[360] healthy living 2013

Healthy

Outlook�orth �ounty

A Special Supplement to North County Outlook | Published September 4, 2013

Marysville • Arlington • Smokey Point • Quil Ceda Village • Tulalip

Health & Safety Fair Vendor Map Inside!

[360]

September 14, 2013

2013 HEALTH & SAFETY FAIR

Do You Snore?Are You Tired Throughout the Day?Do You Stop Breathing at Night?

You May Be Suffering From

SLEEP APNEA

Alan D. Erickson, DDS

www.alanderickson.com

360-435-3661302 E. Division Street

Arlington

Dr. Alan Erickson offers an alternative solution to C-PAP.

Explore an alternative withOral Appliance Therapy

Come by and meet Dr. Erickson at the Cascade Valley Health & Safety Fair and

have your questions answered.

1[360] HealtHy living guideSeptember 4, 2013North County Outlook

Personal Health, Community Health . . . . . . . . . . . . . . . . .2Cascade Valley Health & Safety Fair . . . . . . . . . . . . . . . . . .3Healing from the Inside-Out . . . . . . . . . . . . . . . . . . . . . . .4Award-Winning Wound Care . . . . . . . . . . . . . . . . . . . . . .6Plasma Donors Help Medical Research . . . . . . . . . . . . . .8Healthier Schools, Healthier Kids . . . . . . . . . . . . . . . . . .10Improve Heart Health . . . . . . . . . . . . . . . . . . . . . . . . . . .11Create a Healthy Sleep Environment . . . . . . . . . . . . . . .12New Clinic Serves Uninsured . . . . . . . . . . . . . . . . . . . . .13Living Well After Retirement . . . . . . . . . . . . . . . . . . . . . .14Health and Safety Fair Information . . . . . . . . . . . . . . 16-17Health District Warns About Bats . . . . . . . . . . . . . . . . . .18Dental Care Worlds Away . . . . . . . . . . . . . . . . . . . . . . . .19Insurance Exchanges Open in October . . . . . . . . . . . . .20Keep Medications Secure . . . . . . . . . . . . . . . . . . . . . . . . .22Directory of Medical Providers . . . . . . . . . . . . . . . . . 23-27Directory of Dental Providers . . . . . . . . . . . . . . . . . . 28-29Fighting Cancer at the Dinner Table . . . . . . . . . . . . . . . .30Shedding Excess Weight After 50 . . . . . . . . . . . . . . . . . .31Cost-Effective Knee Replacement . . . . . . . . . . . . . . . . . .32

Table of Contents

Better Health Through Chiropractic

Dr. Gay and his staff are trained on the latest chiropractic treatments and technologies.

Same day treatment available!Call us today for your complimentary, no obligation consultation

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2 [360] HealtHy living guideSeptember 4, 2013

North County Outlook

Editorial Content, Photography . . . . . . .Beckye Randall, Christopher Andersson

Advertising Manager . . . . . . . . . . . . . . . . Sue StevensonAdvertising Sales . . . . . . . . . . . . . . . . . . . . Brenda FelderSales Assistant . . . . . . . . . . . . . . . . . . . . Debbie GliddenPage Design & Composition . . . . . . . . . Beckye RandallGraphic Design, Cover Design . . . . . . . . . .Carrie HarrisAdministrative, Billing . . . . . . . . . . . . . . . . . Teri LemkeCover Photography . . . . . . . . . . . . . . . . Gabe Rodriguez

Published by North County OutlookP.O. Box 39 • Marysville, WA 98270

September 4, 2013

[360] Healthy Living Production Team

This year’s [360] Healthy Lifestyles publication serves a double duty . In addition to distribution to readers of North County Outlook, visi-tors to Cascade Valley Hos-

pital’s upcoming Health and Safety Fair, set for Sept. 14, will also receive the publica-tion as their official guide to the event . For that reason, the centerfold section includes a handy map of the vendor lo-cations and activities planned

for the Health Fair .North Snohomish Coun-

ty is becoming a magnet for world-quality health care providers, while still offer-ing access to private practi-tioners for personalized care . Whether you’re looking for a primary care physician, a great orthodontist, treatment for a sleep disorder or nutri-tional counseling, chances are all your health care needs can be met without ever leav-ing the Marysville-Arlington area .

Our civic leaders are also mindful of the health needs

of area residents . Initiatives that include expanded walk-ing and biking trails promote active lifestyles for all ages, and classes offered by Parks and Recreation departments provide opportunities for all kinds of exercise—both men-tal and physical . And don’t discount the benefits of social interactions provided by local hobby clubs and community service organizations .

Health may begin at home—on our dinner plates and in the yard—but it ex-pands outward to encom-pass the entire community in which we live .

And healthy communities, in turn, are necessary for us to thrive in-dividually .

That whole cir-cle of life thing .

By Beckye Randall Staff Writer/Editor

Personal health tied to community health

Invisalign®, Clear Braces and Low-Friction Braces for Children and Adults

Complimentary examinationsJason R. Bourne, DDS, MS

Member–American Dental Association

Washington State Dental AssociationSnohomish County Dental Society

American Association of OrthodontistsPacific Coast Society of Orthodontists

Washington State Society of Orthodontists

815 State Avenue, Suite 3 • Marysville • 360-659-0211On the corner of 9th and State Ave., in the Opus Bank building

9633 Market Place, Ste 104 • Lake Stevens • 425-334-4053

Visit our website at bourneorthodontics.com

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for short-term rehab, designed to restore your independence!

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Find resources at Health & Safety FairOn Saturday, Sept. 14, the

public areas at Cascade Val-ley Hospital will host a wide range of resources and ven-dors to help local residents embrace a safe, healthy life-style .

The hospital’s first Health and Safety Fair, which runs from 10 a.m. to 2 p.m., will offer something for everyone, from low-cost flu shots cour-tesy of Costco, to an interac-tive “Blood and Guts” exhib-it, courtesy of Pacific Science Center . Visitors can also take advantage of a wide variety of free and reduced-cost health screenings, as well as great health and safety resources

from orga-nizations in our com-munity .

F r e e and low-cost health screenings will include blood glu-cose levels, cholesterol, hearing and vision, bone density and even Body Mass Index (BMI) .

15-foot walk-through models of an inflatable heart and brain provide a unique viewpoint into our major or-gans .

Seniors will also find infor-mation on assisted liv-ing options, Medicare and other topics .

C o m -m u n i t y safety edu-cation is

also on tap for the one-day event, including free car seat safety checks and hands-on tours of Arlington fire trucks . Learn about Germbusters, Mr . Yuk, and Snohomish County Safe Kids .

As a well-respected health provider in north Snohomish County, the staff at Cascade Valley Hospital is looking forward to not only provid-ing helpful resources for local residents, but also acquaint-ing potential users with all the services the hospital of-fers .

Health fair attendees can take self-guided tours of the facility, which was complete-ly renovated a few years ago to incorporate galleys filled with local artwork, state-of-the-art exam and treatment rooms, and a cafeteria that gets high marks for freshness and quality .



The nerves that run through your spine are sig-nals from the brain sent down to all parts of the body . Dr . Shawn Gay, of Ar-lington Family Chiroprac-tic, described the brain as a computer and the wires that come out of that computer are the nerves that control your bodily functions . They are meant to connect and transmit commands, which makes the spine and nerves vitally important for your body to function correctly .

Chiropractic doctors use established methods to im-prove their patients’ spines and encourage nerves to heal from the inside-out .

Dr . Gay has been adjust-ing spines since he opened Arlington Family Chiroprac-tic in 1999 and has grown his practice ever since . This year the business is the platinum sponsor of the Cascade Val-ley Hospital Health and Safety Fair .

The office, located at 20218-77th Ave. NE in Ar-lington, has three chiroprac-tors on staff: Dr . Marcus Woodall, Dr. James Stirton and Dr . Gay .

Healing patients from the ‘inside-out’By Christopher Andersson

Staff Writer

Sometimes patients don’t know how far-reaching the benefits will be, said Dr . Gay .

Because the nerves reach all parts of the body, chi-ropractic adjustments can have positive effects in many places throughout the body . Patients of Arlington Family Chiropractic not only see re-sults for back and neck pain, but also for headaches, heart-burn, bed wetting, allergies, sciatic pain, and more .

New patients are also sur-prised that the adjustments don’t hurt .

“People who have never been to the chiropractor be-fore hear that popping noise and they think it hurts be-cause they’ve been brought up watching Jean-Claude

Van Damme or Steven Sea-gal movies . The first thing that you hear from people who get a manual adjustment is ‘that didn’t hurt’ or ‘that feels good’,” said Dr . Gay .

Arlington Family Chi-ropractic is also a compre-hensive health and wellness center .

The practice offers acu-puncture and massage thera-py . The massage therapists are approved providers through most insurance companies, including Regence .

Many health services are available, including digital x-rays, custom-made orthotics, exercise and rehabilitation programs and nutritional counseling for healthy living . A new counselor who spe-

cializes in the ‘ideal protein’ weight loss diet will also be available soon .

Arlington Family Chiro-practic’s doctors and staff really try to listen to the pa-tients and make the experi-ence personal for each one, said Dr . Gay .

“We tend to spend extra time with patients that need extra time,” he explained . “Some people want to get in and out and some people want more time. We custom-ize our care to the patient .”

Their treatment plans are also tailored for each indi-vidual person’s need .

“We adjust our treatment plans for the patient. We don’t recommend the same

n (From left) Dr. James Stirton, Dr. Shawn Gay and Dr. Marcus Woodall provide expert patient care at Arlington Family Chiropractic.

Continued next page

Whatever we can do to help [our

patients] or make things better for

them, that’s what we do.


treatment plan all the time, because different problems require more or less care,” said Dr . Gay .

Patients feel comfortable coming in because the staff is friendly and loves the com-munity .

“People actually like to come and see us,” said Dr . Gay . “You know when you’re doing good when patients bring you food . I get lots of food .”

The business has been easy to grow because patients keep coming back, he said . The first patient that came to Arlington Family Chiro-practic is still a patient .

All the staff members at Arlington Family Chiro-practic love their jobs, which really helps with the healing, he said .

“That’s the benefit for us really, watching a patient walk in in misery and then a week later walking out with a big smile on their face . That makes our day . And whatever we can do to help them or make things better for them, that’s what we do,” said Dr . Gay .

Dr . Gay said that he also tries to make his business as accessible as possible for pa-tients .

The office has late hours on Mondays, Wednesdays,

and Fridays, and they’re also open on Saturdays. Walk-ins are welcome for returning

Chiropracticpatients and new patients can get same-day adjustments .

The doctors can also make house calls, he said .

“If a patient is stuck at home and they can’t get to our office, we’ll make an ef-fort to get them adjusted at their house,” he said .

They are on-call for 24 hours for emergencies as well and the office phone transfers to Dr . Gay’s phone during the night . He assures callers he is always available to talk .

For more information go to www.arlingtonfamily chiropractic.com or phone (360) 654-6359.

Continued from previous page

n Chiropractic practitioners focus on restoring healthy spine and nerve functions.

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With consistently high stan-dards and positive patient out-comes, the Wound Care Center at Cascade Valley Hospital has racked up another award to add to its trophy wall .

For the fifth time, the Wound Care and Hyperbaric Medicine Center in Arlington has been recognized as a “Center of Dis-tinction” by Healogics, Inc ., the nation’s largest provider of ad-vanced wound care services .

The statistics back up the award. While treating 3,500 patients over a twelve-month period, the center achieved a 91 percent wound healing rate within 30 days and scored a 92 percent in patient satisfaction scores .

Over the center’s 15-year life span, that healing rate exceeds 96 percent, and 98 percent of all patients indicate they would “highly recommend” its ser-vices .

Dr. Peter Wolff, the Wound Care Center’s medical director and a vascular surgeon, talked about the need for specialized, aggressive wound care .

“If a wound hasn’t healed within 30 days, it usually won’t heal with traditional methods,” said Dr. Wolff. “Yet many pa-tients being treated by primary care physicians continue to un-dergo months or even years of futile treatment .”

According to its online state-ment, the mission of the Cas-cade Valley Hospital Wound Care and Hyperbaric Medicine Center is to provide expert,

Award-winning wound care in north Snohomish County


evidence-based medical treat-ment to patients who suffer from wounds that have failed to heal despite usual medical treatment .

The staff at Cascade Val-ley Wound Care Center is in the business of “limb salvage .” Their efforts are geared toward avoiding amputation through the use of aggressive treatment strategies that have been shown to be effective over a nationwide sampling of cases .

That aggressive approach makes a difference, according to Dr. Wolff, but it’s not always the easiest course .

“We have to justify the higher costs up front, because in the long run, taking these ag-gressive measures will be more cost-effective,” said Dr. Wolff. “Consider the long-term costs of amputation—prosthetics, re-

habilitation, possibly the need for continued nursing care—plus the decline in a patient’s quality of life . If we can save that limb, it’s actually better for everyone—even the insurance company .”

That mindset also means the patient must be 100 percent on-board with the prescribed treat-ment .

“If you miss an appointment, we’ll hunt you down,” said Handley, only slightly exagger-ating .

Dr. Wolff is equally as ada-mant about patient lifestyle changes . If a patient with vas-cular damage, which is interfer-ing with wound healing, refuses to stop smoking or maintain a healthy diet, he or she may be discharged from the program .

“It should be a national policy that to qualify for ag-

gressive limb salvage treatment, you can’t be a smoker,” said Dr. Wolff. “Just like for organ transplants—patient coopera-tion is critical for the success of the treatment .”

Teri Burt, R .N ., is the clinical nurse manager at the Cascade Valley Wound Care Center. She has worked at the center since its opening 15 years ago and is a Certified Wound Specialist.

“It’s important that we all work as a team,” said Burt . “My job is to make sure we’re follow-ing all the protocols, that the staff is cross-trained effectively, and that we work together ef-ficiently .”

As part of the Healogics network, physicians and nurses in the Arlington center can draw on the knowledge and ex-

n Staff members at Cascade Valley Hospital Wound Care and Hyperbaric Medicine Center proudly display the Center of Distinction award. (From left) Nancy Lewis, RN; Teri Burt, RN; Connie Egaas, RN; Nancy Roach, MA, HT; and Peter Wolff, MD.

Continued next page


perience of thousands of wound care specialists located in more than 560 centers across the country .

As a Mentor Center, the wound care specialists at the center are also sharing their knowledge with healthcare pro-fessionals locally .

“Being a Mentor Center means we have reached a level of expertise, from a clinical and business standpoint, where we have valuable information to share with others,” explained program director Michael Handley. “We teach a lot of students—nurses, physicians, nurses’ aides and others .”

The Wound Care Center fea-tures two chambers for hyper-

said Handley. “Wounds have a tough time healing without good blood circulation . In order to heal, a wound must bleed .”

Physicians and special-ists at the center treat a vari-ety of wound types, including diabetic foot ulcers, ischemic wounds caused by insufficient blood flow, venous stasis or slow blood flow, pressure ulcers, vas-cular diseases and post-surgical wounds .

Most patients who come to the Cascade Valley Wound Care and Hyperbaric Medicine Center are referred by their pri-mary physician, but about 10 percent are self-referrals . The center treats 20 to 25 patients each day .

To find out more about the Arlington wound care special-ists, visit www.cascadevalley.org and click on “Clinics .”

baric oxygen therapy (HBOT) . The clear tube-like chambers deliver 100 percent oxygen at increased pressure—equivalent to being underwater at about 40 feet.

Wound care patients who are

prescribed HBOT—and not all patients are good candidates for the procedure—visit the hyper-baric chamber for two hours ev-ery day for 30 to 60 days.

“It’s the only known therapy that helps grow blood vessels,”

WoundContinued from previous page

n Tammy Herald, LPN, checks in with Louise Hall of Marysville during her hyperbaric treatment.

Medical: 360-572-5400Dental: 360-572-5430

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PlasmaLab International, a biomedical facility in Ev-erett specializing in collect-ing plasma from donors with severe allergies and autoim-mune diseases, has expanded its new donor room to hold more donors and is celebrat-ing its twenty-eighth year in business .

“The building remodel and expansion was the natural next step,” says PlasmaLab CEO Kay Hill . “My dream is to double our lab capacity and help advance medical re-search worldwide . As a com-munity we are helping to cre-ate a healthier tomorrow for those suffering from allergies or autoimmune conditions today .”

PlasmaLab is looking for people who suffer from se-vere allergies or autoimmune diseases to participate in the Donor Program . Donors are pre-screened through email or by phone, then once ac-cepted into the program, they are generously compensated for their donations . Donors with high antibody levels to foods can earn up to $200 per plasma donation .

“Each donor is unique but all are deeply valued and ap-preciated,” said Hill. “We’ve had donors with us for more

Plasma donors help medical researchthan 20 years; some donors have given their plasma over 1,300 times. A few years ago we had the Ladies Blood Club, a group of women that met while here at our facility and bonded over their similar diseases . They came to rely on one another and always booked their appointments together, chatting away and supporting each other through difficult times . Of-ten our donors find valida-tion here, where in their real world they may not encoun-ter people who completely understand their medical challenges .”

PlasmaLab Internation-al was established in 1985 when its founders sensed an increased need in the bio-medical industry for a reli-able, cost effective source for high quality diagnosti-cally relevant human plasma . Since that time, PlasmaLab has become a major sup-plier of an expanding array of specialized human in-vitro products for distribution to diagnostic, regulatory, and research facilities worldwide and is licensed by the U .S . Food and Drug Administra-tion (FDA) .

Plasma Donor Programs

PlasmaLab is actively re-cruiting individuals with:

Autoimmune diseases• Severe allergies to foods, • mold, stinging insects, weedsRed blood cell antibodies•

To find out if you or someone you know quali-fies for the Donor Program, please submit your request to become a qualified donor through our web site at www .plasmalab .com .

Hill noted, “This is an in-credible opportunity for peo-ple who suffer with certain diseases to earn extra money and make a difference. We hope you can become one of our special donors .”

What is plasma?Blood is made up of cel-

lular and liquid portions . The liquid portion is plasma and may be up to 55 percent of the blood. The plasma is 92 percent water but also con-tains the vital proteins and antibodies to help fight in-fections . People with certain types of medical disorders, such as allergies, may also have unusual antibodies in their plasma associated to their condition . It is these types of antibodies that are

crucial to diagnostic and re-search facilities . Plasma can be donated as often as twice in a seven-day period, with at least 48 hours between dona-tions . Plasma is quickly and easily restored by your body within 24 hours.

Giving BackPlasmaLab supports vari-

ous community events to help raise awareness for medical research such as the Alliance for Lupus Research Walk With Us to Cure Lu-pus and is a proud sponsor of the upcoming Arthri-tis Foundation’s Jingle Bell Run/Walk this December in Seattle . Contact Deanna at deanna@plasmalab .com to support our team with a financial donation or to walk with us!

To learn more about Plas-maLab International, visit our website at www .plasma lab .com or find us on Face-book and Twitter .

n The Donor Lounge at PlasmaLab International.

People with certain types of medical disorders may also have unusual antibodies in their plasma associated to their condition.


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Lunch is a meal that can provide an energy boost or make you feel drowsy . In the middle of the workday, a big meal can make it much more difficult to be productive as the day goes on . For those looking for a light lunch, consider the following recipe for Nicoise Pasta Lunchbox .

Nicoise Pasta LunchboxServes 240 grams whole-wheat pasta rotini4 ounces green beans, cut into thirds1 egg1/3 cup imported black olives6-1/2 ounces canned tuna steak in

spring water, drained and flaked1 cup cherry tomatoes, halved2 small heads Bibb lettuce, leaves

separated

A light lunch for the workdayDressing1 tablespoon freshly squeezed lemon

juice1 tablespoon extra virgin olive oil1 small garlic clove, crushed2 heaping tablespoons chopped fresh

basilSea salt and freshly ground black

pepperCook the pasta in a saucepan of

lightly salted boiling water for about 12 minutes or until tender . Add the green beans to the pan for the last 3 minutes of cooking time . Drain the pasta and beans, then refresh briefly with cold water .

Meanwhile, add the egg to a small saucepan of cold water . Bring to a boil, then simmer for 6 minutes . Drain and rinse under cold water until cool . Peel

the egg and cut in half .Beat the dressing ingredients to-

gether with the seasoning in a mixing bowl . Mix in the pasta and beans, ol-ives, flaked tuna, and cherry tomatoes . Divide the lettuce leaves between two lunch boxes or bowls and top with the Nicoise pasta and the hard-cooked egg halves .



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Because children spend most of their time in class-rooms, schools are an ideal setting for healthy behaviors to be taught and modeled . Therefore, parents are speak-ing up and getting involved in an effort to improve the health of their children at schools .

One Washington, D.C. mother of two Roots Charter School students recognized the need for her children’s school to incorporate more physical activities into the school day .

“The obesity rate among children is at an all-time high, so getting our kids to

Healthier schools, healthier kidsbe active is more crucial than ever,” said Michelle Jones. “I want to make sure my chil-dren live their lives to the fullest, and getting exercise can help them do that .”

Michelle banded together with other parents to form an advisory council that works with local schools to host events focusing on health and wellness . Activities like yoga, Zumba and healthy eating inspires students, parents and community members to be physically active and make healthier food choices .

Other schools are mak-ing healthy changes through programs with the Centers

for Disease Control and Prevention (CDC) . A New York City school district made 800,000 daily meals healthier by ensuring that foods and drinks meet cer-tain standards for sodium, fat and calories . A school district in Las Cruces, New Mexico has opened physical activity space to the community dur-ing after-school hours .

Eating well and partici-pating in regular physical activity not only has health benefits, but they also have been linked with better aca-demic achievement by en-hancing important skills like concentration and attentive-

ness . For example, students who eat foods rich in protein, vitamins, and minerals are more likely to perform bet-ter than students whose diets are heavy in unhealthy foods, like sweets and fried foods .

To support healthy schools, parents can recommend ways to increase physical activ-ity during the day and ask that healthy food and drink options be made available to students throughout the school day .

Parents can learn more about improving health in their local schools and com-munities at www .Making HealthEasier .org .

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Heart disease is one of the leading causes of death across the globe . According to the World Health Organization, ischaemic heart disease, in which blood supply to the heart is reduced, is the lead-ing cause of death in middle- and high-income countries and the fourth-leading cause of death in low-income countries .

Perhaps the most troubling fact about the prevalence of heart disease is that it can be largely preventable . The American Heart Association notes that there are several ways to easily improve heart health and avoid becoming

Simple tips to improve heart health

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Get movingAerobic exercise is essen-

tial to cardiovascular health . Daily aerobic exercise, which

can be as simple as walking around the neighborhood, can help men and women lower their blood pressure, maintain a healthy weight and lower their bad choles-terol, which can circulate in the blood and cause block-ages that can lead to heart attack .

Easy on the saltAdopt a low-sodium diet

that’s also low in cholesterol . Diet can be a friend or foe in regards to heart health . A heart-friendly diet that’s low in sodium and cholesterol can help you maintain healthy cholesterol levels as well as a healthy blood pressure .

Know your numbersMonitor your blood pres-

sure . A blood pressure read-ing is a staple of many doctor visits, but men and women should monitor their blood pressure even when they aren’t visiting their physi-cians . High blood pressure does not always produce symptoms, but that doesn’t mean it isn’t potentially deadly . High blood pressure is the leading cause of stroke and can contribute to heart and kidney disease . So be sure to monitor your blood pressure and discuss with your physician ways to lower high blood pressure .

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It is easy to overlook the benefits of a good night’s sleep. Without adequate rest a person can be left feel-ing irritable, distracted and sluggish . Those who repeat-edly do not get enough sleep could be facing other health problems as well . For some, the secret to getting a bet-ter sleep is modifying their sleeping environment .

Information from the Centers for Disease Control and Prevention indicate in-sufficient sleep has become a public health epidemic . An estimated 50 to 70 mil-lion American adults report having a sleep or wakeful-ness disorder, and women are twice as likely to suffer from insomnia than men . Plus, one in three people suffer from some form of insomnia dur-ing their lifetime, offers the organization Better Sleep for Life .

In some instances, lack of sleep or too much sleep might be indicative of a medical condition, but it could just be related to poor sleep hygiene and an uncomfortable sleep-

Create a healthy sleep environment

ing environment . Making some changes could make all the difference .Check your mattress

You will spend between seven to 10 hours in your bed each and every night . An uncomfortable mattress could be an underlying fac-tor in your sleep problems . If your bed is several years old, it could pay to invest in a new mattress and box spring . If you sleep with your spouse and your bed is too small, upgrading to a larger size

could provide the room you need . If you cannot afford a new mattress, buying a mat-tress topper in memory foam could mask any problems for the time being .Balance light and dark

In order to trigger sleepi-ness at the right time, it is essential to get at least 30 minutes of natural sunlight each day during the morning or afternoon . In the evening, begin dimming the lights to trigger the body’s natural internal clock and stimulate the production of the natural hormone melatonin, which relaxes the body into sleep . Keep a dark bedroom—in-vest in blackout curtains if need be .Add white noise

Giving your brain a noise to associate with relaxing sleep can help you drift off more quickly. White noise can also mask other sounds that may distract sleep, such

as traffic outside or a part-ner snoring. White noise can come from a special alarm clock that provides sooth-ing sounds of rain or waves . Many people find running a fan in the bedroom provides the right amount of noise and also helps circulate air throughout the room .Cozy, clean and fresh

Make the bedroom a cozy retreat . Your bedroom should be a relaxing sanctuary . Fill it with cozy cushions and pil-lows . Make sure the room is clean and clutter-free . Re-laxing blues and purples can be soothing colors to use in decorating, and the use of lavender essential oil could also add to the relaxing en-vironment .Avoid distractions

When setting up your bedroom, do not fill it with electronics, such as a com-puter, tablet and television . These devices could contrib-ute to wakefulness and actu-ally impede your ability to get the rest you need .Keep cool

A cool bedroom is key to drifting off to sleep . Sweating and overheating can keep you awake, so drop the tempera-ture down at night and dress lightly for bed . You want to feel comfortable and not too hot or cold .

If sleeplessness becomes a chronic problem and is not alleviated by changing the sleeping environment, visit a doctor .

n A good night’s sleep is an important key to good health.

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Community Health Cen-ter of Snohomish County opened its newest branch August 12 in a low-slung building next to Cascade Valley Hospital, at 326 Still-aguamish Avenue in Arling-ton . The facility, which has undergone a $2.4 million facelift, offers both medical and dental care .

The nonprofit clinic is spe-cifically dedicated to provid-ing health care to uninsured children and adults in north Snohomish County .

“Our mission is to see any patient, regardless of the abil-ity to pay,” said Larry Warner, board chair of Community

New clinic serves needy, uninsuredHealth Center of Snohom-ish County during a grand opening event last Friday . “Eighty-eight percent of our patients are below the pov-erty level, but we know they deserve quality health care, and that’s why we’re here .”

CHC is also one of a dwindling number of clin-ics that will accept Medicare and Medicaid patients .

Even before it opened, the CHC dental clinic had booked 51 appointments. Dentists and hygienists on staff are expected to serve approximately 200 patients each month, primarily chil-dren but including adults

who need urgent dental care .The medical clinic on the

ground floor can accom-modate 150 patients each month . The clinic provides services on a sliding fee scale, but as Warner mentioned, no one is turned away due to an inability to pay .

The medical clinic is open

from 8 a.m. to 5:30 p.m. Mondays, Tuesdays, Wednes-days and Fridays, and 9 a .m . to 5:30 p.m. Thursdays. Call 360-572-5400 for appoint-ments .

The dental offices are open 7 a.m. to 5:30 p.m. Monday through Friday. Call 360-572-5430 for appointments.

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As the years tick by for many retirees, the prospect of living independently be-comes less and less certain . But even though it may be time to leave the family home, seniors can still main-tain a healthy, active lifestyle by choosing a residence in a facility like Marysville’s Windsor Square.

Windsor Square, located at 9912-48th Drive NE in Marysville, is a senior apart-ment complex that offers fully-equipped apartment homes combined with meal services, social activities, housekeeping and transpor-tation . The combination of independence and amenities helps seniors who don’t need specialized care maintain their sense of self-determi-nation while providing peace of mind for their families .

“Windsor Square is much more than a collection of apartments,” said execu-tive director Sharon Shaw . “Our residents are provided

Living well after retirement

breakfast and dinner, all their utilities except phone service, weekly housekeeping and laundry services, and lots of activities .”

In addition to informal movie nights, crafts and card games, the center’s activity

director, Pam Schreurs, also plans a monthly Ladies’ Tea and Men’s Breakfast, special birthday parties and other celebrations . Residents have full use of Windsor Square’s library, beauty and barber sa-lon, laundry facilities and ar-eas to host family gatherings .

Most of the 95 apart-ments feature one bedroom, a living/dining area, a small but functional kitchen and surprising amounts of stor-age, all within 575 square feet. With big windows and lots of light, the units offer attractive views of the mature landscaping surrounding the buildings .

There are also six 2-bed-

room units in the complex, measuring 700 sq. ft.

Each unit also comes equipped with several safety pull cords, located in the bedroom and bathroom, in case of an emergency . Staff responds immediately to help the residents and sum-mon emergency medical care if needed .

The apartments are under-going complete remodels as they become vacant, updat-ing the finishes and replac-ing traditional bathtubs with walk-in tub/showers .

In fact, the entire building is slated for remodel begin-ning this fall . The spacious

n Windsor Square’s professional staff includes (from left) Nicole Booth, dining room coordinator; Angela Martin, business office manager; Pam Schreurs, activity director; and executive director Sharon Shaw.


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dining room and kitchen fa-cilities will be expanded, and the public areas will be mod-ernized .

“We’re hoping that our mural in the main entry, which was painted by Gene Waggoner, will remain,” said Shaw . “In fact, the residents signed petitions asking for it to be saved, so we’re hopeful we’ll be able to maintain it .”

Those living at Windsor Square are often asked their opinions about the facility’s operations and amenities, ac-cording to Shaw .

“Our residents don’t have the worry of taking care of a home, and they enjoy being surrounded by others with the same life experiences and

similar needs,” said Shaw . “They’re able to make choic-es for themselves . They’re in charge of their own daily schedule, their meal choices, but they know if they need

some help, we’re here to pro-vide that .”

Transportation to and from medical appointments, or for grocery shopping or other errands, is provided

at no charge for residents . Windsor Square employs more than 20 staff members to maintain the facility and provide services .

“We provide a lifestyle, not just an apartment,” said Shaw .

Windsor Square is one of thirteen senior residences in Washington owned by Campbell-Hogue and Asso-ciates of Bellevue . The com-pany also operates apartment homes in Texas, Arizona and Utah .

One-bedroom apartments are priced at $1,995, includ-ing all amenities .

To find out more or to sched-ule a tour, visit www.windsorsr living.com or phone (360) 653-1717.

Retirement livingContinued from previous page

n The media room is a favorite hangout for Windsor Square’s resi-dents, with comfy chairs and a large screen TV.

Gregory J. Gosch, DDSImplant and Adult Restorative Dentistry

4825 Grove Street • Marysville • 360-659-7617www.drgosch.com

I would do it all over again!“After a long period of resisting going to the dentist my wife suggested I go see Dr. Gosch and I am really glad I did. Dr. Gosch and his staff are very friendly, caring and professional and they make sure you understand the care you are receiving. I had a tooth that was in really bad shape, it ended up breaking and needed to be extracted. After talking with Dr. Gosch I chose to get an implant and I was surprised that it was as easy if not easier than getting a filling. The work was done basically in only 2 visits and both in Dr. Gosch’s office. One visit to do the extraction and place the post and one visit to get my new tooth and it turned out great. I still need more work and have every confidence in Dr. Gosch and his staff and I would recommend them to anyone.”

Craig Bishop-Marysville

Gregory J. Gosch, DDSImplant and Adult Restorative Dentistry

4825 Grove Street • Marysville • 360-659-7617www.drgosch.com

I would do it all over again!“After a long period of resisting going to the dentist my wife suggested I go see Dr. Gosch and I am really glad I did. Dr. Gosch and his staff are very friendly, caring and professional and they make sure you understand the care you are receiving. I had a tooth that was in really bad shape, it ended up breaking and needed to be extracted. After talking with Dr. Gosch I chose to get an implant and I was surprised that it was as easy if not easier than getting a filling. The work was done basically in only 2 visits and both in Dr. Gosch’s office. One visit to do the extraction and place the post and one visit to get my new tooth and it turned out great. I still need more work and have every confidence in Dr. Gosch and his staff and I would recommend them to anyone.”

Craig Bishop-Marysville

Cosmetic & Restorative Adult Dentistry, Implant SurgeonDiplomate, International Congress of Oral Implantologists

Member, American Academy of Sleep Medicine

Dr. Gosch is a Preferred Provider for most dental insurances.

“I would do it all over again.”When I moved to Washington from Oregon in 2000, I was concerned about finding a new dentist for my family. I asked at my new Job at the American Cancer Society if anyone had a great dentist for my kids. Luckily, someone recommended Dr. Gosch and he took care of my kids and me with diligent attention to prevention and repair. As I age he has moved along to installing implants as needed and additional prevention advice for aging teeth. I am grateful for the staff person that has long left my work for the secret of my dentist. My implant you see was in the front of my mouth and very important for it to appear natural. His staff’s conscientious attention to working around a busy family and work schedule has been a blessing. Letting me email in my appointments and texting to remind me of them. So, as I pass along resources to cancer patients in my job, I am sharing my dentist resource to you!I can’t help it I love to help people....hmm must be why I was drawn to the dental practice of Dr Gosch.Still smiling with my implanted front tooth!

Jerri Wood, who is the Quality of Life Manager for the American Cancer Society in Snohomish County.

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The Snohomish County Health District is reminding locals about the dangers of the small bats that call the Pacific Northwest home .

Most bats are harmless, but a few carry rabies, a deadly disease that can be passed on to humans through small bites and scratches . Nine rabid bats were found in Washington last year, and one of them came from Snohom-ish County .

Bats like to “hang out” in vacation cabins, attics, barns and outbuildings, and wherever there are plenty of insects they can eat . A bat bit a toddler in Pasco this year after falling out of a patio um-brella . The toddler got treatment to pre-vent rabies even before it was confirmed that the bat had the disease .

According to Bats Northwest, Wash-ington bats are quite small for the most part, and can squeeze through an open-ing 1” x 5/8”. Attics and walls provide good roost sites and bats often can enter these areas where the sides of a house meet the roof or chimney . If an entry

Health district warns about batshas been used for any length of time, it becomes stained and easier to identify . You can also find entries by watching in the evening for the bats to emerge .

Anyone who might have been bitten, scratched or was simply sleeping in a room where a bat is later found should contact Snohomish Health District Communicable Disease staff at (425) 339-5278. In the Northwest, bats are the only animals likely to carry rabies .

People often call a pest control com-pany to get rid of bats in or near their home . Those companies should also refer people to the Health District to make sure the client was not exposed to rabies . A South Carolina woman who died from rabies in 2011 had sought help for bats in her home, but was nev-er referred to public health for advice about preventing rabies .

Bats found in a home or setting where they may have contacted humans should be safely caught and refrigerat-ed . Call Snohomish Health District to see if the bat needs to be tested . If a bat

is not available for testing and people have been exposed to it, rabies shots are usually necessary .

Any mammal can contract rabies, but cats are especially susceptible be-cause they are natural hunters of flying creatures and often catch bats . It is very important to have your pets vaccinated against this disease, even if they are “in-door” pets .

To safely capture a bat, find a small container like a box or a large can, and a piece of cardboard large enough to cov-er the opening in the container . Punch small air holes in a cardboard box or large can . Put on leather work gloves . When the bat lands, approach it slowly and place the container over it . Slide the cardboard under the container to trap the bat inside . Refrigerate the container until talking with Snohomish Health District staff .

For more information about bats and rabies, visit the state Department of Health website: http://www.doh.wa.gov.

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Recently, Marysville dentist Greg Gosch led a dental mission team to San Ramon, Nicaragua, with Corner of Love Ministries, to provide much needed dental care to people in the surround-ing villages. Joining him on the mission were his wife Susan, a dental hygienist, staff members Cynthia Fox and Jolene Hollingsworth, both dental assistants, Dr . Bud Dubay and his wife Darlene who reside in Stanwood, patient and dental hygienist Carlos Valverde, and dental assistant Ramona Lujan .

Nicaragua, a tropical land that pro-duces some of our favorite Starbucks coffee, is one of the poorest countries in Central America . It is a country of extremes: incredible beauty, a tropical climate, fertile soil that can grow almost anything, yet the majority of people live in tiny shacks, some made out of plas-tic sheets and branches, others of mud bricks . In this remote area, only one in 53 “homes” have potable water. Less than 20 percent of the children are able to attend school for lack of basic needs like clothing or shoes, as well as nomi-nal tuition fees .

After landing in Managua, the capital of Nicaragua, Dr . Gosch and his team, along with the 60 medical team mem-bers, were bused for 3 hours along wind-ing mountain roads to San Ramon . All team members are housed and fed at the Quinta, a beautiful facility completed in 2009. The next day, donated medical, dental, and clothing supplies brought in old suitcases by team members were unpacked, organized and added to the existing stock . Plastic bins were packed with pharmaceuticals, donated clothing items and shoes, donated personal items and dental supplies in anticipation of our first village work day .

Each morning two teams of 30 to 35 volunteers would depart the Quinta in brightly colored buses for a 3-hour ride into the mountains to small country vil-

Providing dental care a world away

lages . Every day brought a new adven-ture . The beautiful scenery and strange plant life made the bus rides amazing . The more adventuresome rode on the top of the buses for a better view .

It was like the “circus was coming to town”, when the buses would ar-rive in the village . The small church or schoolhouse that would serve as the mission facility would be overflowing with people of all ages . Horses, dogs, pigs, chickens, geese, and the occasional turkey were also in the crowds . Lots of volunteers were available to help unpack the buses so the teams could set up and start serving the people . The local pastor was the “go-to” person that helped the process to go smoothly .

“Nothing could have been more re-warding than taking a child out of pain, keeping a wage earner healthy and pro-ductive, knowing that each day lives were being changed and improved,” said Dr . Gosch . “The people were gra-cious and thankful for everything they were provided . Their smiles were conta-gious and in spite of their poverty, they

are the most kind and caring people you could imagine .”

n Dr. Gregory Gosch (right) of Marysville spent several weeks, accompanied by his office staff, helping underserved patients in rural Nicaragua during a recent mission.

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2014 will be the first year that U .S . citizens are required to have health insurance, but a clearer view of their options is coming with Washington Healthplanfinder, the state’s insurance marketplace .

As part of the Patient Protection and Affordable Care Act (a .k .a . Obamacare), states are mandated to create insurance marketplaces for easier comparison/purchas-ing and greater competition between health plans .

The marketplaces, known as ‘health exchanges,’ al-low for a direct comparison of cost, benefits and quality of the multiple health plans available in Washington state .

Insurance exchanges open next monthState officials hope that health exchanges will bring transparency and clarity to the health insurance buying process.

By Christopher Andersson Staff Writer

The state’s exchange will begin enrolling customers on Oct. 1. The site will be lo-cated at www.wahealthplan finder.org .

“An exchange is a mech-anism for organizing the health insurance marketplace to help consumers and small businesses shop for coverage in a way that permits easy comparison of available plan options based on price, bene-fits and services, and quality,” writes a U .S . Department of Health and Human Services official in a guidance letter for states .

All plans available must cover ten basic services: am-bulatory patient care (e .g . outpatient services/clinic visits), emergency services, hospitalization (e .g . room/board/care while hospital-ized), maternity and new-born care, mental health and substance use services, pre-scription drugs, rehabilitative services and devices, labora-tory services (e .g . blood/tis-sue testing), preventive and wellness services (e .g . routine physicals) and pediatric ser-

vices .The health plans are given

metal grades, bronze being the lowest, platinum being the highest . Bronze plans pay 60 percent of the health costs for the patient on average, while platinum plans pay 90 percent of the cost on aver-age .

Four companies, Life-Wise, Premera Blue Cross, Bridgespan, and Group Health Cooperative, were approved to sell health plans in the Washington state ex-change .

“Unfortunately not all of the insurers who applied were approved,” said Mike Kreidler, Washington In-surance Commissioner in a statement . “Several of them struggled to guarantee access to certain providers and hos-pitals . It’s our duty to make sure that if you buy a health plan, you can actually see the doctor or hospital that pro-vides the service you need .”

The four companies will provide a total of 31 health plan options . Residents in some counties are limited in

the choice of plans; however, all are available in Snohom-ish County .

Help navigating between your health insurance op-tions will be offered online, in-person or over the phone .

The call center for phone assistance opened on Sep-tember 3, 2013. The toll-free number is 1-855-923-4633, and is available weekdays 7:30 a.m. to 8 p.m. with help provided in 175 different languages .

In-person assistance will be provided by the What-com Alliance for Health Ad-vancement in Bellingham .

Online assistance may not be available until later, ac-cording to the Puget Sound Business Journal. A mobile app may also be available later as well .

Open enrollment, the time of the year you are free to make changes to your health coverage, begins on Oct. 1 and ends on March 31, 2014. New health coverage would begin January 1, 2014.

Under the Affordable Care Continued next page

(LAST MODIFIED)March 28, 2012 10:35 AM

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Act every one is required to have health insurance in 2014, or they will pay a fee when filing their income tax return .

There are some exceptions, includ-ing: individuals with an income below $10,000 or families with an income be-low $20,000; if you would have to pay more than eight percent of your income taking into account tax credits; those that are part of a Native American tribe; or those that are part of a religion op-posed to acceptance of benefits from a health insurance policy .

The fine for an individual being unin-sured will begin at $95 in 2014, increase to $325 in 2015 and increases again to $695 in 2016.

According to Kreidler, 1.1 million people in Washington state are unin-

sured. That includes 112,400 in Sno-homish County .

Medicaid and tax credits for those with low income are expanding under the Affordable Care Act and could help an estimated two-thirds of Snohomish County’s uninsured .

Under new guidelines, any Wash-ington state adult earning below 138 percent of the federal poverty level ($15,856 annual income) would be eligible to enroll in Medicaid, accord-

ing to Washington State Health Care Authority .

People with income below 400 per-cent of the federal poverty level ($45,960 for an individual, $94,200 for a family of four) will have subsidies available to pay a portion of their monthly premium and will have a cap on out-of-pocket expenses if they bought their insurance from an exchange .

For more information go to wahb exchange.org or wahealthplanfinder.org .

MarketplaceContinued from previous page



Prescription medications of all kinds can pose a danger if taken by someone other than the patient. While some may produce uncomfortable side effects, the powerful drugs used to combat cancer can be deadly .

A cancer diagnosis is sel-dom easy for the person re-ceiving the news or his or her loved ones . Cancer treat-ment often involves weeks of intensive medical therapy that can include radiation, chemo therapy and oral med-ications .

Though such medications can be a key component of successful treatment, extra pills in the home can pose additional hazards to chil-dren and even elderly resi-dents who may inadvertently get into unsecured pills .

Cancer patients may be prescribed a number of pre-scription medications during the course of their treatments . Antidepressants, opioids, steroids, anti-convulsants, and radiopharmaceuticals may be prescribed to treat pain and other side effects of cancer. When taken in the right doses, these medicines can help patients withstand and ultimately overcome their disease . In the wrong hands, the same drugs can prove poisonous, especially to young children .

According to Safe Kids Worldwide, 500,000 parents and caregivers per year call a poison control center because a child accidentally ingested

Keep medications secure, safe

medicine or was given the wrong dose. In 2011, 67,000 children were treated in an emergency room for medi-cine poisoning . Based on emergency room visits, many children come in contact with these medications in places other than the medi-cine cabinet . Kids may find spare pills on the ground, in a purse or bag or on a counter or nightstand .

The United States Cen-ters for Disease Control and Prevention reports a 160 per-cent increase in poisonings in children from 1999 to 2009, 91 of which are the result of a drug overdose . The Cincin-nati Children’s Hospital says

that kids ages five and young-er are the most likely victims of prescription drug poison-ing . In homes where there is an abundance of medications being used to treat cancer or other illnesses, diligence is needed on the part of adults .

Childproof bottles are seldom enough . Very often adults forget to close the lids properly . Tenacious children can sometimes figure out how to get lids off of bottles even if they are touted as childproof .

Cancer patients tak-ing medication might want to employ some additional safety measures in order to protect young children .

• Do not advertise medica-tion use to your children . Take pills away from curi-ous eyes so that youngsters are not tempted to try Mom or Dad’s medicine, which for all intents and purposes, looks like candy to a child .

• Store medications high up, ideally in a locked cabinet . Remain careful when re-turning pill containers to these locked cabinets after use .

• Use individual-dose cases, many of which can be locked with a key or a combination code . This can protect against spills should the case fall on the floor .

• Ask for medications to be prescribed in blister packs that are more difficult to open .

• Dispose of any expired medication or pills you no longer need so there are no extras lying around the house .

• Dispose of pills in an out-side garbage receptacle so that children or pets can-not find them and swallow them .

• Never store pills in a con-tainer other than the pre-scription container or a medication dispenser .When cancer treatment

necessitates the taking of additional medications, it becomes even more impor-tant to protect children from accidental—and sometimes intentional—ingestion of medications .


CHEMICAL DEPENDENCY/ADDICTION MEDICINEGreg Bauer, OwnerAlpine Recovery Service Inc .16404 Smokey Point Blvd. #109Arlington • 360-658-1388

Catholic Community Service Recovery Center1227 2nd StreetMarysville • 360-651-2366

Compass Health3320 173rd Place NEArlington • 425-349-8700

Compass Health4308 76th Street NEMarysville • 425-349-7352

Focus509 N West Avenue, Ste. BArlington • 425-349-8130

Scott Wykes, PhDClearview Counseling1106 Columbia Avenue #100Marysville • 360-651-5693

CHIROPRACTICDonne Bates, DCGranite Falls Chiropractic13821 Jordan RoadArlington • 360-691-7731

Melanie Bober, DCPeterson Family Chiropractic415 N. Olympic AvenueArlington • 360-435-9200

Dennis L . Booth, DCFourth Street Chiropractic Center1606 4th Street Ste . EMarysville • 360-659-2938

Devin A . Brossard, DCSymmetry Chiropractic & Wellness

Directory of Local Medical ProvidersCenter3710-168th St. NEMarysville • 360-722-1578

David G . Brown, DCBrown Family Chiropractic4505 107th Place NortheastMarysville • 360-653-4774

Bob DeFever, DCMarysville Chiropractic1617 Grove StreetMarysville • 360-659-6241

Michael Eberle, DCEberle Chiropractic Clinic1603 3rd StreetMarysville • 360-653-7333

Loren C . Ernst, DCErnst Chiropractic Clinic16714 Smokey Point Blvd.Arlington • 360-659-8464

Shawn Gay, DCArlington Family Chiropractic20218 77th Avenue NEArlington • 360-435-3900

Jay F. Goodwin, DCSmokey Point Chiropractic4113 172nd Street NEArlington • 360-653-4626

Tony Gutierrez, DCGutierrez Family Chiropractic3704 172nd St NE, Ste . NArlington • 360-658-3818

Craig Hedlund, DCHedlund, Welly & Schultz Chiropractic17432 Smokey Point Blvd. #105Arlington • 360-653-2222

Doron Kantor, DCChirocare9528 State Ave, Ste. BMarysville • 360-659-6554

Michael Keehn, DCKeehn Chiropractic Clinic, P .S .1241 State Avenue #101Marysville • 360-659-8411

Stephen Keehn, DCKeehn Chiropractic Clinic, P .S .1241 State Avenue #101Marysville • 360-659-8411

Matt McCann, DCMcCann Family Chiropractic11605 State Avenue #111Marysville • 360-657-7183

Gordon Myco, DCState Street Family Chiropractic919 State Avenue, Ste. 102Marysville • 360-653-6010

Douglas A . Nordstrom, DCNordstrom Chiropractic Center1818 Grove St.Marysville • 360-653-6533

James Oosterwyk, DCArlington Chiro & Wellness113 W. Division StreetArlington • 360-435-5200

Scott Peseau, DCArlington Spine Center215 E. 3rd StreetArlington • 360-474-9900

Les Peterson, DCPeterson Family Chiropractic415 N. Olympic AvenueArlington • 360-435-9200



CHIROPRACTIC (Cont’d)Jeffrey B. Ronning, DCRonning Chiropractic3116 188th Street NE, Ste . AArlington • 360-653-8307

Stan Rosebrook, DCArlington Chiropractic Center514 N West AvenueArlington • 360-435-3052

Ken Shotwell, DCShotwell Chiropractic118 E. Haller AvenueArlington • 360-435-2222

James Stirton, DCArlington Family Chiropractic20218 77th Avenue NEArlington • 360-435-3900

Marcus Woodall, DCArlington Family Chiropractic20218 77th Avenue NEArlington • 360-435-3900

DERMATOLOGYNorth Sound DermatologyDieter Schmidt, MD FAAD FACMSK . Mireille Chae, MD FAADKatrina Bassett, MD FAADCraig Baucher, MPAS PA-CVena Melendez, MMSc PA-C16410 Smokey Point Blvd., Ste 300Marysville • 425-385-2009

Amy Cheng, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Alexander Jack, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

DIALYSISPuget Sound Kidney Center18828 Smokey Point BlvdArlington • 360-454-5280

ENDODONTICSKathleen Mulligan, DDS1513 10th StreetMarysville • 360-658-2577

FAMILY PRACTICEJared M. Anderson, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Lise Alexander, MDTulalip Health Clinic7520 Totem Beach RoadMarysville • 360-651-4511

Charles T . Chaffee, MDArlington Family Medicine7530 204th Street NEArlington • 360-435-8810

Harold Clark, MDMarysville Family Medicine4404 80th St NEMarysville • 360-659-1231

David A . Dunnington, MDSmokey Point Family Medicine16410 Smokey Point Blvd., Ste. 101Arlington • 360-659-4440

Jennifer Engstrom, MDProvidence Medical Group – Marysville18630 State AvenueMarysville • 360-658-6800

Susana Escobar, MDMarysville Family Medicine4404 80th St NEMarysville • 360-659-1231

James R. Fletcher, MDWhitehorse Family Medicine875 Wesley Street, Ste. 250Arlington • 360-435-2233

Vernon Hall, DOCascade Valley Health Alliance3823 172nd Street NEArlington • 360-618-5000

Anne Herbert, PA-CCascade Valley Health Alliance3823 172nd Street NEArlington • 360-618-5000

Mark Holland, MDMarysville Family Medicine4404 80th St NEMarysville • 360-659-1231

David W. Janeway, MDWhitehorse Family Medicine875 Wesley Street, Ste. 250Arlington • 360-435-2233

David Jimenez, MDSeamar Clinic9710 State AvenueMarysville • 360-653-1742

Ann C . Kammeyer, MDMarysville Clinic1416 8th Street, #1Marysville • 360-659-3191

Robert J. Klem, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900


FAMILY PRACTICE (Cont’d)Mark A . Lucianna, MDArlington Family Medicine7530 204th Street NEArlington • 360-435-8810

Dennis S . Mann, DOSmokey Pt Osteopathic Family Medicine16410 Smokey Point DriveArlington • 360-651-1833

Jose Mata, MDSeamar Clinic9710 State AvenueMarysville • 360-653-1742

Sean McElhaney, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Tuyen Nguyen, MDSeamar Clinic9710 State AvenueMarysville • 360-653-1742

Carmen Oprea, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-618-5000

Anne E . Pham, MD4420 76th Street NEMarysville • 360-651-7490Tari Lynn Roche, DOCascade Valley Smokey Point Clinic16410 Smokey Point Blvd., Ste. 200Arlington • 360-653-4569

Greg Sanders, MDSeamar Clinic9710 State AvenueMarysville • 360-653-1742

Philip Smith, MDMarysville Family Medicine4404 80th St NEMarysville • 360-659-1231

Mark Spencer, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-618-5000

Philip Zylstra, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-618-5000

GENERAL SURGERYEkaterina Knowlton, MDCascade Surgeons875 Wesley Street #230Arlington • 360-435-6097

Monroe C. Whitman, III, MDCascade Surgeons875 Wesley Street #230Arlington • 360-435-6097

HEALTH CARE CENTERS4th Street Medical Care1602 4th StreetMarysville • 360-659-4141

10 Minute Walk-In Clinic540 N West AvenueArlington • 360-435-8262

10 Minute Walk-In Clinic9528 State Avenue, Ste. AMarysville • 360-658-0233

Cascade Skagit Health Alliance3623-172nd St. NEArlington • 360-618-5000

Community Health Center326 Stillaguamish Ave.Arlington • 360-572-5400

Grove Street Family Clinic1630 Grove StreetMarysville • 360-653-3500

Marysville Family Medicine4404 80th Street NEMarysville • 360-659-1231

Providence Medical Group – Marysville11603 State AvenueMarysville • 360-658-6800

Sea Mar Community Health Center9710 State AvenueMarysville • 360-657-7910

The Everett Clinic – Marysville4420 76th Street NMarysville • 360-651-7490

The Everett Clinic – Smokey PointSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

INTERNAL MEDICINEMichael John Andreoni, MDProvidence Medical Group – Marysville11603 State AvenueMarysville • 360-658-6800

Don B . Andrews, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Sidra Aslam, DOSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Seyed “Sam” Hejazi, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-618-5000

L Albert Labib, MDProvidence Medical Group – Marysville11603 State AvenueMarysville • 360-658-6800

Patrycja Turek, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-618-5000

OBSTETRICS/GYNECOLOGYDavid M . Gran, MDCascade Valley Women’s Health903 Medical Center DriveArlington • 360-435-0242

Ann A . Hoffman, DOCascade Valley Women’s Health903 Medical Center DriveArlington • 360-435-0242



ONCOLOGYMehrdad Jafari, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-657-8660

Kiarash Kojouri, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-657-8660

Bruce Mathey, MDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-657-8660

OPHTHALMOLOGYBruce J. Ballon, MDHarmon Eye Clinic903 Medical Center DriveArlington • 360-435-8595

Michael J. Fleming, ODHarmon Eye Clinic903 Medical Center DriveArlington • 360-435-8595

R . Lee Harman, MD FACSHarmon Eye Clinic903 Medical Center DriveArlington • 360-435-8595

Bruce E.Wietharn, MDHarmon Eye Clinic903 Medical Center DriveArlington • 360-435-8595

ORTHOPEDIC SURGERYEdward W. Eissmann, MDCascade Valley Orthopedics328 StillaguamishArlington • 360-435-6641

Rodney E. Johnson, MDCascade Valley Orthopedics328 StillaguamishArlington • 360-435-6641

Paul E . Naumann, MDCascade Valley Orthopedics328 StillaguamishArlington • 360-435-6641

OTOLARYNGOLOGY (EARS, NOSE, THROAT)Gary L . Brown, MDCascade Medical Group20302 77th Ave NEArlington • 360-435-6300

Jonathan Regan Grant, MDCascade Medical Group20302 77th Ave NEArlington • 360-435-6300

James R. Gross, MDCascade Medical Group20302 77th Ave NEArlington • 360-435-6300

Natalie Higgins, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

David Hock, DOSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Gary K. Johnson, MDCascade Medical Group20302 77th Ave NEArlington • 360-435-6300

David A . Riley, MDCascade Medical Group20302 77th Ave NEArlington • 360-435-6300

PEDIATRICSKrista Galitsis, MD, PhDCascade Skagit Health Alliance3823 172nd Street NEArlington • 360-618-5000

Rosana L . Go, MDCascade Valley Arlington Pediatrics875 Wesley St., Ste. 130Arlington • 360-435-6525

Susana Myers, DO, MPHSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Denise Shushan, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Doina A . Stefan, MDCascade Valley Arlington Pediatrics875 Wesley St., Ste. 130Arlington • 360-435-6525

PHYSICAL THERAPYElaine Andersen, PTCascade Rehabilitation Associates3710 168th St NE, Ste. A102Arlington • 360-658-0508

Annie Balok, DPT, L/ATCSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Dawn Bostic, PT, OCSIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

David Kalahar, MPTCascade Rehabilitation Associates3710 168th St NE, Ste. A102Arlington • 360-658-0508


PHYSICAL THERAPY (Cont’d)Stephanie Kiel, OTR/L, CHTCascade Rehabilitation Associates3710 168th St NE, Ste. A102Arlington • 360-658-0508

Amy LaBorda, PT, DPTIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

Chris LaPolla, PTIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

Joan Myrick, LMPIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

Brittany Olson, DPTCascade Rehabilitation Associates3710 168th St NE, Ste. A102Arlington • 360-658-0508

Katy Osmundson, ATCIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

Debbie Phibbs, OTR/L, CHTIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

Jim Romo, PTReaction Physical Therapy3131 Smokey Point Drive, Ste. GArlington • 360-658-8400

Catherine Schneider, PTAIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

Katie Templin, PTAIRG7728 204th St . NE, Ste . AArlington • 360-403-8250

Stephanie Wilson, DPTSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

PLASTIC/COSMETIC SURGERYGary L . Brown, MDCascade Medical Group20302 77th Ave NEArlington • 360-435-6300

Natalie Higgins, MDSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

PODIATRYFred J. Hawley, Jr., DPMAlpine Foot & Ankle Clinic17432 Smokey Point Blvd., Ste. 103Arlington • 360-653-2326

Jeff Korab, DPMSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Jessica Lund, DPMSmokey Point Medical Center2901-174th St. NESmokey Point • 360-454-1900

Michael B . Riojas, DPMFoot & Ankle Specialists of Washington875 Wesley Street, Ste. 110Arlington • 360-474-9600

Todd C . Skiles, DPMMarysville Foot & Ankle Clinic9516 State Avenue, Ste. DMarysville • 360-653-3354

PSYCHOLOGYFrank J. Hammer, PhDCascade Medical Center 326 S. Stillaguamish Avenue, Ste. 7

RADIOLOGYKristin R . Grant, MDCascade Radiology Consultants330 Stillaguamish AvenueArlington • 360-435-0504

Ross P . Hartling, MDCascade Valley Hospital330 S. Stillaguamish AvenueArlington • 360-435-2133

Pierre Lanthiez, MPH, MDCascade Valley Hospital330 S. Stillaguamish AvenueArlington • 360-435-2133

SLEEP MEDICINEMuhammad Sayed, MDCascade Valley Sleep Disorders Center875 Wesley, Ste. 240Arlington • 360-435-7374



Directory of Local Dental ProvidersDavid J Abdo, DDS122 E Maple St. Arlington • (360) 435-8411

Greg Adams, DDS1083 State Ave. Marysville • (360) 659-0864

Allen Creek Family Dentistry6618 64th St NEMarysville • (360) 651-2900

Arlington Dental Clinic520 N Olympic Ave. Arlington • (360) 435-4043

Arlington Family Dentistry3911 171st St NE Arlington • (360) 658-7741

Arlington Family Dentistry, DMD17306 Smokey Point Dr Ste 21 Arlington • (360) 658-7806

Arlington Pediatric Dentist3710 168th St. NE Suite B-105 Arlington • (360) 657-1650

Autumn Wood Dental430 N West Ave. Arlington • (360) 474-9163

Avenue Dental Care3402 173rd Pl NEArlington • (360) 659-8777

Timothy Bennett, DDS3943 116th St NEMarysville • (360) 651-9580

Dennis I Booth, DPC P1606 4th St.Marysville • (360) 659-2938

Boulevard Dental16825 Smokey Point Blvd. Arlington • (360) 653-5197

Cedar Family Dentistry505 Cedar Ave. Marysville • (360) 659-3232

Patricia V Conn, DDS7825 47th Ave NEMarysville • (360) 659-1223

Dirk T De Young, DDS1222 2nd St. Marysville • (360) 653-2783

Bryce K Duskin, DDS20210 77th Ave NE Arlington • (360) 435-2151

Eagle Family Dental Center20210 77th Ave NEArlington • (360) 435-2151

Jonathan Erhardt, DDS7825 47th Ave NEMarysville • (360) 659-1223

Alan D Erickson, DDS302 E Division St. Arlington • (360) 435-3661

Jeffrey L Erwin7825 47th Ave NEMarysville • (360) 283-5936

Holly E Eydenberg, DDS3943 116th St NE # 103Marysville • (360) 651-9580

Gentle Dental Marysville 3943 116th St NEMarysville • (360) 836-1872

Shahram Ghafghazi, DDS3943 116th St NE Marysville • (360) 651-9580

Beth A . Gold, DDS5100 Grove St.Marysville • (360) 659-6732

Gregory J Gosch, DDS4825 Grove St.Marysville • (360) 659-7617

Otto J. Hanssen3533 172nd St NE Arlington • (360) 436-6932

Kevin A Harrison, DDS16410 Smokey Point Blvd # 305, Arlington • (360) 653-7654

John D Hixson, DDS PS7825 47th Ave NE Marysville • (360) 659-1223

Donald R Hodges, DDS3210 Smokey Point Dr # 102Arlington • (360) 657-3965

J DR Hong, DDS1809 4th St. Marysville • (360) 653-1114

Tara Hudson, DDS1622 Grove St. Marysville • (360) 659-5611

Jeff D Huleatt, DDS20210 77th Ave NE Arlington • (360) 435-2151

George R Hussey, DDS FAGD16825 Smokey Point BlvdArlington • (360) 653-5197

Roger Knaphus, DDS6618 64th Dr NE Marysville • (360) 651-2900

Chia C Lee, DDS3131 Smokey Point Dr # H2Arlington • (360) 658-3131

Kulits Ortho3325 Smokey Point Dr. Arlington • (360) 659-5749Paul E Kulits, DDS302 E 3rd St. Arlington • (360) 435-2764

Lakewood Dental Care2704 171st Pl NEMarysville • (360) 652-1400

Brad A Larreau, DDS3210 Smokey Point Dr. Arlington • (360) 653-5577


Misky K Lopez, DDS9710 State Ave. Marysville • (360) 653-1742

John B Ludu, DMD6618 64th Dr NE Marysville • (360) 651-2900

Shawn E Magelsen, DMD5100 Grove St Ste B Marysville • (360) 658-7750

Nanda K Manogaran, DDS16410 Twin Lakes Ave # 107Marysville • (360) 652-0800

Marysville Children’s Dentistry919 State Ave # 104 Marysville • (360) 659-8100

Marysville Dental Center7825 47th Ave NEMarysville • (360) 659-1223Matthew J Maynard, DDS3325 Smokey Point Dr # 101 Arlington • (360) 659-7633

Samuel A McClary, DDS3823 172nd St NE Arlington • (360) 653-4569

McClary Kim & Wahan, DDS16410 Smokey Point Blvd, Arlington • (360) 658-8822

Kathleen Mulligan1513 10th St. Marysville • (360) 659-2577

Northwest Smile Design5100 Grove St.Marysville • (360) 658-7750

OM3 Oral Surgery16410 Smokey Point BlvdArlington • (425) 743-0227

Phillip A Paulsen, DDS4403 76th St NE Marysville • (360) 659-6774

Kelly B Peterson, DDS5100 Grove St # B Marysville • (360) 658-7750

Pleasant Smile Dental16410 Twin Lakes Ave Ste 107Marysville • (360) 652-0800Pioneer Denture Clinic619 Cedar Ave.Marysville • (360) 659-6300

Eustaquio Rivera Jr10528 66th Ave NE Marysville • (360) 657-1549

Bart F Robison, PS3710 168th St NE Arlington • (360) 651-9394

Olaru Serban, DDS4922 Grove St. Marysville • (360) 659-8548

R Sharma, DMD6618 64th St NE Marysville • (360) 651-2900

Shaw Orthodontics4305 76th St NEMarysville • (360) 653-4114

Lu Lisa Shuwen, DDS3325 Smokey Point DrArlington • (360) 653-7098

Smokey Point Family Dentistry3533 172nd St NE Arlington • (360) 658-3000

Smokey Point Orthodontics3325 Smokey Point Dr # 102Arlington • (360) 659-5749

Smokey Point Smile16825 Smokey Point BlvdArlington • (360) 653-5197

Stillaguamish Family Dentist4126 172nd St NE Arlington • (360) 657-3687

Robert & M A Strom7115 77th Ave NEMarysville • (360) 658-6102

Sunrise Dental of Arlington3131 Smokey Point Dr.Arlington • (360) 658-3131

Jeff E D Theis, MD, MSD3325 Smokey Point Dr Ste 102 Arlington • (360) 659-5749

Thomas Family Dentistry17432 Smokey Point Blvd Arlington • (360) 659-8406

Christopher Vanderhoef, DDS3911 171st St NE Arlington • (360) 658-7806



Few, if any, families can say they have never had an expe-rience with cancer . Cancer is a potentially deadly disease with no cure. While cancer can be treated effectively, there is no way for men and women to eliminate their risk of developing cancer .

Though cancer may strike even the healthiest of persons, there are ways men, women and even children can reduce their risk . One such way is to consume certain foods that researchers feel can reduce cancer risk . Though precisely how these foods fight cancer remains a mystery, cancer researchers feel they can ef-fectively lower an individual’s cancer risk when combined to form a healthy diet .Beans and Legumes

Beans boast numerous healthy attributes, and their potential to reduce cancer risk is one such attribute . Beans contain many phytochemi-cals that researchers feel pro-tect the cells from the type of damage that can ultimately make a person susceptible to cancer . Beans also have been shown to decelerate tumor growth and prevent tumors from releasing potentially harmful substances that can damage nearby cells .Colorful fruits and vegetables

It may seem odd that a food’s color can have an im-

Fighting cancer at the dinner table

pact on cancer risk, but col-orful fruits and vegetables contain more cancer-fight-ing nutrients than fruits and vegetables that aren’t as flashy .Consuming such fruits and vegetables also helps men and women maintain a healthy body weight, an im-portant benefit when consid-ering overweight and obesity increases a person’s risk for multiple cancers .Foods with folate

Folate is a B vitamin that can reduce a person’s risk of developing several cancers, including those of the colon, rectum and breast . Those who are fond of a healthy break-fast to begin their day may already be getting healthy doses of folate, which can be found in eggs, fortified break-fast cereals, orange juice, and strawberries, among other foods . If toast is your break-

fast of choice, opt for whole wheat toast, as whole wheat products are a good source of folate .Grapes

Studies have shown that resveratrol, a key ingredient in grapes, may prevent the type of damage that triggers the production of cancerous cells . Though scientists are not yet comfortable saying grapes, or beverages like grape juice and wine, can reduce cancer risk, they believe that the antioxi-dant and anti-inflammatory properties of grapes make them a healthy option .Tomatoes

Tomatoes are widely be-loved, and perhaps that love affair stems from the to-mato’s role in fighting can-cer . Though the reasons are unknown, tomatoes have been linked to lowering

men’s risk for prostate can-cer. One such study, a 1995 study from researchers at the Harvard Medical School, found that men who ate 10 or more servings of toma-toes per week reduced their risk of developing aggressive prostate tumors by nearly 50 percent . Later research from the author of the 1995 study found that processed toma-toes, such as those found in tomato paste and tomato sauce, were even more effec-tive at reducing cancer risk than fresh tomatoes . Toma-toes have also been linked to lowering a person’s risk for lung and stomach cancers .Water

Water may not qualify as a food, but it may protect peo-ple from bladder cancer . Po-tential cancer-causing agents in the bladder are diluted when drinking water . In ad-dition, the more water you drink the more frequently you’re likely to urinate, which means cancer-causing agents have less time to come into contact with the lining of your bladder .

Many foods can help in-dividuals in the fight against cancer . Though one food alone may not be potent enough to do the job, when several cancer-fighting foods are included in a person’s diet, the effects may be sig-nificant .

n Tomatoes, whether served fresh or as a paste or sauce, have been linked to reducing a person’s risk for various cancers, including can-cers of the prostate, lung and stomach.


Losing some weight is a goal for many people regard-less of age. While youngsters and young adults might be able to get away with a few extra pounds without suf-fering any significant conse-quences, older adults carrying some extra weight might be putting their overall health at considerable risk .

Shedding weight after the age of 50 is not always easy. As a person ages, muscle mass tends to dwindle while body fat has a tendency to increase . Since fat burns fewer calories than muscle, weight gain as a person ages is bound to hap-pen . But that doesn’t mean such weight gain is inevi-table . In fact, men and wom-en willing to make certain changes with regard to diet and exercise can shed pounds after 50 while preventing fu-ture weight gain .Diet

Men and women need fewer calories as they age . For example, men and wom-en in their 40s may need as many as 200 calories more per day than they will when they reach their 50s. Count-ing calories might seem dif-ficult, so men and women in their 50s and older who don’t think they can count calories can try to eat more low-calorie foods like fruits, vegetables and whole grains .

Consuming fewer calo-ries often requires changing dietary habits, not only with

regard to what you’re eating but also how you’re eating and even how you shop for food . Men and women used to dining out for lunch every day can start bringing their own lunches so they can gain greater control of their daily caloric intake . For those who find they’re frequently too exhausted to cook each night, they can prepare meals in ad-vance to have healthy, home-made meals waiting instead of always ordering takeout or delivery. When shopping for food, people should avoid doing so on an empty stom-ach so they’re less inclined to buy unhealthy snacks .Exercise

Exercise is another essen-

tial component to shedding pounds after 50, though men and women over 50 should always consult a physician before they begin a new ex-ercise regimen . The Centers for Disease Control and Pre-vention points out that regu-lar exercise can help older men and women prevent the onset of a host of ailments, including heart disease and diabetes . In addition, the CDC notes that regular physical activity as one ages helps muscles grow stronger, which increases the chances that an individual will be able to perform necessary daily activities without the assis-tance of others . Maintaining that independence into older

adulthood is a goal for many men and women, and it’s a goal that’s far more realistic for men and women who ex-ercise than it is for those who don’t .

When coupled with a healthy, low-calorie diet, rou-tine exercise can help men and women over 50 shed extra weight and keep the weight off once it’s gone . According to the CDC, older adults need at least 2 hours and 30 minutes of moderate-intensity aerobic activity, such as brisk walk-ing, every week and muscle-strengthening activities on 2 more days a week. These muscle-strengthening activi-ties should work all the ma-jor muscle groups, including the legs, hips, back, abdomen, chest, shoulders, and arms . Muscle-strengthening activ-ities include lifting weights, working out with resistance bands, exercise such as push-ups and sit-ups that use body weight for resistance, and yoga . Even gardening that involves digging and shovel-ing can be considered a mus-cle-strengthening activity .

Weight gain is often an expected side effect of aging . But men and women don’t have to gain weight as they get older . Some simple di-etary changes and a commit-ment to routine exercise is all it takes to shed weight after 50 and keep that weight off once it’s gone .

Shedding those excess pounds can be difficult but worthwhile

n Diet and exercise are the keys to healthy weight loss at any age, but losing excess weight as we age becomes more difficult.



At the age of 46, elementary school teacher Linda Seward started notic-ing difficulty maintaining mobility and keeping up with her class due to constant knee pain . After years of pain medication and alternative treatments, Linda, like many other Americans who face osteoarthritis of the knee, didn’t see measurable improvements and the pain was affecting her quality of life and abil-ity to work .

“It got to a point where I couldn’t walk more than a few yards without pain and it was very difficult to stoop, bend, or kneel . I was literally hang-ing onto walls when I walked students down the hall,” said Linda, who ulti-mately underwent knee replacement surgery as a last resort at the age of 56. “Since my surgery, there’s not a day that goes by that I’m not amazed at how I’m able to move without pain . I never have to take pain medication and it’s like I’m in my thirties again .”

There is a desire among the aging population to stay active and remain in the workforce . The combination of the aging population and the rising epidemic of obesity can lead to an in-creasing demand for joint replacement . The demand for total knee replacement is expected to exceed 3 million by the year 2030—up from 600,000 in 2009, according to the Agency for Healthcare Research and Quality .

A new study published this month in the Journal of Bone and Joint Surgery ( JBJS) demonstrates the importance of maintaining access to knee replace-ment surgery for those suffering from osteoarthritis .

Researchers found that the societal benefits for working-age knee replace-ment patients far outweigh the actual

Knee replacement a cost-effective option for osteoarthritis

cost of the surgery and rehabilitation, compared to non-surgical treatments for osteoarthritis of the knee . The di-rect costs for knee replacement surgery and rehabilitation of a Medicare patient averaged $20,704 and these costs are offset by an average indirect savings of $39,697. The end result is a lifetime so-cietal net benefit ranging from $10,000 to $30,000 per patient.

“Most of the societal savings come from the patient’s ability to maintain employment and increase earnings over a longer time in the workforce. We also found benefits from fewer missed worked days and lower disability pay-ments,” said study author and health care economist Lane Koenig, Ph .D . “This methodology application has opened the door for a broader set of health care services to be evaluated us-ing a societal perspective, which is truly exciting .”

More than 90 percent of people who have total knee replacement surgery ex-perience a dramatic reduction of knee

pain and a significant improvement in the ability to perform common ac-tivities of daily living, allowing them to return to work and tremendously enhance their quality of life . The new study, “The Direct and Indirect Costs to Society of Treatment for End-Stage Knee Osteoarthritis,” shows how knee replacement surgery can be a valu-able and cost-effective treatment for patients with end-stage osteoarthritis, estimating lifetime societal savings of about $12 billion from the more than 600,000 total knee replacement surger-ies performed in the U.S. in 2009.

“The demographic profile of a knee replacement patient is changing,” said John R. Tongue, M.D., American Acad-emy of Orthopaedic Surgeons (AAOS) past-president . “Half the patients get-ting knee replacements now are younger than 65 years of age and most of them are still in the workforce .”

Dr. Tongue added, “We know that when a knee replacement is done on patients at the appropriate time, it adds tremendous value to their lives . It gets them back to work and back to their families . It improves their quality of life and allows them to be productive and active again . But until now, that value has been hard to quantify . This study al-lows patients to see the big picture ef-fect on their daily lives and in the long term .”

The full JBJS study, identifying a quantifiable view of the value of knee replacement surgery compares costs for direct medical care, long-term medical care, home modification and long-term nursing home use for both surgical and non-surgical treatments among patients age 65 and older. See www .ANationIn Motion .org/Value/Knee.

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