Healthy 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.


  • 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


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

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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 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 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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