In This Issue PacMed Diabetes ProgramRecipe: Pumpkin Mousse for the HolidaysInterventional Pain Management Helps PatientsCommunity Events Concussions and SportsFlu ManagementWalking for FitnessPlastic SurgeryFind Us on Facebook

Accredited Diabetes Education Program Helps Patients Meet Their Goals

Healthy TodayA newsletter from Pacific Medical Centers.

Fall/ Winter2010

Diabetes is a life-altering disease and one that requires making a lot of lifestyle changes to be healthy. Diabetes isn’t curable; however, you can get better at living with it and doing what you need to do to feel your best every day. These changes typically include managing one’s diet, exercising more, testing blood sugar levels and monitoring blood pressure and cholesterol. Still, even people who are under a physician’s care and strongly motivated to take charge of their diabetes can get overwhelmed at times or need some extra emotional support. That’s where we can help.

At Pacific Medical Centers, we’ve created a comprehensive program to help our patients with diabetes understand and manage their condition so they can get on with the other things in their lives that they really care about. By working with an educator one-on-one or in a class, diabetic patients create specific, attainable goals—such as remembering to take medications, exercising more or eating within a certain level of carbohydrates. They are then tracked and monitored, and their goals are adjusted, all in a collaborative environ-ment with their providers. This system has been shown to improve disease management.

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At PacMed You’ll FIND:

•Afamiliarface—Your primary care doctor will see you for all your routine checkups and most other visits, and can coordinate any specialty care you might need.

•Careforeveryinchofyou— Our clinics offer a full range of primary and specialty services.

•We’repracticallyneighbors—Visit any one of 10 convenient locations.

•Youarecovered—We accept most major insurance plans.

•Wespeakyourlanguage— Many of our physicians are fluent in languages other than English, and you can request our interpreter services in most clinics.

•Same-dayappointments— Even if it’s your first visit. Just call 1.888.4PACMED (472-2633) or go to our Web site.

•Clinicswithextendedhours,on-siteparkingandmore.

Diabetic Pumpkin Mousse(Serves 6)Serving Size: 1/2 cup Prep time: 6 minutes

Dr. Rebecca Over provided this healthy holiday recipe for diabetic patients that everyone in the family can enjoy.

Diabetic-FriendlyFoodPlanningfortheHolidaysFor people who are watching what they eat—for whatever reason—the holidays can be a challeng-ing time. For people with diabetes, it’s especially important to continue watching in order to avoid sugar highs and lows. Eating moderately at regular intervals, making healthy choices and getting exer-cise are good for everybody, so if you can, make this a family goal.

If you have diabetes and are going to be faced with tempting holiday foods and drinks, talk to your nu-tritionist and create a holiday meal plan. It’s quite possible that you can have some treats, as long as you are substituting them for your daily carbohy-drates and not adding them in.

Many people find that they enjoy the holidays more when they can control the menu. It’s easy to make favorite foods using ingredient substitutions—for example, basting turkey with fat-free broth instead of butter or drippings. The Web and bookstore are full of friendly recipes and ideas.

Make your appointment with PacMed nutritionist Cristina Lattuga or Jan Rystrom now to create your personalized holiday eating plan—and get valuable moral support. You’ll find that there are lots of ways to enjoy the holidays and still be good to yourself.

We’re very proud that our diabetes self-management education program has been accredited by the American Association of Diabetes Educators (AADE). This recognition affirms PacMed’s commitment to partnering with our patients with diabetes to help them live their best lives.

Dr. Rebecca Over is the endocrinologist at Pacific Medical Centers who oversees the program. She wants to reach all patients with diabetes and encourage them to practice self-management skills to avoid com-plications. “For the upcoming year, we will be targeting patients whose diabetes is uncontrolled and ensuring that they are part of the education program—and if not, referring them for one-on-one counseling or a group session, or to the chronic disease nurse case management program available in our Northgate clinic under the direction of Terri Wolber, DNP, ARNP,” she says.

PacMed has three full-time certified diabetes educators, Barbara Benson-Bishop, RN; Cristina Lattuga, RD; and Jan Rystrom, RD. Two other nurses are close to completing their certification. In addition, certain PacMed specialists are closely affiliated with the program. At-Risk Foot Specialist May Chang, ARNP, cares for those with diabetic-related foot issues. Dr. Bonnie Collins, Nephrology, helps people manage diabetic kidney disease. And Drs. Tony Huynh, Christopher Kuntz and Niraj Patel, Ophthalmology, conduct annual dilated retinal exams.

In the United States alone, 23.6 million people have been diagnosed with diabetes, making it one of the largest epidemics in this country. At PacMed, we are committed to fighting this disease. We have over 30 physicians certified in diabetic care by the National Committee for Quality Assurance, we offer accredited diabetes education, and we are a proud sponsor of the American Diabetes Association.

Diabetes, continued from p. 1

Ingredients:2 cups canned pumpkin (not pumpkin pie filling)1 Tbsp honey2 tsp cinnamon2 tsp grated lemon peel1 cup fat-free ricotta cheese

Directions:In a medium bowl, combine the pumpkin, honey, cinnamon and lemon peel. Mix well. Fold in the ricotta cheese. Refrigerate for 1 hour and serve.

Diabetic Meals in 30 Minutes—Or Less! 2nd edition by Robyn Webb. 2006, American Diabetes Assn.

Nutritional information per serving (1 serving = 1/2 cup)Calories: 57 Fat: 0 g Saturated Fat: 0.1 gTotal Carbohydrate: 9 g Dietary Fiber: 2 g Sugars: 6 gCholesterol: 13 mg Sodium: 36 mgProtein: 6 g

Several hundred friends of PacMed participated in Step Out, a fundraising event on Saturday, October 9, in support of the American Diabetes Association’s efforts to prevent and cure diabetes.

If you’ve experienced chronic pain, you know it can overshad-ow your whole life, negatively affecting work, interactions with family, exercise and hobbies. “The primary role of a pain phy-sician is to get patients more pain-free and functional,” says Dr. Marshall Bedder, Director of Interventional Pain Manage-ment at the First Hill clinic. “At PacMed, we have the expertise to handle all basic and complex pain problems.”

Dr. Bedder has more than 20 years of experience in pain medi-cine. He is certified in Anesthesiology and Pain Medicine by the American Board of Anesthesiology and in Addiction Medicine by the American Board of Addiction Medicine. His goal with interventional pain management is to help patients avoid more invasive treatments, limit their need for further surgeries and decrease the amount of medications they need to take.

Another member of the Interventional Pain Management team, Gladys Romasanta,ARNP, worked for 8 years with neurosurgical patients who experienced chronic spine pain. She saw that their pain frequently raised psychological and social issues, such as depression, which

only added to their medical challenges. To better treat these patients, she returned to school to become a psychiatric nurse practitioner, a program she completed this past June. “Pain is a biological, psychological and social issue,” she says. “Good pain management doesn’t treat just the painful body part; it deals with the whole patient.”

Pain may follow an injury or operation, or be caused by degen- eration (such as aging or arthritis), cancer, shingles and many other ailments. Because pain can be caused by so many things, and because patients are referred from all over PacMed, the Interventional Pain Management team works closely with col-leagues in our Neuro-Muscular-Skeletal specialties (Neurology, Rheumatology, Orthopedics, Physiatry/Physical Medicine and Rehabilitation, Sports Medicine, Podiatry and Physical Therapy), with our Behavioral Health providers and with our primary care physicians. Together, these medical experts can determine the correct diagnosis and appropriate treatment and therapy regimen to bring about the best possible outcome for patients.

With any treatment plan, Dr. Bedder aims to help patients reduce or eliminate the need for addictive opioid pain medications. “I feel confident we can outline a superior, multifaceted treatment plan to enhance patient comfort,” he says.

Common therapies include steroid and local anesthetic injec-tions. Spinal injections are done under fluoroscopic guidance to enhance efficacy and patient safety. Radio Frequency Thermal Coagulation is another technique that dulls some of the smaller nerves at arthritic facet joints (joints in the spine), giving the patient 18 to 24 months of continuous pain relief. In addition, Dr. Bedder is a recognized leader in spinal cord stimulation. Spinal cord stimulation is a cutting-edge technology that uses implanted devices similar in function and appearance to pacemakers to help patients with persistent pain following back surgeries or with neuropathic pain.

Interventional Pain Management Helps Patients Regain Functionality

Community EventsWinter Tree Lighting Ceremony, December 4, 20104:30 p.m., Mill Creek City Hall

PacMed is proud to sponsor the annual Tree Lighting in down-town Mill Creek. Immediately following, the “Santa’s Coming to Town” parade will proceed down Main Street. Bring non-perish-able food items for the Volunteers of America Food Bank—and your cameras!

Holiday Lighting Event, December 4, 20105:00 p.m., Carol Edwards Center, Molbak’s and Barnes & Noble – Woodinville

Neighbors, be sure to come out to view lights, hear great music, participate in crafts and watch Santa’s arrival! PacMed is a proud sponsor of this event and we hope to see you there!

Seattle Wedding Show, January 8–9, 2011 Washington State Convention & Trade Center

PacMed is a sponsor of this highly anticipated annual event. Why is a healthcare organization sponsoring a wedding show? Because our wish for you and your fiancé— and your family-to-be—is that you have a long, healthy life together.

Stop by our clinics to pick up a show program and a coupon for a discount-ed ticket at the door. Each bride-to-be who comes to talk to us at our booth will receive a small gift.

For event times and other information, go to www.weddingshow.com.

You can see Dr. Bedder’s video profile by visiting the Who We Are section of our website (www.PacMed.org).

Since the summer of 2009, all children and teens in Washington who want to play school or club sports must first sign a Concussion Information form. A parent or guardian must also sign.

The form describes common symptoms of concussion and explains our state’s recently passed Zackery Lystedt Law, which says that ifayouthplayerappearstohavesustainedaheadinjuryorconcussioninpracticeoragame,heorshemaynotreturntoplaywithoutwritten clearancefromalicensedheathcareproviderwhoistrainedintheevaluationandmanagementofconcussion. The reason for this precau-tion is that, while symptoms may seem mild, if the player sustains a second head injury before the first one has time to heal, the damage can be serious, even unrecoverable.

What is a concussion? Basically, it’s a bruise to the brain. This happens when the head is bumped or jolted, and the brain is shaken against the skull. The result can be tempo-rary loss of brain function; for instance, the person might exhibit slurred speech or pass out—but this is not always the case, and symptoms can be hard to detect. That’s why it’s important for a professional to make a diagnosis.

Dr. Chris Maeda, a PacMed physician who specializes in Sports Medicine, sees many concussions in his practice.

Sports Fans, It’s the Law: When in Doubt, the Kid Sits Out“Most people don’t actually lose consciousness or get amnesia, which are the more obvious signs,” he says. “Instead, a child might have headaches, or more subtle symptoms such as trouble concentrating or personality changes, which can be harder to detect. Nausea and vomiting can be common.”

At our Northgate clinic, pediatrician Dr. Manny Eusebio educates parents about concussion when they bring in their children for checkups. “A concussion is not really visible,” he says. “So it’s extremely important for parents to monitor for symptoms of a concussion before allowing their children to resume athletic activities. If any mental status changes develop, or other symptoms get worse, bring them in to see us right away.”

With rest, most people recover fully within a few hours or days; with more serious cases or repeat injuries, however, recovery can take weeks or even months. Sometimes, medical intervention such as surgery may be required. So, even if your child seems fine, neversendhimorherbackintopracticeoragamethesamedayasaninjury.

ConsiderAddingImPACTConcussionTesting toaPre-seasonPhysical ImPACT(ImmediatePost-concussionAssessmentandCognitiveTesting)isacomputer-izedexamthatcanbetakenbeforeenteringintocontactsports—oftenaspartofapre-seasonphysical—andlaterusedtoaidintheassessmentofapossibleconcussionandhelpassistwithreturn-to-playdecisions.Alreadythe“goldstandard”oftheNFL,MLS,NBAandothersportsorganizations,ImPACTtestingisgainingpopularitywithstudentathletes.PacMedwillbeofferingthetestinitiallyattheBeaconHillclinicandthenatourotherclinicsunderthesupervisionofLisaOlsson,neuropsychologist.

Anon-invasivetest,ImPACTprovidesbaselineinformationaboutanindividual’s normalreactiontime,attentionspan,workingmemoryandmore.Setupina computer-basedformat,ittakesapproximately20minutestocomplete.Ifapersonisbelievedtohavesufferedaconcussion,thetestcanbeadministeredagaintohelpdeterminetheseverityofheadinjuryandwhenitisappropriatetoreturntoregularactivities,includingsports.Follow-uptestingisgenerallydoneasapartofamoreextensiveevaluationofconcussionandistypicallydoneinconjunctionwiththepatient’sprimarycarephysician,specialistsandDr.Olsson.

Baselinetestsshouldbeupdatedeverythreeyearsinchildren;typi-cally,adultstakeitonce.Baselinetestinggenerallyisnotacoveredinsurancebenefitsoindividualsareencouragedtocheckwiththeirinsurancecompanybeforeschedulingatest.Mostinsur-ancedoescoverpost-injurytesting.

Don’t Get the Flu: Get Vaccinated Influenza viruses are highly contagious and easily spread when an infected person coughs or sneezes. You can best avoid getting the flu by having a flu shot—a safe and effective way to help protect yourself and those around you.

Influenza viruses are unpredictable and constantly changing; therefore, a new vaccine is made each year to help protect against the most current strains. The 2010–2011 flu vaccine will protect against three different flu viruses: an H3N2 virus, an influenza B virus and the H1N1 virus that caused so much illness last season. According to the Centers for Disease Control, everyone over the age of 6 months is encouraged to receive this shot. People with chronic illnesses such as asthma, diabetes and heart disease are especially advised to get it, as this population has a higher risk for getting the flu and for developing complications.

The vaccine is available as both an injectable (inactivated) vaccine and as a nasal spray. Though a very small number of people may experience mild side effects, neither form of the vaccine can cause you to actually get the flu. Influenza virus activity increases until February or March, so the sooner you get your shot, the sooner you’ll be protected.

Because the flu virus lives on surfaces for 24 hours, even if you get the vaccine, it’s important to wash your hands on a regular basis to prevent the spread of this virus to others.

Walking for FitnessJust about every medical news story these days concludes that walking is one of the best things you can do for your health. Walk-ing has been credited with helping to prevent cancer, heart disease, osteoporosis and mood disorders, and with helping to control (or even prevent) diabetes and obesity. Walk-ing improves circulation, boosts the immune system and exposure to vitamin D, helps with breathing and combats depression. In Octo-ber, the journal Neurology published a study saying that walking may even lower one’s risk of developing Alzheimer’s disease.

So, what’s not to like about walking? It’s free, it’s refreshing, almost everybody can do it and it doesn’t even take much time or dis-tance to see health improvements—just 30 minutes a day can do it (about six miles total over the course of a week). All you need are supportive shoes and the right clothes for the weather. (Easily removable layers are rec-ommended). Even in winter, apply sunscreen and drink water—but not so much you have to keep stopping!

While you’re walking, stay alert. If you wear headphones, be sure you can hear what’s go-ing on around you, including dogs and bikes.

Speaking of dogs, if you have one to walk, you’ll both benefit. Research published in December 2009 by the University of Missouri found that dog walkers are more consistent about getting regular exercise and show more improvement in speed and fitness than people who walk with a human companion.

If you haven’t exercised in a while or have physical concerns about walking, check with your doctor before starting a new routine.

What to Do if You Get the FluIf you get vaccinated, you won’t have to worry about what to do if you get the flu. People who don’t get the shot and do get the flu can expect to feel pretty sick for 7 to 10 days. Although there are several types of antiviral medications for treating flu, most people can get well without them. The recommendations for treating the flu are essentially the same as those for dealing with the common cold:

• Stay at home until fever has been gone for at least 24 hours without the use of fever-reducing medications.

• Keep children with illness home from school, day care, sports and other activities.

• Get plenty of bed rest.

• Drink lots of clear fluids such as water, tea with lemon, juice and broth.

• Avoid using alcohol and tobacco, and exposure to second- hand smoke.

• Relieve fever and aches with acetaminophen, ibuprofen or aspirin; use as directed. Do not use aspirin if you are younger than 20 years old.

• Use alcohol-free, over-the-counter medications to relieve symptoms of congestion, dry throat or persistent cough.

Call your healthcare provider if your symptoms become extremely severe, if you do not feel any improvement after 7 days or if your symptoms reoccur before you have completely recovered.

Maybe people always say you look tired, when you feel perfectly rested. Or maybe your frown lines make you look older than you should. These are two examples of common cosmetic problems that can be fixed—safely and discreetly—by Dr. Lamperti, right in our Canyon Park or First Hill clinic.

Dr. Lamperti, who is board-certified in both Facial Plastic & Reconstruc-tive Surgery and Otolaryngology–Head & Neck Surgery, has dedicated his career to helping people look and feel their best. He has traveled extensively throughout the country to study with the leaders in plastic surgery to expand and refine his techniques. This has allowed him to stay at the forefront of the field and produce the most natural-looking and durable results possible.

Dr. Lamperti offers both non-surgical treatments such as Botox®, skin fillers and skin resurfacing, as well as outpatient surgical procedures to improve the different regions of the face, including rhinoplasty (reshaping the nose for aesthetics and/or to improve breathing) and otoplasty (reducing the prominence of the ears). He also does revision rhinoplasty to correct past nose surgery that resulted in nasal problems or an unnatural appearance.

Before performing any procedure, Dr. Lamperti has an extensive consulta-tion with a prospective patient. Frequently, he employs computer imaging to assist in treatment planning and set realistic expectations based on the patient’s particular anatomy, skin type and other facial features. “In my practice, I stress the importance of learning about my patients’ aesthetic concerns, budgetary constraints and time commitment to recovery, and then educate them about their options so that we may devise a customized treat-ment plan together,” he explains. The cost of the consultation can be applied to scheduled treatments and procedures.

Non-surgicalTreatments:• Botox injection • Skin filler (Radiesse/Restylane/

Juvedérm) • Lip augmentation • Laser resurfacing/chemical peel/

dermabrasion

SurgicalTreatments:• Rhinoplasty (nose surgery) • Revision rhinoplasty • Facial fat grafting • Face-lift• Brow-lift• Blepharoplasty (eyelid surgery)• Neck liposuction• Chin augmentation• Otoplasty (ear pinning)• Mole excision• Scar revision

PacMed Welcomes Dr. Thomas Lamperti, Facial Plastic Surgery

Cosmetic procedures

An annual study by the American Academy of Facial Plastic and Reconstructive Surgery reveals that there has been a 60% in-crease in men and 30% increase in women electing to have cos-metic procedures since 2000.”

You can see Dr. Lamperti’s video profile by visiting the Who We Are section of our website (www.PacMed.org).

To learn more or to schedule a consulta-tion, visit www.pacmed.org/face or call 206.505.1453.

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Pacific Medical Centers Welcomes Our Newest Healthcare ProvidersThesemenandwomenbringabroadrangeofclinicalskillsandpersonalexperiencetotheirpractice.Tolearnmoreaboutourproviders’ medicalinterests,backgroundandtreatmentphilosophy,pleasevisittheWhoWeAresectionofourWebsite(www.PacMed.org). Orscheduleanappointmenttoday.

Asapediatrician,Iviewmyroleasbeinganadvocatefor childrenandadvisortoparents….Ilovegettingtoknow familiesastheygrowandchangeandhelpingparents navigatetheirwaythroughthevariousagesandstages.”

—AkikoHall,MD,Pediatrics

Peoplewillnotcarehowmuchyouknowuntiltheyknow howmuchyoucare.Istrivetodevelopthistypeofcareby clinicallyteachingpatientsthevalueofandpropertechniques oftherapeuticexercisesandhomeexerciseprograms.”

—DennisSealey,PT,AT/L,PhysicalTherapy

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Ibelieveintreatingthewholepatient,consideringmypatients’values,personalitiesandqualityoflife.Ifocusonpreventiontoensuremypatientshaveashealthyandfulfillingalifeaspossible.”

—RohiniKamath,MD,InternalMedicine

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DonnaLaVallie,DO,MPH,FamilyMedicine*Federal WayDr. LaVallie, who is an NCQA Recognized Practitioner, is a strong believer in the team approach to managing chronic diseases such as diabetes. She plays jazz piano and guitar.

MichelePulling,MD,GastroenterologyFirst HillAlong with spending quality family time, Dr. Pulling enjoys travel, soccer and running. She speaks conversational Spanish.

RezaAskari,MD,GynecologyFirst Hill, Renton Dr. Askari enjoys reading, tennis, skiing, travel and publishing. He also speaks Farsi.

JulieJungels,MD,InternalMedicine*Totem Lake Dr. Jungels’ professional interests include geriatrics, bariatric medicine and primary care. When she’s not working, Dr. Jungels can be found showing horses, reading or knitting. She speaks conversational French.

RohiniKamath,MD,InternalMedicineCanyon ParkDr. Kamath’s focus is on physical and mental wellness. She relaxes by running along Lake Washington or spending time with her family, dogs and cats.

MelissaMolsee,MD,InternalMedicine*RentonA traveler and hiker, Dr. Molsee is interested in international health and preventive medicine.

ThomasLamperti,MD,OtolaryngologyCanyon Park, First Hill Dr. Lamperti is interested in general otolaryngology and all areas of facial plastic and reconstructive surgery. He enjoys photography, playing piano and physical fitness activities.

MarshallBedder,MD,PainMedicineFirst Hill Dr. Bedder has a medical interest in alleviating pain of spinal origin. His hobbies include fishing, gardening and running.

AkikoHall,MD,MPH,PediatricsCanyon Park Dr. Hall is concerned with violence prevention, adoles-cent health and immigrant health. A mother of twin boys, she likes to hike and travel. She speaks conversational Japanese and German.

CourtneyRogers,DPT,PhysicalTherapyCanyon Park Dancing, outdoor activities, traveling, photography and spending time with family and friends are some of Dr. Rogers’ pastimes. She speaks conversational Spanish.

DennisSealey,PT,AT/L,PhysicalTherapyNorthgateA former Husky Head Trainer (for 22 years), Dennis is especially interested in musculoskeletal injuries, joint re-placement and shoulder rehabilitation. He’s a big sports fan who also loves golf, Sudoku and crossword puzzles.

TinaMullen,CertifiedPhysician’sAssistant(PA-C),SurgicalAssistantFirst Hill Tina’s favorite leisure activities are running, cooking, reading, photography and travel.

DonaldPick,MD,UrologyFirst Hill Dr. Pick most enjoys hiking, reading, basketball, playing bass and guitar, and spending time with his wife and new baby.

*NCQA Patient Centered Medical Home Recognition

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See a video of this provider on www.PacMed.org

1200 - 12th Ave SSeattle, WA 98144

Locations BeaconHill1200 - 12th Ave SSeattle, WA 98144206.326.2400

CanyonPark1909 - 214th St SE #300 Bothell, WA 98021425.412.7200

DiagnosticCenter forSleepHealth1800 Yale Ave 10th FlSeattle, WA 98101206.709.8999

Diagnostic&Wellness CenterforWomen805 Madison St #401Seattle, WA 98104206.568.3800

FederalWay33501 First Way S #200Federal Way, WA 98003253.214.1920 866.985.6337

Specialties & Services

FirstHill1101 Madison St #301Seattle, WA 98104206.505.1101

Lynnwood19401 - 40th Ave W #100Lynnwood, WA 98036425.744.7153

Northgate10416 - 5th Ave NESeattle, WA 98125206.517.6700

Renton601 S Carr Rd #100Renton, WA 98055425.227.3700

TotemLake12910 Totem Lake Blvd NE #101Kirkland, WA 98034425.814.5000

1.888.4PACMED(472-2633)www.PacMed.org

Primary CareFamily MedicineFamily Medicine Including ObstetricsGeriatricsGynecologyInternal MedicineNutritionPediatrics

Medical SpecialtiesAllergyCardiologyDermatologyDiabetes & Metabolism, EndocrinologyGastroenterologyLiver DiseaseNephrologyNeurologyOncology & HematologyPhysiatryPulmonologyRheumatologySleep MedicineSports MedicineWomen’s Health

Surgical SpecialtiesFacial Plastic Surgery General SurgeryGynecology

OphthalmologyOrthopedicsOtolaryngology

- Head & Neck SurgeryPodiatric Medicine - Foot & Ankle SurgeryUrology

Other ServicesAudiology - Hearing Aids Behavioral Medicine- Neuropsychology- Psychiatry—Adult & Geriatric- Psychotherapy

- Individual—Child/Adolescent & Adult

- Couples Therapy- Family Therapy

Cancer Screening - Colonoscopy - Mammography Clinical Trials Cosmetic Services - Surgical & Non-surgical Treatments DXA (Bone Density Screening) Optical Shop Optometry Physical Therapy

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