Eating Disorder Awareness

In the United States, 20 million women and 10 million men suffer from an eating disorder at some point in their life. Eating disorders are serious, potentially life-threatening conditions that affect a person’s emotional and physical health.

February 22-28, 2015 is National Eating Disorders Awareness Week. The goal of National Eating Disorders Awareness Week is to highlight the seriousness of eating disorders and to improve general public understanding of the causes, triggers, and treatments available for eating disorders. Increasing awareness and access to valuable resources can encourage early detection and interventions.

The theme for this years’ National Eating Disorders Awareness Week is “I Had No Idea”. This theme hopes to recognize that early intervention is crucial and spotlight the diversity of those affected by eating disorders (men and women alike of all ages). Early intervention is a key component because it often increases the chances of a full recovery for those who seek professional help.


The most common eating disorders are anorexia nervosa, bulimia nervosa, binge eating disorders, or other specified eating or feeding disorders. Identifying the early signs or symptoms of an eating disorder can greatly impact the course for recovery. Learn more about the warning signs of eating disorders below.

Anorexia Nervosa

Anorexia nervosa is characterized by self-starvation and extreme weight loss. This deprives the body of important nutrients that it needs for proper functioning. Health consequences from anorexia nervosa may include slow heart rate, low blood pressure, severe dehydration, and fatigue or fainting. Some of the warning signs of anorexia nervosa are:

  • Extreme or dramatic weight loss
  • Overly occupied with weight, calories, and food
  • Severe food restrictions (refuses to eat certain food groups or types of food)
  • Often comments about appearance related to weight  and exhibits anxiety related to weight
  • May develop food rituals (how many bites to eat or chewing each piece a specific number of times)
  • Avoids meal times and situations that involve food
  • Excessive exercise routines
  • Withdrawal from friends, family, and usual activities

Bulimia Nervosa

Bulimia nervosa is characterized by a cycle of binging and compensatory behaviors, such as self-induced vomiting or the use of laxatives. Electrolyte imbalances, tooth decay, esophageal inflammation, and possible gastric rupture are just a few of the health consequences of bulimia nervosa. Some of the warning signs can be:

  • Sudden disappearance of large amounts of food (or finding wrappers or containers from foods)
  • Frequent bathroom trips with or without the smell of vomiting or evidence of laxatives (packaging from laxatives)
  • Excessive exercise routines
  • Swelling of cheeks or jaw area
  • Calluses or scars on hands or knuckles (from self-induced vomiting)
  • Discolored teeth (or stained teeth)
  • Withdrawal from friends, family, and usual activities

Binge Eating Disorder

Binge eating disorder (BED) is characterized by recurrent binge eating without the use of compensatory behaviors. High blood pressure, high cholesterols, diabetes, or musculoskeletal issues are a few of the health consequences of BED. Warning signs of BED may be:

  • Frequent episodes of eating large amounts of food
  • Eating when not hungry
  • Eating to the point of feeling/acting uncomfortable

Other Specified Eating or Feeding Disorders

Other Specified Feeding or Eating Disorder (OSFED), is a feeding or eating disorder that causes significant distress or impairment, but does not meet the criteria for another feeding or eating disorder. These can include:

  • Atypical anorexia nervosa (weight is not below normal)
  • Bulimia nervosa with less frequent behaviors
  • Binge-eating disorder(with less frequent occurrences
  • Purging disorder (purging without binge eating)
  • Night eating syndrome


If you’re wondering how you can become involved in raising awareness, consider educating yourself about eating disorders. Spreading the truth about eating disorders can help squash the myths and misinformation that hinder early intervention and recovery. Visit the National Eating Disorders Association (nedawareness.org or nationaleatingdisorders.org) for more information.


Talking with baby

Community Health Association of Spokane Valley Clinic


Did you know something as simple as talking to your baby can help them be more successful in school?  75% of your baby’s brain development occurs in the first 2 years of life.  You are your baby’s first teacher!  The more words they are exposed to during this time the better.  Simple things like telling your child what you are doing, “Mommy is making your bottle now,” and pointing out things you see, “Look at the big red ball,” help their language develop.  You may be tempted to turn the TV on and let your baby be exposed to language that way.  Unfortunately, studies have shown this actually makes their language development worse.  Instead, turn the tv off and talk directly to your baby throughout the day, making eye contact with them, and giving them a chance to respond.  This helps with language and communication skills that are needed throughout life.

Books and songs are another way to help develop their language skills.  Sing simple songs over and over again, and you will quickly see that they will begin to recognize the song.  Exposing them to books is a great opportunity.  You might find your 6 month old baby has no interest in sitting down and reading a book, but let them explore books.  They will probably start by sticking it in their mouth, but soon they will start looking at the pictures, and before you know it they will have their own favorite book.  Your baby may not want to sit on your lap and read the entire book.  That’s ok!  Flip through the book with them.  Point out different pictures.  Practice animal sounds.  Your baby will enjoy the time spent cuddling with you, while also building a foundation for their developing language and a love for reading.

By Ashlee Mickelson, Physician


Homeless Quick Facts

Dr. Paul Farmer, cofounder of Partners in Health states, “The idea that some lives matter less is the root of all that is wrong with the world.” We gathered as a group at the homeless memorial as a testament that no lives matter less.

Here are a few dry statistics to ponder, but we all known that human lives are more than a sum of statistics.

  • There were 633,782 people experiencing homelessness on one night in January 2012, this translates to a national homeless rate of 20 per 10,000 people.
  • A majority of the homeless population is comprised of adults (394,379 people).
  • Approximately 38 percent are families with children (239,403 people in 77, 157 households)
  • And 16 percent (99,894 people) are considered chronically homeless, meaning they are living with a disability and staying in shelters or on the streets for long periods of time or repeatedly.
  • On any given night, it is estimated that almost 23,000 people are homeless in Washington State.
  • Nationally, during the past 13 years, there were 1,289 incidents (339 fatal attacks) recorded of what is characterized as hate crimes against the homeless.  These crimes were violent and brutal, including drowning, burning, shooting and stabbing.  These crimes were committed by people who were not homeless themselves.  (National Coalition for the Homeless, 2013)
  • For every age group, homeless persons are three times more likely to die than the general population. Middle-aged homeless men and young homeless women are at particularly increased risk. The average age of death of homeless persons is about 50 years, the age at which Americans commonly died in 1900.2 Today, non-homeless Americans can expect to live to age 78.3
  • Homeless persons die on the streets from exposure to the cold. In the coldest areas, homeless persons with a history of frostbite, immersion foot, or hypothermia have an eightfold risk of dying when compared to matched non-homeless controls.

Gustavo Guttierrez, the liberation theologian and Notre Dame Professor states, “In the final analysis, poverty means death: lack of food and housing, the inability to attend properly to health and education needs, the exploitation of workers, permanent unemployment, the lack of respect for one’s human dignity, and unjust limitations placed on personal freedom in the areas of self-expression, politics, and religion.”

The problems we face are bigger than us as a community, but little actions can accumulate and have a profound effect and as a community we can help alleviate the suffering of our often forgotten and ignored members.

By William Bomberger, PA-C at Denny Murphy Clinic


CHAS Gets National Recognition for Quality!

This week the U.S. Health Resources and Services Administration announced quality improvement award funding for Community Health Centers. There are 1,300 health centers across the nation, and CHAS is one of just 57 health centers to be recognized as a “National Quality Leader”. National Quality Leaders are health centers that are the highest performers compared with national standards and benchmarks in key clinical areas. CHAS received the National Quality Leader award for exceeding national clinical benchmarks (Healthy People 2020 objectives and health center national averages) for chronic disease management, preventive care, and perinatal/prenatal care. This is a very prestigious national recognition! Additionally, CHAS was also recognized as a “Clinical Quality Improver” for demonstrating at least a 10 percent improvement in clinical quality measures between 2012 and 2013.

“This funding rewards health centers that have a proven track record in clinical quality improvement, which translates to better patient care, and it allows them to expand and improve their systems and infrastructure to bring the highest quality primary care services to the communities they serve,” said U.S. Health and Human Services Secretary Sylvia M. Burwell.

“These funds reward and support those health centers that have taken steps to achieve the highest levels of clinical quality performance and improvement,” said Health Resources and Services Administration Administrator Mary K. Wakefield, Ph.D., R.N.

One of our core values is commitment to quality improvement, with that commitment, we are psyched to be on this list!  Readthe U.S. Health and Human Services’ national press release here.



Diabetic-Friendly Recipes: Chocolate Pudding “Cake”

Chocolate Pudding “Cake”


Try this quick and easy dessert, it’s great to take to a party and everyone will love it.

Prep time: 15 minutes

Serves: 12


  • 30 graham cracker squares (15 sheets broken in half), divided
  • 1.4 ounce box sugar-free, fat-free instant chocolate pudding mix
  • 1 ½ cups fat-free milk
  • 12 ounces fat-free whipped topping, thawed and divided
  • ¼ cup mini-chocolate chips


  1. Arrange 10 graham squares, slightly overlapping, on bottom of 8-inch square pan.
  2. In a large bowl, prepare pudding according to package directions. Cool in refrigerator for 5 minutes.
  3. Fold 6 ounces whipped topping into pudding and incorporate well.
  4. Spread half of the pudding mixture over graham squares in pan; cover with 10 of the remaining graham squares. Repeat layers.
  5. Refrigerate 3 hours or overnight.
  6. Top dessert with remaining 6 ounces light whipped topping. Sprinkle with mini chocolate chips.

Nutrition facts for 1 rectangle (2” x 2 2/3”)

Calories: 165

Carbohydrates: 29g

Protein: 3g

Fat: 3.0g

Sugar: 13g

Dietary fiber: 1g

Sodium: 210mg

by Keri Smith, CDE, registered dietitian at Valley Clinic


Diabetes-Friendly Recipes: Shrimp Fajitas!

Eating healthy can seem challenging even when a person does not have diabetes. See the recipe below for a diabetic friendly meal.

Shrimp Fajitas


Serve this dish with jicama sticks and guacamole. You can make this colorful dish even more vibrant by using different color peppers or purple onion.

Prep time: 15 minutes

Serves: 5


  • Cooking spray
  • 1 pound medium shrimp, peeled and deveined
  • 1 teaspoon canola oil
  • 1 red bell pepper, sliced into thin strips
  • 1 green bell pepper, sliced into thin strips
  • 1 medium onion, sliced into thin strips
  • ¼ cup water
  • ½ tablespoon chili powder
  • ¼ teaspoon cayenne pepper (optional)
  • ¼ teaspoon cumin
  • ½ teaspoon salt (optional)
  • ½ teaspoon ground black pepper
  • 10 corn tortillas


  1. Coat a large non-stick skillet with cooking spray.  Cook the shrimp over medium heat for about 2 minutes.  Remove the shrimp from the pan and set aside.
  2. Add the oil to the pan and heat. Add the bell peppers and onions and cook for about 7 minutes or until they begin to brown. Add the shrimp and any juices back to pan.
  3. Add the water and spices, including salt (optional) and pepper. Bring the mixture to a boil; reduce heat and simmer until the water evaporates. Serve the shrimp and peppers in the corn tortillas.

Nutrition facts for 2 fajitas:

Calories: 245

Carbohydrates: 31g

Protein: 24g

Fat: 3.5g

Sugar: 4g

Dietary fiber: 5g

Sodium: 385mg


by Keri Smith, CDE, registered dietitian at Valley Clinic


November is National Diabetes Month

Diabetes wordcloud

Did you know that in 2012, approximately 29.1 million Americans (or 9.3% of the population) had diabetes? Of the 29.1 million, 21.0 million were diagnosed and 8.1 were undiagnosed.

What are some of the signs or symptoms of diabetes?

The most common symptoms of diabetes are:

  • Frequent urination
  • Increased thirst
  • Increased hunger
  • Fatigue
  • Blurry vision
  • Slow healing wounds
  • Pain and/or numbness in hands or feet

If you are experiencing some of these signs or symptoms, you might want to talk to your doctor about checking for diabetes.


Myths About Diabetes

Test your knowledge about diabetes by answering true or false to the following statements.

  • Diabetes is not that serious of a disease.  FALSE! However, if diabetes is properly controlled, you can prevent or delay diabetes complications.
  • If you are overweight or obese, you are at an increased risk for developing diabetes. TRUE! But this does not mean that you will absolutely develop it.
  • People with diabetes cannot eat sweets or chocolate. FALSE! Though it is suggested that these types of foods be eaten in small portions and only on special occasions.
  • Once a person is diagnosed with diabetes, they have to be on insulin right away. FALSE! Sometimes there are other ways to manage your diabetes. Be sure to keep regular check-ups with your provider, consider meeting with a dietitian or Certified Diabetes Educator (both available here at CHAS), join one of our Healthy Living with Diabetes Workshops, and aim to maintain a healthy lifestyle.

Stay tuned for some amazing diabetic-friendly recipes coming next week…

by Keri Smith, CDE, registered dietitian at Valley Clinic



Mental Health Awareness

quote-on-stigma-health-58-healthyplaceDid you know one in four adults experiences mental illness in a given year? That’s about 62 million Americans. About 13.6 million live with a serious mental illness such as schizophrenia, major depression or bipolar disorder. 1

Those numbers are staggering; however the real staggering fact is, despite the number of people living with a mental illness, there is still a stigma behind having a mental illness which keeps people from getting treatment. C.S. Lewis wrote, “Mental pain is less dramatic than physical pain, but it is more common and also more hard to bear.” The best way to get rid of a stigma behind a subject is to educate yourself and others about the topic. Currently, only one in three people with a mental illness receives treatment. Why is this? Partially because people are afraid they will be treated differently if they are labeled as mentally ill. Those with mental illnesses can suffer from low self-esteem, as the train of thought is if no one finds them “normal,” then they are probably not normal. Of course, those who have a normal physical illness do not have people viewing them as not normal at all.

What is mental health?

Mental health is our emotional, psychological, and social health. It determines how people feel, think, and even how we act. It’s a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning. It can affect how we make choices, feel, and perceive the world around us.

Many factors contribute to mental health problems, including:

  • Biological factors, such as genes or brain chemistry
  • Life experiences, such as trauma or abuse
  • Family history of mental health problems

Mental health problems are common but help is available. People with mental health problems can get better and many recover completely.

What can I do to help?

  • Learn about the signs of mental health problems.
  • Express your concern and support of someone with mental illness.
  • Reassure that you care. No one should have to deal with mental illness alone. Know where to turn in your community if you or a loved one has to deal with a mental illness.

It’s important that we educate ourselves on mental health to disrupt misinformation and unfair discrimination about an illness that affects so many. CHAS believes that the best health and quality of life are achieved by caring for the whole person – mind, body, mouth. That’s why our clinics integrate medical care with behavioral/mental health and dental care. Our caring professionals work as a team to deliver the right care for the each individual.


Resources for learning about and dealing with mental health issues:

Mental Health First Aid: http://www.mentalhealthfirstaid.org/

First call for help: http://fbhwa.org/programs/crisis-response/first-call-for-help/


1 National Institutes of Health, National Institute of Mental Health. (n.d.). Statistics: Any Disorder Among Adults. Retrieved March 5, 2013, from


by Matt Grebe, Communications Specialist


ALS: Amyotrophic Lateral Sclerosis

By now you have probably heard of the Ice Bucket Challenge, seen a few of your friends take the challenge, or perhaps have even taken it yourself. It’s certainly a fun way to promote awareness around ALS, however many are getting caught up in the hype behind the #IceBucketChallenge without being fully aware of what the disease is.

ALS, or amyotrophic lateral sclerosis, often referred to as “Lou Gehrig’s Disease,” is a disease that affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. The progressive degeneration of the motor neurons in ALS eventually leads to their death. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzed. Early symptoms of ALS often include increasing muscle weakness, especially involving the arms and legs, speech, swallowing or breathing. Death usually results an average of 5 years after diagnosis.

In the Northwest, we have a special advocate for ALS, former pro football player and Spokane native, Steve Gleason. Gleason attended and played football for Gonzaga Prep, WSU, and eventually went on to be most remembered for his blocked punt on the night the New Orleans Superdome reopened for the first time after Hurricane Katrina. In 2011, Steve was diagnosed with ALS. Steve is determined to inspire others by continuing to pursue life adventures despite his diagnosis, and has challenged the worlds of technology and science to identify their most promising developments toward new treatments and a cure.

While the Ice Bucket Challenge may have a limited shelf life as a viral campaign, ALS is an ongoing disease and awareness needs to continue.

by Matt Grebe, Communications Specialist


3 Tips for Heading Back to School

It’s already time to head back to school? What? Say it ain’t so!

It sure seems like the school year drags on and on. So why is it that summer break flies by? As a parent, summertime usually means relaxed schedules, less supervised homework, and lots of play time. Getting back on track not only takes effort from your child, but a lot of effort on your part too. So, I’m sorry to break the news, but if you haven’t started shopping for pencils and notebooks yet, now is the time! It’s also time to start preparing your child for the start of school:

  1. Get needed immunizations. Although time at the pool sounds like much more fun, we can’t ignore the need to get your child their required immunizations. Contact your health care provider to ensure that your child is up to date. You may also want to inquire about recommended immunizations such as the flu vaccine.
  2. Get needed medications and paperwork. If your child has a chronic health condition, such as asthma or allergy, you’ll also want to ensure that you have spare medication for the school; and any necessary paperwork completed by your health care provider. Prior to the first day of school, drop off those medications and paperwork at your child’s school. Make sure you inform your child’s teacher of the chronic health condition as well.
  3. Get back on schedule. During the summer, bed times and wake times are generally more lax. To ease into the start of the school year, start getting your child to bed a little bit earlier in the evenings; and getting him or her up a bit earlier in the morning. Keep adjusting wake up times as you near the beginning of school. Doing so will ensure a less cranky kiddo – and in turn will decrease your stress level too!

by Kelley Halverson, Communications Manager