Limit sweet treats at Halloween

Costumes and candy. For many kids, those are the two main ingredients for a happy Halloween.

Unfortunately, the candy component can sometimes get out of hand. But you can help your kids control their candy cravings and still have a great Halloween.

Start by setting limits on candy before the costumes go on. Discuss how much candy is reasonable to eat in a day and the times of day when it’s OK to have candy. Talking about these things beforehand will help kids feel like they’re part of the rulemaking process.

You can also set the right tone by choosing to hand out non-candy treats such as stickers, noisemakers or crayons.

Once trick-or-treating is over, have your kids divide their candy haul into two piles: one for their favorite candies and the other for all the rest. Let them eat a little from each according to the pre-Halloween plan.

Source: Academy of Nutrition and Dietetics

Connecting with another reality

People who are dying seem to connect with another reality. Could it be heaven, could it be the brain reacting to the lack of oxygen or blood flow? The message is the same either way; the person going through this process becomes disconnected but almost always is comfortable there.

Sometimes in the throes of death people will raise their hands. Sometimes family members can identify a task the dying person is doing with their hands, like knitting.

We’ve had the privilege to witness the sweetness of a dying person talking with their deceased mother or father. We’ve had patients calling to their deceased pets. Some people even ask other living family members to interact with their vision of a deceased relative.

I recall a hospice RN and I visiting with a family who had just moments before had a family member die. A few days later a ceremony took place in their yard. Rituals were performed and things were said and we looked up to see four eagles circling around above. There wasn’t just one but four; extremely unusual and powerful.

I recall a deceased patient’s spouse telling us that her husband told her that he would let her know he was okay by giving her white feathers after his death. She found white feathers in shoe boxes in closets that hadn’t been opened in years. She found white feathers under her car seat. Coincidence? Maybe—but it meant something significant to her. She was assured and comforted.

We hunger for resolution when someone dies. We want to know that what was wonderful about them still exists somewhere.

David Eichwald, MSW at The Cottage in the Meadow

Memorial Participates in L&I Pilot Project for injured workers

Topic: L&I Pilot Project for injured workers
Guest: Lisa Rutherford, Family Nurse Practitioner
Date: October 29, 2013

Memorial is participating in a University of Washington pilot program that identifies injured workers who are at high risk of being out of work for more than four weeks. The program aims to assess their injuries and improve on their progress by involving them more in the process.

How does it work?
The works complete a survey of health-related questions. In addition to specifics about their injuries, we ask about how badly injured they think they are, and how quickly they think they can get back to work. Their answers are used to determine a score and the level of risk they face for significantly delaying their return to work.

We put together a game plan of sorts for them. It’s almost a more holistic approach, with everyone working for the same goal together. We get physical or occupational therapists involved if necessary, and we communicate with those specialists more often to ensure we are on the same page.

We spend more time coaching these patients about what to expect for pain, and encourage them to go slowly in their recovery, setting boundaries for what they should and shouldn’t try to do. It’s almost like having a personal medical trainer and a life coach.

The biggest thing is that we require each patient to keep a lot of physical activities – a daily diary. We meet frequently with them and keep them more involved in the process. It’s intended to increase self-accountability.

Why is this so important?
• Program like these are intended to help get injured workers back into the workplace – because that’s the ultimate goal. Our goal is to get them back in some capacity – ideally at full capacity in their original job, performing as they always did.

But even a modified capacity – light duty, or only working part time – is better than being off work completely.

• It’s a good thing across the board – decreases costs for the employer, and it’s good for the worker too, because they only get about 60 percent of wages when they are off work.

Have similar pilot projects been done?
• The Center for Occupational Health and Education, known as COHE
It’s a group that advocates for best practices in rehabilitating injured workers – and it originally started out as a pilot program. The program resulted in cost savings, and the state Department of Labor and Industries adopted it statewide.

Not every provider participates, but the providers at The Springs do.

Key point of the program: One of the best practices is that it advocates for direct communication with the employer immediately after seeing the worker – the patient – for the first time. The employers feel like they’re more connected to the process, and they should be, because when a worker makes a claim, it involves them and affects them.
o That direct contact also enables me to establish if there is light duty available for the worker, what other options are available, and to get the employer more information. For example: For a patient who may have developed carpal tunnel syndrome, we can work with the employer to examine and address whether ergonomic changes are needed.

Is it time to update your will?

You can include a bequest to The Memorial Foundation in your will, living trust, a codicil to your will, or an amendment to your living trust.  Be sure to consult with your professional legal advisor to discuss what works best for your situation.

Example of language:

I give, devise and bequeath (identify here the specific sum of money, the specific asset or the portion of the residual estate) to Yakima Valley Memorial Hospital Charitable Foundation (The Memorial Foundation), specifically to support [describe the primary purpose or program that your gift will be supporting, but use general language so that the restriction is not so limited as to prevent the charity from applying the money in the most efficient way.]

If the Board of Trustees of The Memorial Foundation determines that all or part of the gift is no longer needed, or for any reason cannot be used for the stated purpose, then they can determine an alternate designation, giving consideration to the original purposes described above.

We welcome your call at (509) 576-5794.



Where has Tootie been?

Take a look at what Tootie has been doing the last two weeks. Tootie is a momma to 3 healthy, shiba inu boys. This is Tootie’s Salmon Litter and the boys are named Sockeye, Coho, and King. The boys have doubled in size, with Coho being the rabble-rouser of the group.

They are just starting to walk, eyes are open, but their ears are still closed. Momma Tootie will have her hands full when they are fully mobile! The pups will have their first therapy visits at North Star Lodge around Thanksgiving. Enjoy!

Can vitamin D prevent diabetes? Study seeks to find out

The National Institutes of Health (NIH) is sponsoring the first nationwide clinical trial to find out if vitamin D supplements can help delay or even prevent type 2 diabetes in people at high risk for the disease.

Researchers said they hope the Vitamin D and Type 2 Diabetes study—dubbed D2d—will come down decisively one way or another on a topic that’s been widely debated.

“This study aims to definitively answer the question: Can vitamin D reduce the risk of developing type 2 diabetes?” said Myrlene Staten, MD, the D2d project officer at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a branch of the NIH.

“Vitamin D use has risen sharply in the U.S. in the last 15 years, since it has been suggested as a remedy for a variety of conditions, including prevention of type 2 diabetes,” Dr. Staten said. “But we need rigorous testing…That’s what D2d will do.”

The study seeks to enroll about 2,500 people over the age of 30 who have prediabetes. That means their blood glucose levels are higher than normal, but not high enough to be called diabetes.

Researchers will split the people into two groups. One group will receive a daily vitamin D supplement—specifically, vitamin D3. The other group will receive a placebo.

The study will be double-blind: Neither staff nor participants will know who is getting vitamin D or a placebo. Researchers will follow both groups for about four years.

Previous observational studies have suggested a link between vitamin D and diabetes, noted Anastassios G. Pittas, MD, D2d’s lead investigator. This and other claims about the vitamin’s benefits helped push sales of vitamin D supplements to $425 million annually, according to background information about the study.

“While there is a lot of hype about vitamin D and its health benefits, there is not yet any conclusive evidence from long-term clinical trials to support a recommendation of vitamin D supplementation for diabetes prevention,” Dr. Pittas said.

That’s also the position of The Endocrine Society. That group’s most recent statement on the issue is that “strong evidence does not exist to support the tenet that vitamin D supplementation reduces the risk of type 2 diabetes.”

According to the American Diabetes Association (ADA), nearly 26 million people in this country have diabetes. The vast majority have type 2. Although genetics plays a role in who gets type 2 diabetes, so do other factors—like excess body weight, according to the ADA.

“It is critically important to find new methods that are safe, effective and easy to use to stem the tide of future diabetes cases,” said Dr. Pittas. “Even though it is well-established that maintaining a healthy diet and staying physically active can lower the risk of diabetes, the number of people with the disease continues to increase.”

Twenty medical centers in 17 states will take part in the D2d study. Anyone who is interested in learning more or enrolling in the study should visit

Extra sleep on weekends isn’t a cure-all for lost sleep during the week

Extra sleep on weekends isn’t a cure-all for lost sleep during the week



Sleeping in on weekends may help you feel more rested after not getting enough sleep during the workweek, but it may not reverse the effects of sleep loss on your attention span, according to a small study in the American Journal of Physiology-Endocrinology and Metabolism.

Studies have consistently shown that lack of sleep can cause problems other than daytime fatigue, such as increased inflammation (believed to play a role in heart attack and stroke) and abnormal blood sugar levels (the defining characteristic of diabetes), according to the American Physiological Society.

But whether “catching up” on one’s sleep—something that Americans commonly attempt to do on weekends—can reverse the ill effects of missed sleep isn’t well known. Researchers sought to answer that question in this study, looking specifically at the relationship between poor sleep, chemical changes in the body and alertness.

About the study

The study involved 30 adults between the ages of 18 and 34 who were healthy and free from sleep disorders. All spent 13 nights in a bedroom-like lab setting.

For the first four nights, people were allowed to sleep eight hours (a healthy amount of sleep, according to the study). The next six nights, researchers woke the people up after six hours of sleep (restricted sleep). For the final three nights, people were allowed to sleep for 10 hours (recovery sleep).

Brain waves were monitored during sleep, and participants underwent a variety of tests throughout the study, including blood tests that measured interleukin-6 (a marker of inflammation) and cortisol (a hormone released during periods of stress).

Finally, researchers measured attentiveness by having participants take a test in which they pressed a button whenever a dot appeared on a screen.

The study found that interleukin-6 levels rose sharply after restricted sleep. However, that effect was reversed after two nights of recovery sleep.

The relatively mild sleep restriction in this study didn’t raise cortisol levels, but the authors noted that previous studies found that cortisol levels increased after more severe limits on sleep.

Cortisol levels did drop during recovery sleep, however, suggesting that sleep “may serve as an ‘antistress’ antidote,” the authors wrote.

Notably, the participants’ scores on the attention test, which fell along with fewer hours of sleep, did not get better after two nights—a typical weekend—of recovery sleep. This suggested that more than a weekend of extra sleep may be needed to make up for not getting enough sleep during the week.

The take-home message
Many Americans cut back on sleep during the workweek, with plans to make up for it by sleeping more on their days off.

That may not be a safe tactic, according to the study’s findings.

Those who may particularly want to rethink it are people whose job requires them to be alert so they can care safely for others or for themselves, the authors suggested.

Memorial’s Media Relations

Memorial’s media relations staff is available to assist media in answering questions about the hospital, locating an expert spokesperson, or obtaining more information about a news release or event.

Memorial’s Media Center is designed to provide journalists with current information about the organization and its services. We invite you to sign up for our Media Center distribution list to receive press releases and other health care information relevant to journalists on a regular basis.

Memorial contacts

Leif Ergeson
Director of Communications
Phone: 509-575-8116
Fax: 509-575-8529

Shannon Dininny
Media Relations
Phone: 577-5051


Patient information

Memorial complies with the patient privacy guidelines established by the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other related regulations, which limit the amount of information that may be released about patients. Please see the making a media inquiry page for complete information.

911 and Heart Attacks

Memorial is implementing a new initiative to encourage people to call 9-1-1 when they think they are having a heart attack or stroke.

The statistics:

  • So far in 2013, only 35 percent of patients suffering a heart attack were brought to Memorial by ambulance. Two-thirds came by private vehicle.
  • Compared to other Washington counties, we are on the low side. In parts of Pierce County, 80 percent of heart attack victims travel to the hospital by ambulance.

Why is it so important?

When you’re having a heart attack or stroke, blood circulation to the heart or brain has been cut off. Cells are not getting enough oxygen. The longer it takes to restore blood flow, the more damage is done.

  • In the heart, that means decreased heart muscle and possibly death.
  • In the case of a stroke, it could mean paralysis or an inability to speak, depending on the part of the brain that was damaged.

In September, the average response time in Yakima – from the time of the 9-1-1- call to the time EMS arrived at a patient’s door – was 3.5 minutes. Ambulance crews do more than just pick you up and deliver you to the hospital. They start providing care the moment they arrive:

  • They assess and diagnose the patient
  • They can start to administer medications and start an IV
  • In heart attacks, they could begin a hypothermia protocol to cool down the body and try to preserve heart function.

They also notify the hospital staff. If it’s the middle of the night, that means the heart team has already been notified and is already en route to the hospital to meet you there.

The timely services for heart attack and stroke are unsurpassed by any other hospital in the area.  Memorial is categorized as a Level 1 cardiac center and Level 2 stroke center by the Washington State Dept. of Health, the top categories in our region.

On average, data shows that calling 9-1-1 gives a 20-minute head start to the administration of treatment than if a patient arrives by private vehicle. In addition, there is the risk the patient could lose consciousness while driving him or herself or while being driven by a family member or friend, who would be unable to help them.

So why wouldn’t someone call 9-1-1?

Some people aren’t sure they’re having a heart attack or stroke. They don’t want to make a big deal about it. They don’t want to be viewed as weak, or they fear ridicule if it turns out to be less serious.

Some worry about the financial cost of the ambulance ride. Most insurance policies cover emergency treatment, but there is no guarantee. Out-of-pocket expenses vary greatly among insurance carriers. But the costs that can arise from medical complications from delaying treatment can be far higher, as can the cost of having a worse outcome.

Calling 9-1-1 can be the difference between surviving and dying. It also can be the difference between fully recovering and suffering long-term adverse effects.