Living Well Alliance, Reimagined!
The Living Well Alliance (LWA) started the year off strong. However, the program itself will look a little different going forward.
To start, LWA coordinator and dietitian, Christy Goff, is moving into a clinical dietitian role at PacMed, where she sees patients four days per week. This means she is now available for individual nutrition counseling at PacMed and can help with referrals and scheduling appointments for your employees who are interested in nutrition services. (PacMed accepts many health insurance plans, but it is best to check with your personal plan and talk with your provider before scheduling.)
Also, all LWA programs will now be virtual offerings, with booking available on Wednesdays. You can still book individual company webinars. We offer two subscription options as well—one that continues our monthly nutrition webinar program and a new “Deskercise” subscription, with videos that focus on quick and gentle stretching and strengthening, led by a registered yoga teacher or physical therapist. Learn more at www.livingwellalliance.org or email lwa@pacmed.org.
The LWA will miss partnering with you all regularly, but we hope you continue to work with us at PacMed. In the meantime, if you would like some nutrition inspiration, check out these awesome cooking videos, filmed and edited by Christy herself!
Cajun Parmesan Salmon
Cold-water, fatty fish such as salmon are the highest in omega-3 fatty acids, which enhance the function of certain immune cells. Look for wild, rather than farm-raised fish for higher omega-3 content. Fish is also a rare source of vitamin D. So you can enjoy this crispy, well-seasoned salmon in good health!
NUTRITION CORNER: Hydration quest
A tall, cool drink of water is sure to quench your thirst—and keep your body functioning properly and feeling good. Makes sense, since our bodies are 70 percent water. In fact, most all of the body’s major systems depend on water to survive. Today, we hope to convince you to take another sip and stay hydrated!
What WATER does for your body:
- WATER regulates our body temperature. Your body is a perfect HVAC system: When it heats up, it releases water as sweat. Then the evaporation cools the body. Without this essential system, you’d overheat when you exert yourself or exercise.
- WATER forms saliva and mucus. These slippery, moist substances aid in digestion, and they keep our nose, mouth and eyes moist. This moisture helps keep teeth clean, flushes grit from our eyes and prevents friction.
- WATER protects body organs and tissues. When your skin is plump with water, it’s more resistant to premature wrinkles and skin disorders. On the inside, water keeps your blood thinner, helping regulate blood pressure.
- WATER lubricates the joints. The cartilage in your joints and the disks of your spine are natural shock absorbers. They are about 80 percent water, so if you get dehydrated, your joints dry out and can’t absorb shock as well. Drink water to help decrease joint pain.
- WATER aids digestion. Dehydration can lead to a host of digestive problems, including constipation, an overly acidic stomach, heartburn and stomach ulcers.
- WATER supports the liver and kidneys. The kidneys regulate fluid in the body, while the liver filters or detoxifies your blood. With good hydration, your kidneys and liver don’t have to work so hard to flush out waste products. Dehydration can also lead to kidney stones, which can be enormously painful.
- WATER dissolves many critical minerals and nutrients. This makes it possible for them to reach various parts of the body. Water also carries oxygen to cells.
How much water do I need?
Every day, your body loses water through the breath, perspiration, urine and bowel movements. So it’s important to continue taking in water throughout the day. There is no universally agreed-upon quantity for daily water intake. The Institute of Medicine suggests an “adequate intake” per day for women is 11 cups and for men, 16 cups—from all sources, including food, beverages and drinking water. While this is a good ballpark, water needs will be different depending on how much a person sweats and whether they live in a hot climate, are physically active or are coming down with an illness.
In general, you can trust your natural thirst mechanisms. If you feel thirsty, then drink more water. You also can pay attention to the color of your urine. It should be very pale or colorless and odorless (except for the first pee after waking up). For the average adult, going pee 4-10 times in a 24-hour period is considered normal.
Watch for symptoms of dehydration, including dry mouth, fatigue, constipation and decreased appetite. (Contact your health care provider if you experience the more severe symptoms of dizziness, elevated temperature, confusion and decreased blood pressure.)
Note: While water seems harmless, it can be dangerous to overhydrate. Taking in too much water can dilute your body’s electrolyte content. While rare, this can lead to water intoxication and possible death.
What’s the best source of fluids?
While all fluids and hydrating foods count toward your hydration, plain water is the best option because it has zero calories.
Caffeinated and alcoholic beverages tend to pull water from the body and make you urinate more, so while adding fluids you also lose more than with plain water. Sports drinks contain water, sugar, flavorings and minerals such as sodium and potassium. These drinks are marketed to imply that the ingredients are necessary to prevent dehydration, but even for athletes, the evidence for this is controversial.
Fruits and vegetables contain natural sugars and minerals, and are anywhere from 80 to 98 percent water. For example, watermelon contains 92 percent water, 8 percent natural sugar, and essential electrolytes such as, calcium, magnesium, potassium and sodium.
I always forget to sip. Help!
- Carry a reusable water bottle everywhere
- Drink water with meals and when ordering food out
- Chill water ahead of time if you enjoy a cooler temperature
- Set a timer for water consumption, download a hydration app or keep a daily “water log”
- Eat foods that are full of water, such as melon, cucumbers, celery and low-salt, broth-based soups.
- Create water intake challenges with friends and colleagues (see note above about overhydrating)
- Buy or make carbonated water
- Infuse water with non-calorie flavors—muddled mint leaves, cucumber, strawberries, or frozen citrus wedges or melon balls; food-grade flavor oils; a mint tea bag; sugar-free mixer
- Explore flavored waters, so many choices!
Ease into new habits
If you were inspired to make a New Year’s resolution and are struggling, here’s some sage advice from our experts.
Start small. To set yourself up for success, bit off a small piece—not the whole beast! If your aim is to run, walk or roll 2 miles a day and you’re starting at zero, begin with a realistic goal. Start with 1 mile on two days a week. Then build up with incremental changes.
Choose function over fiction. People often set big, number-driven goals: Lose 50 pounds by summer, Do a spin class each week. It’s easy to quickly feel disconnected from such vague, unrealistic goals! Can you choose something more meaningful, more functional? Like, lose 50 pounds before our family gathering next September. Or do three spin classes each week to prepare for July’s 30-miler with Jose.
Be patient and kind. With yourself! Change can be challenging, and one of the best motivators is to create a supportive team. Find a friend or family member with a similar goal, and egg each on, offer advice and a supportive ear.
Start safe. Before making any big change to your health routine (such as kicking off a new diet or exercise regimen), schedule a visit with doctor. They can help you choose the safest approach, given your overall health, and can even help you track and adjust your progress.
Looking for a primary care provider to help you with your healthy goals? PacMed Primary Care has a robust team of providers for the whole family at nine neighborhood clinics.
Hang out to dry: Resetting alcohol intake
For centuries, alcohol has been used to celebrate successes and calm stresses. We all create automatic habits, some related to alcohol—perhaps opening a beer when your team’s playing or enjoying a glass of wine every evening. A new year is a great time to step back and observe the effects that alcohol has on your life.
What are some of the downsides of alcohol to your body? Here are three, some more hidden than others:
A toxin. Alcohol is a toxin to the body, and therefore, overindulging comes with a few consequences. The body priorities the breakdown and excretion of alcohol as soon as it enters the body. This puts a hold on the digestion of food calories for later digestion or to be stored into fat cells, leading to an increased risk for weight gain and fatty-liver disease over time.
Weight gain. Alcohol, surprisingly, is higher in calories (3 more calories per gram) than carbohydrates or proteins. People also tend to overeat once they’ve had a bit of alcohol, especially on an empty stomach.
Sleep disrupter. Alcohol can impact your sleep. While it tends to have a sedative effect and can help people fall asleep, studies suggest that the breakdown of alcohol interferes with the later, restorative REM phase of sleep. This can make you more restless in the second half of the night, leading to issues the next day with concentration, memory recall and low energy.
Making a change can be a challenge. Some people do well quitting cold turkey, like with the “Dry January” movement. Here are some ways to ease into a changed relationship with alcohol:
- Add a glass of seltzer or plain water in between alcoholic beverages. You’ll stay better hydrated, plus your hands will stay busy!
- Track the times of day that you tend to drink, and see if you can hold off for 1 hour before taking a drink.
- Check your favorite drink’s alcohol content, and find something similar with a lower percentage.
- Find a support person or counselor to help you work through barriers to change and to assist with sticking to your goals.
- Try one of our mocktails (see boxed list below)
Once you’ve started making a change, you will likely experience better sleep, more energy and perhaps weight loss. Your may also find positive changes in your mood. If you’re eliminating large amounts of alcohol over the long term, it can lower your risk for chronic diseases like dementia, heart disease and many types of cancer. You’ll also save money!
If you think you’d benefit from support in making a change and overcoming barriers, PacMed has a wide range of professionals in our Behavioral Medicine team.
One mocktail please, shaken, not stirred.
A mocktail is a cocktail without the alcohol. Give one a try!*
- Citrus Mimosa—orange, grapefruit or pomegranate juice mixed with flavored seltzer water or sparkling cider.
- Pomegranate Mojito—mint, lime, soda water and a splash of pomegranate juice and/or limeade!
- Blueberry Mojito Mocktail—sweet, minty and fresh
- Virgin Bloody Mary—so many bold flavors, you might not miss the vodka!
- Virgin Moscow Mule—try infusing the simple syrup with rosemary
- A non-alcoholic beer … or a seltzer flavored with hops from Lagunitas Brewing Co.
- An after-dinner digestive—like calming chamomile tea or a Tazo dessert tea
*Many recipes call for simple syrup, which is a cinch to make.
Back to basics: Parents, don’t delay your child’s care!
A PacMed pediatrician encourages families to keep their children’s health care current, on track.
With COVID-19 upending our lives, many parents have put their children’s regular health care on hold, delaying well-child exams, screenings and immunizations. But health matters. Parents ask me, How do I keep my family healthy? How do I manage if a new health issue arises? Your primary care provider can help you reset and move forward.
Get up-to-date with immunizations
The Centers for Disease Control (CDC) reports that many children are currently missing vaccinations (also called immunizations). This puts them at risk for preventable diseases, like whooping cough, scarlet fever, mumps and measles. Many of us aren’t familiar with these age-old childhood diseases! That’s because safe and effective vaccines for them have been used by families for decades, and outbreaks today are unusual. But that can change if we don’t keep up on childhood immunizations.
Of course, parents want their children to be protected from diseases. So how do you catch up? A good first step is to contact your primary care provider. They can help get your family back on track and answer your questions about immunizations for children and teens.
Check in for well-child checkups
These appointments are important because children develop so rapidly from age zero to 5, and then into their teens. Regular checkups help ensure early recognition of issues—which leads to early interventions and better outcomes.
During COVID-19, you can still schedule appointments for well-child visits and developmental screenings. These exams occur every few months during the first year, once or twice up to age 2, and then every year thereafter. You can learn more about the schedule of regular childhood visits at PacMed. Immunizations can be done during well-child visits.
Balance mental and physical health
Keeping our families fit, both physically and mentally, is an ongoing challenge these days. What’s important? How about the 4 S’s—
- Help kids manage screen time: Set limits, choose “time out” times for devices, model good behavior.
- Focus on getting enough good-quality sleep, for everyone. 10 hours for teens and tweens, more for toddlers, 7-8 for adults. Learn more about sleep.
- Make dinnertime a welcome retreat for sharing, laughing, understanding
- Sweating! Keep up your family’s outdoor time: neighborhood stair climbs (Seattle, Kirkland), walks and hikes, snowshoeing, jumping rope. Change things up with sports like tennis or ultimate Frisbee.
Get a flu shot—it’s not too late
The CDC reports that less than half of children overall had been vaccinated for the 2020–21 flu as of December. The flu shot is the best way to protect your family, which is extra valuable this year.
Simple steps to get & keep our body healthy and balanced
Aysha was interviewed by Warm 106.9 about simple steps to get & keep our body healthy and balanced. Listen to interview.
Love over fear: Working toward health equity in 2021
A message from PacMed’s Executive Team and Equity Council
On MLK Day 2020, the CDC issued its first COVID action, initiating screenings at three airports. The following day, the first US case was diagnosed locally by our partners at Providence Regional Medical Center Everett.
None of us could have imagined the events we have faced in the year since then.
From social to health injustices, we have become more present and aware of the opportunities that lie ahead to make this country one where all people are valued and receive the resources needed to thrive and enjoy life. As a healthcare organization, we acknowledge that until the inequalities to accessing healthcare in America are addressed, we will not see the long-term positive impact we can contribute to society.
This also means we will need to address racial disparities and bias that exist within healthcare. These are not new issues. They are large, however, and require continuous attention until they no longer exist.
We know there is always room for improvement, which is why we recently completed a survey to gather insights into our bias so that we may use these insights to shape how we proceed. Our Equity Council will be using the results to take actions that make us an even more inclusive organization.
As we embark upon this journey, we will look internally to ensure that our infrastructure supports our longstanding history of providing compassionate care to all patients from all of the diverse communities in the Puget Sound area. This is a piece of our history that brings us pride and we want to continue to be a beacon of service for our diverse community.
We will also look to iconic figures such as the Rev. Dr. Martin Luther King, Jr. for encouragement and guidance on ways to stay focused when there is so much to be done.
As Dr. King states, “the time is always right to do right.” He also reminded us to move from fear—which may be heightened from our experiences this past year—to love.
Hate is rooted in fear and the only cure for fear-hate is love.
It is a very strong love… unembittered through the angry seas of persecution. It is love facing evil with an infinite capacity to take it without flinching.
Hatred and bitterness can never cure the disease of fear; only love can do that.
Hatred paralyzes life; love releases it.
Hatred confuses life; love harmonizes it.
Hatred darkens life; love lights it.
Dr. King’s life and message shine in our memories because of this revolutionary idea: that in the face of increasing chaos, disarming and defusing fear is the only path to healing. Our peace will be found only in facing our fears and overcoming them with love.
The love Dr. King speaks of infuses our care, helping us create a very special culture for our patients and caregivers.
We invite you to join us on this journey of creativity, healing and love. And we wish you a courageous Martin Luther King, Jr. Day.
Tips for Maintaining Mental Health For 2021
I know I am looking forward to a new year on the horizon! But in the meantime, as we make it through the 2020 holidays, I went to my trusted network at Pacific Medical Centers and chatted with Dr. Jenny Le, to ask some questions about how we can all continue coping!
With all the changes that have occurred around the world, what are some common themes you are seeing with patients related to mental health?
At PacMed, we know humans are social creatures. Given the current state of our world and the pandemic, people can have an increased sense of loneliness and isolation, especially while we’re in the peak of the holiday season. Depression and anxiety can also be increased given that we are unable to cope in the usual fashion such as interactions with our loved ones.
How does social distancing and isolation actually affect our body? What overall tips do you have for coping with all of this change?
Unfortunately, social distancing is what is needed during this time to prevent the spread of coronavirus and is what is needed for our community and the world to heal. Eventually, this will end. In the meantime, I recommend my patients try to find their silver lining. It gives us time to appreciate the things that we have and for our health.
While many families are still adjusting to remote learning and parents working from home, can you talk about what working parents and families are experiencing?
It can be extremely difficult for families at this time. I have 2 young children of my own and understand that it can be tough. Keeping an open dialogue and relationship with family members along with keeping some sort of routine can help. The Pacific Northwest is also a beautiful location where we can take advantage of the outdoors.
During times of social distancing, what are your thoughts on the idea “couples that workout together, stay together” concept?
All relationships take work and communication – whether that’s doing workouts together or working on the house together. Both sides need to communicate to ensure that their needs are met. That being said, couples who do activities together and communicate will find themselves happier.
For patients experiencing this kind of stress, how should they approach the conversation of mental health with their primary care provider?
Patients should feel comfortable talking to their primary care provider about any mental health issue or concern. We at PacMed are a great resource and can also help point them in the right direction and begin the conversation on your overall health and wellness plans.
Is there anything else you’d like to share as it relates to the above?
One thing I highly recommend for my patients, if they have not tried this already, is gratitude journaling. There are a lot of so studies that show that after 6 to 8 weeks, gratitude journaling allows people to be happier even though nothing in their life has changed. And just like laughter, it can improve your outlook and mood. Given the state of the world we’re in right now, these small steps can create longer moments of gratitude and happiness to impact your overall health.
A wellness legacy inspires care for all ages
Partners in health: A strong doctor-patient relationship brings custom solutions
When Dr. Christina Chen-Milhone was a child — long before she studied medicine — she was diagnosed with asthma. Thankfully, she had a strong relationship with a talented pediatrician who listened to her experiences. Together, they developed a custom treatment plan to keep her healthy and active.
“I never had to go to the hospital, because my doctor took such great care of me,” she says.
Now, Dr. Chen-Milhone strives to bring that level of care and attention to her practice at Pacific Medical Centers (PacMed) Totem Lake, where she builds deep connections with patients of all ages, from pediatrics to geriatrics. And she had another great mentor along the way.
“My grandfather was a wonderful physician and an inspiration to me. I’d visit his practice and was able to see him help so many people —see people get better over time,” Dr. Chen-Milhone says.
In her own practice at PacMed Totem Lake, Dr. Chen-Milhone loves helping patients get better, and she’s also passionate about preventing illness in the first place. With a strong doctor-patient relationship, regular wellness visits and lifestyle coaching, Dr. Chen-Milhone helps patients stop the stress and pain that illness can bring, before it starts.
“A healthy diet, regular exercise and good sleep hygiene are all important to preventive care at any age,” she says. “I love working with kids, that’s one of the highlights of my job. They’re not only a joy to be around, it’s also a great opportunity to encourage good lifestyle habits.”
Whole body health, for the whole family
Dr. Chen-Milhone is the proud mother of a five-month-old and a two-year-old, and she brings her personal experience into the clinic alongside her years of training.
“I understand a lot of the worries parents may have — things happen to your child and they can’t explain how they’re feeling. It can be scary,” she says. “I can offer reassurance, and explain what might be going on.”
As a specialist in both Pediatrics and Internal Medicine, Dr. Chen-Milhone can help parents and even grandparents, as well as young kids. When a family welcomes a new child, health care needs go beyond the baby. Lactation coaching, for example, helps new mothers during what can be a stressful time.
“Some moms have a difficult experience — pain, trouble latching — and they sometimes give up. There are different ways to latch, different holds you can use, and I love to give the support and encouragement to help new parents enjoy the experience.”