, be sure to talk with your insurance company about your coverage for a colonoscopy. It’s important to understand your insurance coverage for a routine, preventive colonoscopy screening—but also your coverage if a biopsy or polyp is removed during your screening.

Learn more about colonoscopies at PacMed and our colonoscopy specialist, Michele Pulling, MD, including her practice philosophy and special interests. Or call 206.505.1300 for an appointment.

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A Colonoscopy Is Easier Than You Think


A colonoscopy could save your life! When colorectal cancer is detected early, it can be treated. But many people avoid getting a colonoscopy because they feel embarrassed or afraid. Here’s what to expect.

A colonoscopy is a medical screening that checks your colon for cancer and any polyps (unusual growths). To do the screening, the doctor uses a thin, flexible scope that has a light and a small camera on the end. The procedure usually lasts just 15–30 minutes.

For the vast majority of patients, a colonoscopy is easy or mildly uncomfortable. The benefit can be enormous—life-saving, in fact! Learn more by talking with your primary care provider or gastroenterologist.

At-Home Preparation

The preparation you do at home in the days before your colonoscopy are key to a successful screening. If you don’t understand any part of the instructions, be sure to ask your doctor or nurse.

The colon must be empty and clean before the screening. So, for several days before the procedure, you will follow a limited diet. On the day before the screening, you will drink large amounts of a laxative, to ensure your colon is empty. (You will need to be at home on this day because you will use the bathroom frequently.) For the last half-day or night, you will consume only clear fluids.

Finally, be sure to enlist a friend or family member to drive you home from the screening. You cannot take a cab or other service.

During the Colonoscopy

You will be lightly sedated so you relax. You will probably feel sleepy. Most people, in fact, are unable to remember the procedure afterward.

During the screening, you will be covered with a drape. The doctor will examine the walls of your colon using the scope. If you are awake, the doctor will let you know what to expect and check on your comfort. If the doctor finds some small polyps (growths), those may be removed because some polyps can become cancerous over time. If the doctor finds larger polyps, those will be removed and sent to the lab for testing.

Learn more about colonoscopies at PacMed and our colonoscopy specialist, Michele Pulling, MD, including her practice philosophy and special interests. Or call 206.505.1300 for an appointment.

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Baked Apple with Oat Crumble


Warm apples and a crispy topping make this a comforting and healthy dessert. Leave the skin on the apples for a dose of fiber, and serve with a small scoop of vanilla yogurt, if desired.

Serves 4. Serving size ½ apple. Prep time 15 minutes; cook time 60 minutes.

Ingredients:

  • 2 medium apples (such as Gala, Fuji, Honey Crisp or Pink Lady)
  • 3 tablespoons finely chopped pecans
  • 2 tablespoons uncooked regular oats
  • 1 tablespoon brown sugar
  • 1 tablespoon cold butter, cut into small pieces
  • 1/4 teaspoon ground pumpkin pie spice
  • Pinch of salt
  • 1 orange, juiced (use some orange zest to add brightness to the finish product)

Optional: Serve with a dollop of vanilla yogurt

Preparation:

1. Preheat the oven to 350° F.

2. Cut each apple in half horizontally (so the stem is in one half and the flower end is in the other). Use a spoon to remove most of the core from each half, leaving about a half-inch of apple in the floor of the rounded hole.

3. Use your fingers to combine nuts, oats, brown sugar, butter, spices and salt,until mixture resembles coarse meal. Fill each apple half with about 2 tablespoons of the mixture.

4. Place apples in an 8-inch baking dish; pour orange juice around apples in dish. Cover with aluminum foil. Bake 30 minutes. Sprinkle a small amount of orange zest on top for color (optional)

5. Remove foil, and bake an additional 30 minutes or until apples are tender and easily pierced with a toothpick. (Baking time will vary depending on variety, size and ripeness of apples.)

Nutritional Information (without yogurt):

Calories: 101, Total Fat: 4g, Saturated Fat: 2g, Cholesterol: 8mg, Sodium: 100mg, Total Carbohydrates: 17g, Sugars: 11g, Fiber: 3g, Protein: 1g

More recipes online! Go to www.PacMed.org/recipes.

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Eat More Fiber for Digestive Health


By Christine Stirparo, RDN, CD

Are you getting enough fiber in your diet? Adequate fiber intake can help lower cholesterol levels, keep blood sugar levels under control and prevent constipation and diverticulosis.

A high-fiber diet is also usually lower in calories and can increase feelings of fullness after meals, which can help promote a healthy weight. So, how much fiber do we need? What are good sources?

The recommended amount of fiber is 25g per day for women (21g over age 51) and 38g per day for men (30g over age 51). Unfortunately, most Americans fall far short of the recommended amount.

Fiber is found in plant foods such as fruits and vegetables, nuts and seeds, and whole-grain products.

Try these simple substitutions to increase the amount of fiber in your diet:

  • Have steel cut oats with nuts and berries for breakfast instead of cereal.
  • At lunchtime, choose bread products that say “whole wheat” as one of the first ingredients and add vegetables such as tomatoes, cucumber and spinach to sandwiches or wraps.
  • Add more vegetables or beans to casseroles and stews.
  • Try brown rice or wheat pasta instead of white rice or pasta.
  • Snack on fruits and vegetables during the day instead of packaged snacks from home or the vending machine.

As you increase the fiber in your diet, do it gradually and drink plenty of fluids. You may experience constipation and nausea if you consume more than your usual amount of fiber without adequate fluid intake.

Have questions about fiber and nutrition? Our primary care providers can help. PacMed also has dietitians who can help you fine-tune your diet.

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New Year, New PacMed Clinics


Pacific Medical Centers expands its proven model of quality care to south Puget Sound.

“The

The new PacMed Lacey clinic opened December 5, 2016. (Photo by Michael Cole)

As our region grows, so grows the challenge of finding reliable health care options. Fortunately for those living in the south Puget Sound area, two new PacMed clinics opened in 2016—and more locations are on the way.

Our newest clinics—Lakewood opened in May, and Lacey in December—both offer patients our trade mark high-end service and convenience. You can schedule same-day primary care appointments at both locations, and our providers will coordinate any specialty care you might need. Plus, PacMed accepts most major health insurance plans, including Health Exchange options.

“We are pleased to join the Lakewood and Lacey communities,” says PacMed CEO Linda Marzano. “We believe those residents will find value in our proven, low-cost, high-quality care model, which creates positive outcomes for patients and helps them to live their healthiest lives.”

“PacMed offers a patient-centric approach to care that encourages collaboration between patients and providers, as well as within our care teams,” says Dr. Rick Ludwig, Medical Director, US Family Health Plan. “We find that this collaboration, along with a focus on prevention, leads to a better, more personalized experience for our patients.”

The Lakewood and Lacey clinics also offer greater access to care for military families associated with nearby Joint Base Lewis-McChord. PacMed is the only West Coast provider of US Family Health Plan (USFHP) and has been serving the local military community for more than 30 years. USFHP provides active-duty family members and retired military personnel with a civilian option to health care at no added cost. Our military patients routinely express high satisfaction with their overall PacMed experience.

With its expansion into Pierce and Thurston counties, PacMed now operates11 clinics in the greater Puget Sound area. In the last three years, PacMed has increased the number of patients it treats from about 87,000 to more than 100,000.

We invite you to stop by and visit us soon! Our Lakewood clinic is located at 7424 Bridgeport Way W, Suite 201(phone 253.984.2600). Our Lacey clinic is at 4800 College Street SE (phone360.486.2800). You can request an appointment online at www.PacMed.org/schedule or by calling 1.888.4PACMED(1.888.472.2633).

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Wellness Consultations from The Living Well Alliance


Eat! Sleep! Be Merry! The wellness consultations offered by our Living Well Alliance at your worksite deliver all this—and more.

If your employees want to change behaviors to achieve better health, the best place to begin is with focused information delivered by trustworthy professionals. The Living Well Alliance is passionate about supporting your employees. Our programs can help them eat healthier, sleep better and find ways to be at their best health one step at a time—and many of our wellness programs are complimentary.

The Living Well Alliance offers complimentary consultations to employers and other organizations. By meeting with your HR director, we can determine which of our lunchtime classes, confidential screenings, health fairs and other offerings are best suited to your wellness goals. All of our programs and services are led by a nurse, dietitian or other health professional. Employees always have the opportunity to ask our staff questions.

The Living Well Alliance is run by Pacific Medical Centers. Call us today at 206.621.4419 for more information or send us an email.

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – JANUARY 2017


Topics This Issue:


Walk Your Way to Better Health


Why let wintery weather sidetrack your exercise goals? It’s time to bundle up, put on your walking shoes and explore our spectacular scenery. Dr. Ari Gilmore offers this advice on how to get moving.

One great aspect of walking is that you can do it in any weather—without investing in expensive equipment or joining an athletic club. Walking 30 to 60 minutes daily at a moderate pace burns fat, lowers blood pressure and strengthens bones, muscles and joints. It may also reduce risk for heart disease, type 2 diabetes, various cancers and osteoporosis.

If you are just starting a walking program:

  • See your doctor if you don’t currently exercise, have diabetes or high blood pressure, or are over 65.
  • Get fitted for a good pair of walking or running shoes.
  • Dress in layers so you can respond to changing conditions.
  • Stay hydrated. Carry water if it’s warm or you’ll walk for more than an hour.

When walking, don’t lean forward or backward. Stand straight, relax your shoulders, and bend your arms and swing them to add power to your walk. If you are feeling out of shape, start slowly and add a few minutes to your walk each date. If you have a pedometer or fitness monitor, begin with 2,000 to 3,000 steps a day and build from there.

If you experience pain in your feet or elsewhere, try resting up for a day. If you see swelling or bruising, treat it with rest, ice, compression and elevation (often referred to as RICE). If symptoms persist beyond 48 hours, make an appointment with your doctor.

Here's to your winter explorations!

Ari Gilmore, MD, is a family medicine physician at our Beacon Hill clinic. Learn more about Dr. Gilmore at www.PacMed.org, or call 206.326.2400 for an appointment.

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Keep Fit as a Family


Ever wish your kids would stop staring at a screen and be more active? You’re not alone.

The American Academy of Pediatrics (AAP) estimates that today’s children are spending an average of seven hours a day on entertainment media, including television, computers, phones and other electronics. By contrast, AAP recommends one to two hours of screen time a day.

Here are six simple steps to get your kids unplugged and moving.

1. Make a family media plan—a written set of rules and guidelines.Include specifics about time limits, device curfews, guidelines for information not to be accessed or shared on the Internet, as well as consequences for not following house rules.

2. Keep all screens in public spaces and out of bedrooms. Set up an “overnight charging station,” where everyone’s mobile devices are docked for the night and out of reach.

3. Be a role model. Set a good example by curbing your own screen-use time. Replace it with family activities or exercise.

4. Encourage and get involved in physical activities the whole family can enjoy. Go ice skating, cross-country skiing or sledding, or visit a community center for a swim or cardio class.

5. Get outdoors and enjoy the fresh air. Venture out on a family hike, walk to a nearby park or go birdwatching.

6. Teach your kids the nutritional value of food. Encourage healthy snacks and make sure your active family stays well hydrated by drinking plenty of water.

To learn more about PacMed pediatricians, or call for an appointment, 1.888.4PACMED.

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5 Tips to Restore Harmony


1. Evaluate your current work-life balance. Over the course of a week, monitor your daily tasks and activities, and take notes. This will give you a snapshot of your current situation and help you make a plan for moving forward.

2. Use a calendar or to-do list as your personal assistant, to minimize the time you spend running in circles.

3. Move your body. Book a series of “exercise dates” every week.

4. Unplug from technology, especially at dinnertime and at least one hour before going to bed.

5. Prioritize time for rest and recharging. Schedule activities that energize you—and be sure to get a good night’s sleep.

Sometimes we all need a helping hand. If you’re feeling stressed or like your life is out of balance, explore the treatment options provided by our Behavioral Medicine team.

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Soothing Miso Soup


Recipe adapted by Christy Goff, RD, CD

Easy miso soup is full of healing vegetables and probiotics to help ward off winter illness. Any type of miso paste works; yellow or white offer a mellower taste, while red is the boldest, saltiest flavor.

Serves 4. Serving size 1 cup. Prep time 20 minutes.

Ingredients:

4 tablespoons low-sodium miso (a fermented soybean paste, found in the refrigerated case at most grocery stores, preferably lower salt like Organic Miso Master)

4 cups water, divided as 3½ cups + ½ cup

1 tablespoon olive oil

½ cup shitake mushrooms, sliced

1 teaspoon dried wakame (an edible seaweed), chopped

½ block soft tofu, cut into ½" cubes

2 green onions, sliced

Bean sprouts, sesame seed and toasted sesame oil for garnish

Preparation:

1. In a bowl, whisk miso into ½ cup warm water and stir until diluted. Set aside.

2. Heat olive oil in a frying pan on medium heat. Sauté mushrooms 3-5 minutes, or until lightly browned.

3. While mushrooms cook, bring 3½ cups water to a simmer in a large saucepan.

4. To saucepan, add mushrooms, wakame, tofu and green onion. Heat throughout.

5. Add miso and water mixture to pot of water and vegetables. Note:To avoid damaging the probiotics in the miso, be careful to not bring soup to a boil.

6. Transfer into a serving bowl. Add desired amount of bean sprouts and sesame seed, plus a few drops of toasted sesame oil.

Nutritional information per serving:

Calories: 120Fat: 6 gSodium: 180 mgCarbohydrate: 8 gFiber: 2 gProtein: 7 g

More recipes online! Go to www.PacMed.org/recipes.

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The Living Well Alliance—Meet Our New Staff!


As we enter 2017, the Living Well Alliance™ would like to share some exciting changes to our staffing, class topics and pricing options.

First, welcome to Christy Goff, registered dietitian, and Pamela Barber, community liaison. Our team will continue to help you reach your company’s employee wellness goals by providing complimentary services for biometric screenings and health fairs. Please note that the cost for an individual “Take a Break to Educate” class has increased. This small increase, however, enables us to offer more variety in class topics and to host webinars for your organization. Check out our new class packages for additional savings! All classes are taught by our registered dietitian (RD) and registered nurse (RN).Meet the LWA staff and learn about our programs and services.

The Living Well Alliance offers employers on-site wellness education and free health screenings for their employees.

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Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

HEALTH TIPS – FEBRUARY 2017


Topics This Issue:


Take Steps to Prevent Heart Disease


Heart disease is the top killer in the United States for many reasons, but you can fight back and take charge of your cardiovascular health.

First, what does heart disease refer to? Most people immediately think of issues caused by the hardening or narrowing of arteries. These include angina, myocardial infarction (“heart attack”) and sudden cardiac death. You might think of these as “plumbing” problems. Heart disease also refers to electrical problems such as irregular heart rhythms and mechanical issues such as heart valve problems. The heart has many integrated systems that all need to work well together for proper function.

The following recommendations apply to all types of heart disease.

1. Know Your Numbers

In study after study, the best treatments revolve around focusing on addressing the risk factors for heart disease. “Your numbers” are measurements of some key risk factors. Knowing your numbers and setting target goals is the first step in taking charge of your heart health. Talk with your primary care provider or cardiologist about these lab values and lifestyle factors:

  • LDL and HDL
  • Blood pressure
  • Diabetes/HbA1c
  • Body mass index
  • Smoker?

You can even print a wallet sized card to record your numbers and your goals!

2. Find a Communicative Doctor

Successful cardiovascular care depends on good communication. So if you are concerned about your heart health, take the time to find a cardiologist you can talk with. Your cardiologist should answer your questions and clearly explain your diagnosis, test results and treatment options.

Also, don’t be afraid to ask for a second opinion! Information is power, and getting a second viewpoint can help you make the right decisions.

3. Build a Team

Knowing that you are not alone in your fight for improved health can decrease stress and worry. Involve your family as much as possible; they can be an invaluable resource. Bring your friends on board too. They can support you in any diet or exercise goals you have.

Also, don’t be afraid to ask for a second opinion! Information is power, and getting a second viewpoint can help you make the right decisions.

Take Care of the Machine

Finally, recognize that your heart is an engine, working inside of a bigger machine. Treat the machine well by eating well, exercising and making sleep a priority. This will help bring your numbers to goal and keep you tuned into your health. (Be sure to consult with your primary care physician before starting a new exercise program.)

Learn more about the PacMed Cardiology team at www.PacMed.org, or call 206.505.1300 for an appointment.

Heart Attack and Stroke: Do You Know the Symptoms?

While crushing chest pain is the most recognized heart attack symptom in both men and women, as many as one-third of female heart attack patients never experience any chest pain.

Women’s heart attack symptoms may look different. Every woman should learn the signs of heart attack in females and take them seriously.

Most common heart attack signs in women:

  • Chest pain or pressure
  • Sudden shortness of breath
  • Indigestion
  • Sudden pain or discomfort in the back, arm, neck, jaw or stomach
  • Sudden lightheadedness or cold sweats
  • Sleep disturbances

If you have been experiencing unusual discomfort in your limbs or torso on a continual basis, call your doctor today. If any of these symptoms comes on suddenly, with no identifiable cause, call 911 immediately. Do not wait more than five minutes. Do not attempt to drive yourself for help.

Most common stroke signs in men and women:

  • Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
  • Sudden trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking; dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

With these stroke symptoms, call even if the signs have stopped. If treated within three hours, the long-term disability from some common types of stroke can be reduced or avoided.

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Delicious Butternut Squash Soup


Recipe adapted by Christy Goff, MS, RDN, CD

This colorful, mellow soup delivers vegetables and all their nutrients in a tasty, warm bowl.

Serves 6

Ingredients:

  • 3 to 4 pounds butternut squash, peeled and seeded (also can use frozen)
  • 2 yellow onions
  • 2 green apples, peeled and cored
  • 3 tablespoons good olive oil
  • Kosher salt and freshly ground black pepper
  • 2 to 4 cups low-sodium chicken or vegetable stock
  • 1/2 teaspoon good curry powder

Optional Condiments:

  • Scallions, white and green parts, trimmed and sliced diagonally
  • Flaked sweetened coconut, lightly toasted
  • Roasted salted cashews, toasted and chopped

Directions:

1. Preheat the oven to 425° F. Cut the squash, onions and apples in 1-inch cubes.
2. Toss with the olive oil, 1 teaspoon salt and 1/2 teaspoon pepper.
3. Divide the squash mixture between 2 sheet pans and spread it in a single layer. Roast for 35 to 45 minutes, until very tender. (If using frozen squash, roast only the apples and onions in the oven until soft and thaw the squash in the microwave 3-5 minutes or until soft.)
4. When the vegetables are done, put them through a blender or food processor fitted with the steel blade. Add some of the vegetable stock and puree to the texture you desire. When all of the vegetables are processed, place them in a large pot and add enough vegetable stock to make a thick soup. Add the curry powder, salt and pepper to taste. Serve hot with condiments either on the side or on top of each serving.

Nutritional Information (1 serving = 1/6 of recipe):

Calories: 217, Fat 7g, Sodium: 343mg, Carbohydrate: 29g, Sugar: 13g, Fiber: 7g, Protein: 3g

(Nutritional information does not include optional condiments)

More recipes online! Go to www.PacMed.org/recipes.

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Tips for Staying Healthy During Flu Season


By Dr. Ari Gilmore, MD

When the Washington State House of Representatives passed a bill that guaranteed sick leave to employees at companies with more than four employees, Dr. Ari Gilmore was thrilled.

“As doctors, we have a problem with people’s great work ethic, especially if they’re actively coughing,” he says. Dr. Gilmore offers several tips on how to stay healthy during flu season and what to do if you’ve come down with a cold.

Regular hand washing is critical, especially after being in a public place because germs can live on surfaces for a long time. “Avoid touching your face or rubbing your eyes,” he says.

Exercise can also help. “There has been some evidence that regular exercise keeps the immune system up,” says Gilmore. “Also, regular exposure to sauna-type temperatures makes a difference. The elevated body temperature may decrease the activity of a virus. A couple of studies have shown it to impact mild to moderate cold symptoms. So a good day at the gym with a sauna afterward might be good preventive medicine.”

A flu shot is the best bet, especially for people who work in jobs that demand high-volume contact with the public. “Making sure you get your flu shot is probably the most important preventive step,” Gilmore explains.

When to Visit Your Doctor

If you’ve contracted a cold, the best thing to do is stay home—including from your health clinic—at least for the first three days. “If you don’t have a fever, I recommend staying home for the first two or three days. A top mistake is to visit your doctor right away and infect others,” says Gilmore. “Often, we have people coming in on day two. At that point, we don’t have a whole lot of treatment to offer, and you’re just going to spread it around. If it’s been over three days, come in, and we’ll listen to the lung and make sure it hasn’t turned into pneumonia.”

On the flip side, waiting too long to see a doctor can also be problematic. “We’ve had people who’ve had a fever for five or seven days, and by the time they come in, they’re quite ill,” says Gilmore. “For most people, a temperature is going to be resolved in three days. If it’s not, have it checked out.”

The exceptions are those who are at higher risk, including anyone over 65, children under age four with a fever over 101 degrees, or those dealing with other illnesses. “For those particular populations, there are effective treatments like Tamiflu,” says Gilmore. “It’s worth talking to your doctor about.”

Dr. Gilmore practices family medicine at the PacMed Beacon Hill clinic.

For more videos of providers about the flu click here Dr. Bowles, Dr. Bressie, Dr. Gilmore.

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Try the Heart-Healthy DASH Diet


In the spirit of this heart-healthy month, let’s explore the DASH diet. DASH stands for Dietary Approaches to Stop Hypertension, which is another term for high blood pressure.

This eating plan is well researched for its powerful effect on lowering blood pressure by using food’s own nutrients (specifically potassium, calcium and magnesium). This is why the DASH diet recommends eating more—that is, more of foods that are high in these nutrients!

Specifically, the DASH diet encourages you to increase your intake of fruits and vegetables, whole grains, nuts and seeds, and legumes.The plan also encourages you to eat less—less salt, saturated fat, red meat, sweets and sugary beverages, all of which negatively affect blood pressure.

What’s the Big Deal with High Blood Pressure?

Blood pressure is a measure of the force of blood hitting against the walls of your arteries (the vessels around your heart). When blood pressure is too high (> 140/90) for an extended period of time, it puts too much strain on the heart, and the heart cannot effectively pump blood around the body. High blood pressure also contributes to atherosclerosis (the hardening of the arteries), which increases your risk for strokes and congestive heart failure, kidney failure and blindness.

Getting Started with DASH
A good way to start is to simply observe and keep track of your current eating habits. Write down what you eat, how much, when and why. You’ll quickly be able to see where you can start making changes. For example, just decreasing your salt intake while increasing your vegetable intake can have a big impact on lowering blood pressure!

Use these DASH guidelines to find a balance of more nutritious foods and less salty, processed foods.

Increase!

• More fruits and vegetables (4-5 servings of each per day). Choose fresh, frozen or canned with no salt added.

* To increase flavor, sprinkle vinegar or citrus, add fresh or dried herbs or spices, and try salt-free seasoning blends.

• More whole grains (7-8 servings)—such as whole wheat bread/wraps/pasta, oatmeal and brown rice. Cook without salt, and cut back on instant or flavored mixes.

• More unsalted nuts and seeds (4-5 one-ounce servings per week). Add your own flavorings such as cinnamon for sweet or cayenne pepper for spice.

• More beans/legumes (1-2 servings per week). If canned, rinse to remove extra salt, and add lemon or lime juice to keep them tasty.

• More fresh poultry, fish and lean meat (rather than canned or processed types).

Decrease!

• Cut back on frozen dinners, pizza, canned soups or broths.

• Eat less of premixed salad dressings. Make your own with a mixture of olive oil and vinegar, plus a spice or two.

• Buy low- or reduced-sodium or no-salt-added versions of foods and condiments.


(The above recommended intake amounts for the DASH diet are based on 2000 calorie diet.)

Along with choosing a DASH approach to eating, you can make other lifestyle factors to decrease blood pressure. These include maintaining a healthy weight, being physically active, drinking less alcohol and taking prescribed drugs as needed. Talk with your provider! And learn more about the DASH diet at the American Heart Association site.

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What Our Biometric Health Screening Can Do for You!


Brought to you by the Living Well Alliance

In general, health screenings give you insight into your current health status so you can take charge of your health and get the care you need.

A biometric health screening measures physical characteristics such as height, weight, body mass index, blood pressure, blood cholesterol and fitness. This screening evaluates an individual’s health status and provides a benchmark that can be used to track changes over time.

Biometric health screenings offered by the Living Well Alliance are conducted by trained health professionals at your worksite. The screening examines your risk for diabetes and heart disease, two leading health issues facing Americans today. Due to their insidious nature, these chronic diseases often go undiagnosed. But with early screenings and regular primary care visits, they can be treated and managed—and sometimes avoided all together.

This Living Well Alliance biometric health screening is confidential, complimentary to employer groups and takes only 15 minutes per person. Participants also have the opportunity to ask questions of our registered dietitian or nurse.

Learn more about scheduling a worksite biometric screening for employees with the Living Well Alliance. You may also contact Christy Goff, RD, by email or at 206.621.4419

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Health Resources Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

5 Ways to Keep Your Heart Healthy This Summer

Heart disease is still the leading cause of death in the US, and women especially tend to underestimate how susceptible they are to the disease. Let’s make the gorgeous weather, delicious summer foods and fun activities work for your heart!

Our favorite tips just for you:

  • Have fun with exercise!
    It’s easier to embrace daily exercise when you look forward to it. Giving your heart a gentle workout doesn’t have to be trudging on a treadmill, looking at a wall in the gym. It can be any physical activity you enjoy. If you like walking, find a new path to explore in your neighborhood or a flat nature trail you haven’t tried yet.

    Do you like to garden? An hour of digging and planting can burn up to 272 calories for a 150-pound person.

    Give yourself credit for daily chores. Even activities such as household cleaning, sweeping a walkway or doing laundry can count as heart-healthy exercise.
  • Sleuth out hidden sugars and embrace the sweet fruits of summer.
    How does sugar affect heart health? The American Heart Association reports that consuming 17-21 percent of calories as sugar gives people a 38 percent increased risk for heart disease. Secret sugars are everywhere in your kitchen.

    Keep an eye out for ingredients like high-fructose corn syrup, corn sweetener, molasses, cane sugar, honey and sugar molecules ending in “ose” such as dextrose, sucrose and maltose. The big culprits include spaghetti sauce, barbecue sauce, grocery store side dishes like coleslaw and macaroni salads—and cocktail mixers, a summertime favorite.

    Once you’ve identified which foods have added sugars, you can begin trying to cut back. Delicious, ripe fruits of summer and fresh-made juice are an easy way to avoid added sugar. And when baking, consider halving the sugar added to recipe; you might not even notice!
  • Find ways to de-stress.
    Stress is natural in moderate levels and something that most people experience. However, high levels or long periods of stress can have negative effects on heart health. So it’s important to find time in your daily routine to check in on stress and look for ways to reduce it.

    The world’s easiest stress-reliever is to get enough sleep! Activities like meditation, yoga or taking a walk instantly help. If those aren’t for you, try calling a friend, spending time with a pet or writing in a journal to relieve stress.
  • Get regular checkups.
    Early summer is a great time to get a checkup because it gives you a baseline for improvement. It’s no one’s favorite activity, but regular checkups are a crucial part of maintaining heart health.

    Heart-health screenings look at blood pressure, cholesterol, weight, body mass index and other measurements that help paint a picture of the condition of your heart.

    Seeing your doctor regularly can help you catch early warning signs so you can make lifestyle adjustments that improve heart health.
  • Easy, healthy summer meals.
    Meals that are low in saturated fat and low in sugar reduce the risk of heart disease—and summer is an incredibly easy time to accomplish this tip! Consider vegetable kabobs on the barbecue, crisp green vegetables and salads. Eat a kaleidoscope of food colors for the best health: purple beets, red tomatoes, green broccoli, yellow peppers. The whole family benefits from this one!

Have fun this summer and help keep your heart healthy at the same time by keeping these tips in mind!


 

5 Things to Consider When Choosing Sunscreen

Summer is right around the corner, now is a good time take stock of your sun protection from last summer.

Keep these tips in mind to help choose and use an effective sunscreen:

1) Look for the words "broad spectrum" on the label.
The two types of UV light in sunshine than can damage your skin are called UVA and UVB rays. Sunscreen labeled as “broad spectrum” protects against both types of rays. Only sunscreens that protect against both are allowed to advertise the words “broad spectrum” on the label.

2) If you have sensitive skin, study the ingredients.
Some sunscreens include fragrances or alcohols that can be irritating for sensitive skin. It may also help to look for sunscreen that only uses physical blockers such as titanium dioxide or zinc oxide instead of sunscreen that uses chemical blockers such as oxybenzone, octocrylene, octinoxate, etc. The physical blockers have less risk of irritating the skin.

3) Your makeup might already have an SPF.
For women, tinted moisturizers, foundations and powders commonly include a Sun Protection Factor (SPF). Double-check the label of your daily makeup to see if you are using makeup that includes an SPF of 15 or higher. Unless you typically use a thick layer of make-up, you would still need to use a sunscreen as well. Don’t just rely on your make-up. For the face, look for face moisturizers with sunscreen already in them. These sunscreens usually do not have the typical sunscreen smell and may feel nicer on your skin. Don’t forget to also put sunscreen on your neck and upper chest. Put this on in the morning after you wash your face every day to protect your skin.

Please re-apply sunscreen every 3-4 hours if you are going to be continuously outdoors, get wet or are perspiring.

4) Check for an SPF between 30 and 50 for every day use
Look for an SPF of 30 or higher. SPF 15 filters out 93 percent of rays, SPF 30 keeps out 97 percent and SPF 50 blocks 98 percent. No sunscreen can block 100 percent. For daily use, a sunscreen of at least SPF 30 is recommended. If you will be outdoors for a long time (swimming, hiking, etc) please wear a higher SPF.

5) Decide between cream and spray—or use both!
They each are handy in different situations. You may prefer a cream for yourself, but when applying to children, a spray may be easier. Sprays are also convenient for protecting areas that are hard to apply a cream sunscreen to such as the scalp, back or top of the foot. If you do use a spray, be careful around open flames as some sprays include alcohol and may be flammable.

Whatever sunscreen you choose, the best way to protect your skin from sun damage is to be mindful of exposure. Limit time in the sun, apply sunscreen before you go out and reapply every two hours. You can also consider sun protective clothing or wide-brimmed hats.

Besides sun protection, another excellent health strategy is to schedule a dermatology skin screening. They’re fast, easy and can detect skin irregularities early.

Enjoy the sun this summer (but not too much)!


 

Healthy Habits for Summer

It’s early June, but it already feels like summer is HERE. With the warmer weather, and flowers in bloom, try to think of this as a time for you to create healthy changes!

So we’ve put together a few ideas to get ready for summer sun, the beach and feeling great.

Drink water.
If you ever feel slightly tired or sluggish, it’s always a good idea to consider how much water you’ve drank lately. Even if you make great choices in every other aspect of your health, if you neglect water intake, your body may not feel tip top.

The old one-size-fits-all rule was to drink eight 8-ounce glasses of water a day. However, the new thinking is that you should drink half your body weight in ounces per day to stay adequately hydrated. (So if you weigh 150 pounds, you would drink 75 ounces of water each day—or about nine glasses.) Doing some rigorous exercise? Increase your water intake. A reusable water bottle by your side can be a great reminder to sip water.

Get some exercise.
Exercise alone doesn’t promote weight loss, but it’s a key component to a fit body. Setting goals and doing physical activities you enjoy is a good start. The Centers for Disease Control and Prevention recommends adults get at least 2 hours and 30 minutes of moderate-intensity aerobic activity every week, plus muscle-strengthening activities on at least two days.

That might sound like a lot, but when broken out over seven days, you could exercise just 30 minutes on five days. If you are pressed for time, it’s also OK to split up your daily exercise goal into 10-minute chunks. Easy muscle-strengthening ideas include push-ups, squats and sit-ups. Still no time? Doing 15 of each a day is better than nothing and only takes about 5 minutes.

Even if you fall short, aim to have no days with zero activity. Even a short walk is better than a completely sedentary day.

Eat your way to a healthy body.
Being unprepared makes it all too easy to eat foods close at hand rather than healthy foods. A little planning, shopping and chopping will help you lose or maintain a healthy weight and move you toward a healthier diet. Chop vegetables in advance and store in the refrigerator or freezer. Plan and bring healthy snacks for work that keep you well away from the vending machine.

Use the MyPlate method to design meals. The four quarters of your plate should be divided between fruits, vegetables, protein and grains.

Easy "wins" for your eating plan might be choosing a black-bean burger over regular beef or skipping the cheese on a salad or sandwich. If you enjoy salads, be mindful of the dressing. Heavy, creamy options like ranch or blue cheese can be swapped for a balsamic or Italian vinaigrette. On their own these changes seem small, but weekly they add up to big potential weight loss.

Another tip—Try to avoid extra calories from sugary beverages, such as sodas and juices. Read the labels—sometimes even beverages that are labeled as healthy can contain a lot of sugar! Rather, make your own smoothies, containing healthy vegetables, fruits (maybe frozen) and plain yogurt.

Sleep well.
A lack of sleep increases the levels of a hunger hormone called ghrelin and decreases levels of the satiety/fullness hormone called leptin. So not enough sleep could lead to overeating and weight gain. When you get 7-9 hours of quality sleep, your body feels more balanced and that will help you to snack less, make better food choices and have fewer cravings. What else does a lack of sleep do? It makes you crave more carbs!

Four sleep culprits:

  • Smartphone use. Lying in bed with the blue light from your smartphone screen stimulates the brain and may slow the release of the sleep-inducing hormone called melatonin. The result? It’s difficult to fall asleep! Even though many phones now have a “night mode” feature to filter out blue light, the act of engaging with your phone right before bed may still be disruptive to your sleep.
  • Stimulants like coffee, alcohol and food— alcohol especially, because it can make you snore and wakes you.
  • An environment that’s either too hot or too cold.
  • And lastly, a no-brainer—stress.

Be mindful, reduce stress.
Try adding meditation practice into your daily routine. It’s easy to get lost each day rushing from one thing to another, particularly when kids are home from school, and vacation-planning can add to already existing stress levels. Try to take 5 minutes each day to practice gratitude. Research done on this topic has shown that reminding ourselves to be grateful, for not only what is good, but also some of our struggles that help us grow, reduces the stress response in our bodies, and regulates our sleep and mood.

Listen to your body!
Overall, the best way to improve your health and feel good about yourself before summer is to take some time to listen to your body. Treat it well and you’ll be on the path to feeling great in time for summer!


 

To-Go Baked Oatmeal

Ingredients:

  • 2 eggs
  • ¼ cup canola or olive oil
  • 1 cup packed brown sugar
  • ½ cup applesauce
  • 1½ cups non-dairy or cow milk
  • 2 tsp. vanilla extract
  • ½ tsp. salt
  • 1 tbsp. ground cinnamon
  • 3 cups old fashioned rolled oats
  • 2 tsp. baking powder
  • Optional: your favorite toppings (fruit, nuts, chocolate chips, etc.)

Instructions:

  • Preheat the oven to 350 degrees. Line a muffin tin with paper or paper/foil muffin liners.
  • In a large bowl, whisk the eggs, oil, and brown sugar until sugar is dissolved. Add the applesauce, milk, vanilla, salt, and cinnamon. Whisk until well combined. Stir in the oats and baking powder.
  • Fill the muffin tin with ¼ cup of the oat mixture in each muffin cup. Add your favorite toppings. Push the toppings down into the oat mixture with a spoon.
  • Bake for 30 minutes. Let them cool for 5 minutes before eating. Store in an airtight container or freeze in a zip top storage bag.

Recipe courtesy of: The Wholesome Dish


 

Attend a free women’s health event

We invite you to our upcoming educational seminars to discuss common female health concerns:

  • Creating a Better Work-Life Balance
  • How Do I Prevent Osteoporosis?
  • Investing in Your Health: Changing Your Weight By Changing Your Life

Saturday, June 18, at our Renton clinic
9-11am (8:30 registration)
601 S Carr Rd, Suite 100, Renton, WA 98055

Saturday, June 25, at our Canyon Park clinic
9-11am (8:30 registration)
1909 214th St SE, Suite 300, Bothell, WA 98021

Click here for more information.

Seattle Medical Clinic | Seattle Doctor | Primary Care & Specialty Care at PacMed
Health Resources

Don’t have time to workout? Try HIIT Workouts.

Finding enough time to workout is a challenge for many men. Getting up early or squeezing exercise in after work is a difficult habit to build. Finding a workout that fits your schedule and you enjoy and that delivers maximum benefits? That’s the goal for many people.

One of the top trends in the fitness world today is high-intensity interval training, or HIIT. These workout programs feature short intervals of high intensity followed by longer rest periods. This approach gives maximum physical benefits in a short amount of time.

If you’re pressed for time and seeking a quick workout that still generates benefits and gets you sweating, HIIT can be a great option.

What is HIIT?
High-intensity interval training is a method of exercise that alternates quick, high-intensity intervals with longer, slower intervals for recovery. The goal is to perform short bursts of all-out work (typically about 30 seconds) that pushes your body near its limit. This is followed by periods of less intense activity to recover, typically about 1 minute. Together, these intervals have been shown to make the body work harder than performing a cardio exercise at a constant level for an equal amount of time.

Why do a HIIT workout?

  • A HIIT workout increases overall physical fitness. Pushing yourself during the intense part of the interval increases endurance and stamina. You may notice a difference during other workouts and daily life.
  • Even after a HIIT training, your body continues to burn calories. A HIIT training’s intensity means your body has to work harder to get back into balance after exerting itself. So even when you’re resting after your workout, your body continues to burn calories.
  • The workout is short—a great benefit if your schedule is packed. A quick HIIT workout of 10 minutes has many benefits. If you have more time, shoot for a 15-20 HIIT session.

How do I start?
Ease into HIIT. If you’re not accustomed to high-intensity exercise, a HIIT workout can be a shock to your body.

A HIIT-style workout can include almost any aerobic exercise—running, cycling, Pilates. Any aerobic activity you enjoy can be turned into a HIIT training session. In general, perform your chosen activity all-out for about 30 seconds and then recover for 1 minute. (For example, sprint for 30 seconds and then walk for 1 minute.) This can be repeated for 15-20 minutes, depending on your fitness level. And don’t forget to warm up for at least 5 minutes before a HIIT session.

HIIT workouts are intense, so it should be just one type of workout you do. Incorporate it maybe once or twice a week to start and allow recovery between sessions.


 

5 Things to Consider When Choosing Sunscreen

Summer is right around the corner, now is a good time take stock of your sun protection from last summer.

Keep these tips in mind to help choose and use an effective sunscreen:

1) Look for the words "broad spectrum" on the label.
The two types of UV light in sunshine than can damage your skin are called UVA and UVB rays. Sunscreen labeled as “broad spectrum” protects against both types of rays. Only sunscreens that protect against both are allowed to advertise the words “broad spectrum” on the label.

2) If you have sensitive skin, study the ingredients.
Some sunscreens include fragrances or alcohols that can be irritating for sensitive skin. It may also help to look for sunscreen that only uses physical blockers such as titanium dioxide or zinc oxide instead of sunscreen that uses chemical blockers such as oxybenzone, octocrylene, octinoxate, etc. The physical blockers have less risk of irritating the skin.

3) Your makeup might already have an SPF.
For women, tinted moisturizers, foundations and powders commonly include a Sun Protection Factor (SPF). Double-check the label of your daily makeup to see if you are using makeup that includes an SPF of 15 or higher. Unless you typically use a thick layer of make-up, you would still need to use a sunscreen as well. Don’t just rely on your make-up. For the face, look for face moisturizers with sunscreen already in them. These sunscreens usually do not have the typical sunscreen smell and may feel nicer on your skin. Don’t forget to also put sunscreen on your neck and upper chest. Put this on in the morning after you wash your face every day to protect your skin.

Please re-apply sunscreen every 3-4 hours if you are going to be continuously outdoors, get wet or are perspiring.

4) Check for an SPF between 30 and 50 for every day use
Look for an SPF of 30 or higher. SPF 15 filters out 93 percent of rays, SPF 30 keeps out 97 percent and SPF 50 blocks 98 percent. No sunscreen can block 100 percent. For daily use, a sunscreen of at leas