by Michelle | Jan 9, 2025 | Featured, Uncategorized
Many of us view the new year as a new beginning. Full of hope and optimism, we might be thinking of goals or changes we would like to achieve. Common themes are weight loss, better sleep habits, eating healthier, and being more active. Over many years as a fitness instructor, I have watched my classes swell in number in January, only to see my numbers return to normal by March. I, myself, am guilty of setting ambitious goals and not always sticking with them. What is it about change that is so hard for us? And what is the secret sauce for people who succeed at making changes?
As you can imagine, the answers to those questions are complex. One thing is tried and true and backed by research. We have to be ready for change. What does readiness look like? There is a model, called the Transtheoretical Model (TTM), that describes the various levels of readiness for behavior change. It can be helpful to understand this model and what each stage looks like. We can then use the model to identify which stage we are at for any given behavior we hope to change. Once we are aware of our level of readiness, we can begin to identify what motivates us to progress to the next level.
Model of Behavior Change
There are six stages to the TTM. Mind you, there were only five stages when I first learned this but I love the one that has been added. You’ll see why.
1. Precontemplation: No acknowledgment of a problem and no consideration of change
2. Contemplation: Acknowledgment of a problem and serious consideration of change in the future
3. Preparation: Initiation of some behavioral change
4. Action: Substantive behavioral efforts lead to alteration of the previous pattern
5. Maintenance: Change is sustained through continued effort
6. Termination: There is no desire to return to prior negative behaviors
To illustrate this model, I will use an example from my own experience. I used to be a night owl, going to bed at 11 o’clock and dragging myself out of bed in the morning at six or seven, depending on my obligations. Often, I was getting 8 hours of sleep, so I really didn’t consider this to be a problem. For a long time, I was in the Precontemplation stage regarding my sleep habits. They were out of sight and out of mind.
At some point, I realized that, too often, I was not getting enough sleep, which left me feeling run down and susceptible to getting sick. I noticed that I was snacking late at night which led to weight gain. I also realized I was wasting a lot of time watching TV in the evening. I began to wonder if my priorities were out of alignment and how changing my sleep habits might play a role in that. This is the Contemplation stage of behavior change, a time of dawning awareness that things are perhaps not as they should be.
The issues I was becoming aware of, motivated me to want to change my sleep patterns. Any Preparation stage for changing sleep habits will likely involve your alarm clock. Gradually, I began to work my way toward a 10:00 PM bedtime and a consistent 6:00 AM wake time. I was not always successful but was on the front end of developing new habits, using my alarm clock as my guide.
Before long, my sleep routine became consistent, keeping the same bedtime and wake time during both weekdays and weekends. I enjoyed having extra time in the morning for exercise, reading and prayer and began shifting my bedtime even earlier, to my current 9:00 PM “hard stop” and my 5:00 AM (sometimes earlier) wake time. This process took me from Action stage to Maintenance stage which I enjoy today.
Yes, I enjoy my sleep routine. It allows me to start my day off on the right foot. Watching less TV at night means fewer wasted hours of my day – and fewer calories too! I have more mental and physical energy and I am rarely sick. This is how we come to the Termination stage, where we no longer desire the former behavior because it no longer serves us. We come to prefer our new behaviors because we feel better than before, gaining a greater sense of control, or agency, over our lives.
Spend some time thinking about your own desires for behavior change. Start with something you believe you can change and then work your way through the stages of this model. I should add that this process can take a long time – sometimes a lifetime! It took me twenty years to transition my sleep patterns and the timeline was determined by my levels of awareness, readiness and motivation along the way. What are you ready to change?
AUTHOR: Michelle Jenck, Adventist Health Tillamook Director of Community Well-Being
by Guest | Dec 28, 2024 | Being Well, Featured, Uncategorized
With the introduction of hormone therapy in the 1960s, women flocked to their doctors to treat their menopause symptoms. The therapy was groundbreaking and provided relief for millions of women. The treatment grew in popularity until the early 2000s. The use of hormones abruptly dropped after a women’s health study raised serious concerns over risks. With few other options available, the fallout from the study left an entire generation of healthcare providers struggling to treat women in their menopausal years. This gaping hole in women’s health is now getting addressed with more education, research, and a look back at that sentinel study that stopped it all.
What is menopause
Natural menopause occurs when a woman or person identified as female at birth has gone 12 months without any period. This defines the end of not just menstruation but also the end of fertility, as the ovaries are no longer functioning as effectively. This decreased function results in less hormone production, primarily the estrogen hormone. An estimated 1.3 million women enter menopause each year, with approximately one-third of their lives spent in menopause. The average age for natural menopause is 51 years. But symptoms may begin up to 10 years before menopause in what is known as perimenopause or the menopause transition.
Surgical menopause involves removing both ovaries with a surgery known as an oophorectomy. The removal of ovaries relates to medical issues, which can occur at any age. The missing ovaries will trigger menopause symptoms due to the lack of hormones they typically produce.
Common Menopause Symptoms
| Hot flashes are the sudden sensation of warmth in the face, neck, or chest with or without sweating |
Night sweats are hot flashes with sweating that occur at night |
| Difficulty sleeping, which may cause daytime fatigue and irritability |
Thinning of bones (osteoporosis), which may cause bones to break more easily |
| The vaginal skin may become thin or dry, causing irritation and painful sex |
Urinary issues such as recurring urinary tract infections (UTIs) and incontinence |
| Mood changes, such as depression or irritability |
Anxiety |
| Joint pain, aches, or stiffness |
Hair loss or thinning |
| Memory or concentration problems, commonly called “brain fog” |
Heart palpitations where your heart beats suddenly become more noticeable |
| Decreased interest in sex |
Tinnitus, a constant ringing in the ears |
| Weight gain |
Increased facial hair |
Types of hormone therapy
Hormone therapy is the use of prescription medications to boost hormone levels in the body. For the treatment of menopause, this therapy replaces the declining estrogen and progesterone. For menopause, this therapy comes in two types.
Systemic therapy. Estrogen and progestin, or similar compounds, are absorbed into the blood and travel throughout the body to treat symptoms. This method is very effective at treating hot flashes. Systemic therapy comes in the form of:
- Oral pills
- Patches placed on the skin
- Gels or sprays placed on the skin
- Ring inserted into the vagina
Low-dose therapy. Also known as vaginal estrogen therapy, this medicine treats just the vaginal area in the form of topical or vaginal creams. Low doses rebuild and moisturize vaginal tissue. Because of the small doses of this therapy, there are fewer risks as only a minimal amount enters the bloodstream.
Concerns about hormones for the treatment of menopause
In 1991, the Women’s Health Initiative (WHI) began a long-term study on women’s health. The study focused on cardiovascular disease, cancer, and osteoporosis-related fractures. In 1998, the study looked at hormone therapy use with both estrogen and the combination of estrogen and progestin. By 2004, researchers had stopped both studies early after finding increased risks of heart disease, stroke, pulmonary embolism, and breast cancer. The halting of the studies made headlines, leading many women to stop using hormones. Women aged 52-65 had the greatest decline as use dropped 88% in this group.
The impact of the WHI study was profound. Few other treatments were well studied. An entire generation of healthcare providers were left lacking information on treating menopause, and women felt this. A survey in 2021 found that 73% of women ages 40-65 were not getting care for their menopause symptoms. An additional 65% said they would not consider hormone therapy.
The benefits of treating symptoms
About 70-80% of women have menopause symptoms negatively affecting their quality of life. Hot flashes are the most reported symptom and can last more than a decade. However, up to 40% of individuals will continue to have symptoms into their 60s, and up to 15% will have hot flashes into their 70s. Hot flashes affect not only physical comfort but also sleep and mood.
The tide is changing with menopause treatments. Since the WHI study, research has shown hormone therapy is safer in younger women. Starting MHT within 10 years of the onset of menopause or before age 60 poses less risk. Hormone therapy is the most effective method of treating vasomotor symptoms like hot flashes. About 80% of women get relief from symptoms within two weeks of starting hormone therapy. There are still risks, and each individual should discuss their personal risk with their healthcare provider. Risks associated with hormone therapy:
- Stroke
- Uterine cancer
- Blood blots
- Breast cancer
For many, the benefits of hormone therapy outweigh the risks.
- Reduced menopause symptoms
- Relief of vaginal discomfort and dryness
- Improved bone health
- Ease symptoms of overactive bladder
- Lower risk of cardiovascular disease
- Reduced risk of developing type 2 diabetes
But hormones aren’t the only treatments. More research backed non-hormonal options are available to treat a variety of symptoms.
When to see a healthcare provider
Menopause treatment is in the spotlight with organizations nationwide. Locally, Oregon Health and Sciences University (OHSU) began offering training on menopause care. The classes are offered statewide to primary care providers and community health partners. With this program, OHSU focuses on reaching healthcare providers located in rural areas, including Tillamook County.
The impact of menopause symptoms cannot be understated. They are disruptive for many women daily, affecting how they feel, work, and relate to others. Perimenopause and menopause symptoms last for a decade or more, yet 1 in 8 adults still avoid talking about menopause. If you have perimenopause or menopause symptoms, talk with your healthcare provider. You can discuss:
- Whether you have reached menopause
- The symptoms you have and how much they affect you
- Your health risks based on your age and general health
- Whether hormone therapy is a good option for you
- Alternative treatment options to hormone therapy
If you need assistance in finding a provider to treat your menopause symptoms, check The Menopause Society’s website for a link to menopause specialists. If you are in the Columbia Pacific CCO, look at their Find a Provider page.
Written by: Leanna Coy, FNP-BC, Freelance Health Writer
References:
Menopause definitions. (2024). The Menopause Society. Retrieved December 2, 2024. https://menopause.org/patient-education/menopause-glossary
Menopause. (2024). Society for Women’s Health Research. Retrieved December 2, 2024. https://swhr.org/health_focus_area/menopause/
Walsh, J. (January 10, 2024). How gaps in research lead to gaps in care for aging women. Harvard Medical School News & Research. https://hms.harvard.edu/news/how-gaps-scientific-data-lead-gaps-care-aging-women#:~:text=Ambrosio%3A%20Menopause%20is%20inextricably%20intertwined,third%20of%20their%20lives%20postmenopausal.
Signs and symptoms of menopause. (March 14, 2023). NHS. https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/signs-and-symptoms-of-menopause/
Hormone Therapy. (2024). The Menopause Society. Retrieved December 2, 2024. https://menopause.org/patient-education/menopause-topics/hormone-therapy#:~:text=What%20Is%20Hormone%20Therapy?,night%20sweats%2C%20and%20sleep%20disturbances.
Kohn, G.E., Rodriguez, K.M., Pastuszak, A.W. The history of estrogen therapy. Sex Med Rev. May 27, 2019. PMID: 31147294
About WHI. (2021). The Women’s Health Initiative. Retrieved December 2, 2024. https://www.whi.org/about-whi
Iyer, T.K., Manson, J.E. Recent trends in menopausal hormone therapy use in the U.S. JAMA Network. September 27, 2024. PMID: 39331374
Elflein, J. Treatment of menopause symptoms among older U.S. women as of 2021. Statista. August 5, 2021. https://www.statista.com/statistics/1255552/treatment-of-menopause-symptoms-among-older-us-women/
The Menopause Society. September 4, 2024. Hormone therapy usage rates still low despite proven benefits. https://menopause.org/press-releases/hormone-therapy-usage-rates-still-low-despite-proven-benefits#:~:text=It’s%20estimated%20that%2070%25%20to,continue%20to%20have%20hot%20flashes.
Yang, J. (November 20, 2023). Share of U.S. adults who avoid talking about menstruation or menopause as of 2022. Statista. https://www.statista.com/statistics/1424427/menstruation-and-menopause-taboo-us/
Solving the mysteries of menopause, one conversation at a time. (October 24, 2024). Oregon Health News Blog. https://covidblog.oregon.gov/solving-the-mysteries-of-menopause-one-conversation-at-a-time/?utm_medium=email&utm_source=govdelivery
by Renee Aufdermauer | Dec 18, 2024 | Being Well, Featured, Uncategorized
Michael “Smily” Hurliman’s story begins like many others—a high school kid longing to fit in and be accepted. In his teenage years, Michael quickly became known as the guy who could bring alcohol to the party, earning a false sense of popularity. What started with drinking alcohol soon led to smoking weed, and eventually, Michael was introduced to methamphetamine.
By the age of 17, Michael’s life had already begun to spiral out of control. His first visit to rehab came that year, but quickly relapsed into a destructive cycle of drug and alcohol abuse. Trouble with the law followed. Michael later described this period not as feeling defeated, but as being depleted—there was a void he didn’t yet know how to fill.
Another stint in treatment seemed hopeful but ultimately he failed to remain clean. Michael’s addictions deepened, and he began selling drugs, further entrenching himself in a life of lawlessness. His family, heartbroken and desperate to save him, staged an intervention when he was 21 years old. The confrontation triggered a torrent of emotions, and Michael retreated to his room in frustration.
It was in this pivotal moment that Michael’s fate took a remarkable turn. Holding a nickel he considered lucky, he made a decision. “Heads, I’ll go to treatment,” he said to himself. “Tails, I’ll go on the run.” When the coin landed on heads, Michael honored the result and entered treatment once again.
This time, he stayed clean for a while, but the consequences of his past caught up to him. Arrested for crimes committed during his years of addiction, Michael faced another battle.
After serving his time on parole, Michael moved to Hillsboro in hopes of starting fresh. Unfortunately, he quickly fell back into the grip of drugs and alcohol. It wasn’t long before he met the woman who would become the mother of his son. With the news of a baby on the way, Michael and Jessica made the decision to clean up their hard drug use and try to build a better life for their growing family. For a time, things seemed to be going well. But the pull of addiction was never far behind.
As the years went on, Michael found himself struggling once again. But when Jessica was diagnosed with cancer, everything changed. She fought bravely for almost 11 months before passing away, leaving Michael in a deep state of grief and despair. Her death only worsened the hold addiction had over him.
Hit hard by the loss of his partner and the mounting pressure of his addiction, Michael reached rock bottom. He realized that he couldn’t keep running from his problems and was deeply missing his son. With a long list of warrants, unpassed drug tests, and the looming threat of prison, Michael made a life-changing decision. He called his parole officer and said he wanted to turn himself in and face the consequences.
During court, Michael learned that he qualified for rehab, a decision that would become the turning point he had been waiting for. His prayer was answered, and Michael entered treatment once again, determined to break free from the chains of addiction. This time, he committed himself to staying clean.
Michael returned to Tillamook, drawn by the support system, resources, and people who had successfully overcome similar struggles. He knew he needed to be in an environment that would help him stay on the right path. He joined the reentry program offered at Helping Hands, began attending meetings at the Serenity Club and began rebuilding his life.
Getting clean has transformed Michael in ways he never thought possible. He is now a devoted father to his 15 year old son, and has a steady job at Bob J. Johnson Flooring, and holds the position of President and Board Member of the Serenity Club, where he has served in various roles. His experiences have fueled a deep passion to give back to his community. Michael dreams of helping others break free from addiction and regain their lives, just as he has done.
Michael’s Advice for Those Struggling
For anyone battling addiction, Michael offers simple yet powerful advice: “Just show up to a meeting.” Taking that first step to connect with others who understand what you’re going through can make all the difference. Surround yourself with a clean and sober community—friends who will support and encourage your recovery journey. Building those connections is key to staying on the path toward a better life.
During his time in treatment, Michael found strength in two quotes told to him by an old guy named “1 Legged Larry” that deeply resonated with him:
“All you have to do is change everything.”
“Do the next right thing.”
If you or someone you know is looking for support on their recovery journey, there are local resources available to help:
– Serenity Club Tillamook : 5012 Third St. Tillamook, 503-842-1115 (check out their website for meeting days/times
– Celebrate Recovery : Tillamook Church of the Nazarene, 2611 Third Street, Tillamook; 503-842-2549 and St. Mary’s By the Sea, 275 S. Pacific Street, Rockaway Beach, 503-318-2370
– Helping Hands Reentry Outreach Centers- Tillamook Hope Center : Contact Brianne Prince (503) 354-8014
These organizations provide valuable support, community, and tools for overcoming addiction and rebuilding a better life. Remember, you’re never alone—help is available, and recovery is possible.
by Renee Aufdermauer | Dec 5, 2024 | Featured, Uncategorized
Our pets bring joy, companionship, and a sense of well-being to our lives, playing a key role in our overall wellness. Whether it’s a wagging tail greeting us at the door or the soothing purr of a cat, pets help reduce stress and enhance our happiness. However, when fleas invade their space—and ours—it can quickly become a source of stress and frustration. Fleas not only irritate our pets, causing itching and discomfort, but they can also become a nuisance for the entire household. Taking proactive steps to manage fleas helps ensure that the wellness our pets provide is not overshadowed by the challenges these tiny pests bring.
While fleas can be a challenge, there are effective, budget-friendly, and non-toxic ways to tackle the problem. Fleas not only discomfort pets but can also impact human health and the home environment. Thankfully, with consistent effort and the right approach, you can control fleas without resorting to expensive or harmful treatments, keeping your pets and your home a haven of wellness.
Understanding Fleas and Their Lifecycle
Fleas are small but tenacious insects that thrive in warm, humid environments. They go through a complex life cycle with several stages, including eggs, larvae, pupae, and adults. Each stage can resist typical insecticides, which is why it’s important to address fleas at all stages of their life cycle to fully eliminate them. According to the CDC’s guidelines on flea control, a comprehensive four-step process is the most effective way to manage a flea infestation.
The Process to Manage Fleas in Your Home
Sanitation:
Thorough cleaning is the first and most important step in controlling fleas. Fleas and their eggs can hide in pet bedding, rugs, carpets, and even along the edges of walls. To break the flea life cycle, wash all bedding, rugs, and pet bedding in hot water, then vacuum thoroughly, including floors, carpets, and areas along walls. Sweep hard floors and vacuum often to pick up any stray fleas or eggs. This helps to reduce the flea population in your home without relying on toxic chemicals.
Pet Treatment:
It’s essential that every pet in the household is treated. Start by bathing your pets with soap and water to gently kill adult fleas. After the bath, use a flea comb to remove any remaining fleas, paying close attention to the face, neck, and area in front of the tail. Be sure to consult with your veterinarian to choose the best non-toxic flea treatment for your pets. There are many natural flea treatments available that don’t contain harsh chemicals, and your vet can guide you on the safest options.
Home Treatment:
Home treatment should begin at the same time as pet treatment to ensure that the flea life cycle is disrupted. While commercial pest control applicators can provide professional help, there are also natural home treatments available, like diatomaceous earth (food grade), which can be sprinkled around areas where fleas tend to hide.
Follow-Up:
Fleas are tough and resistant to insecticides at various stages of their life cycle. To fully eliminate fleas, you’ll need to follow up with additional treatments. The CDC recommends that you apply two or more follow-up treatments within 5-10 days after the initial treatment. Continue regular vacuuming and cleaning during this period to pick up any remaining eggs and juvenile fleas that might have been missed in earlier treatments.
Fleas are a common challenge for pet owners, but with the right approach, you can manage them without relying on expensive or toxic products. By following the CDC’s four-step process and integrating natural flea control methods, you can protect both your pets and your family from these pesky insects. Regular cleaning, pet treatments, home interventions, and follow-up care are essential to breaking the flea life cycle and keeping your home flea-free.
For more information visit: https://www.cdc.gov/fleas/section-name/index.html
For more local health and wellness information, visit www.tillamookcountywellness.org or follow Tillamook County Wellness on Facebook and Instagram.
by Guest | Dec 2, 2024 | Eat Well, Featured, Recipes
A rich and flavorful chili made with lean ground turkey, hearty beans, and a blend of aromatic spices!
Ingredients
1 teaspoon vegetable oil
1 pound lean ground turkey (15% fat)
⅔ cup chopped onion (about ½ medium onion)
½ cup chopped green pepper (about 1 small pepper)
2 cloves garlic, minced or ½ teaspoon garlic powder
1 can (15 ounces) kidney beans, drained and rinsed
1 can (15 ounces ) great northern beans, drained and rinsed
1 can (16 ounces) pumpkin
1 can (15 ounces) crushed tomatoes
1 can (15 ounces) low-sodium broth
½ cup water
2 Tablespoons packed brown sugar (optional)
1 package taco seasoning mix (1.25 ounces)
To make gluten-free, choose gluten-free options for broth and taco seasoning.
Directions
- Wash hands with soap and water.
- Rinse fresh vegetables under running water before preparing.
- In a large saucepan, heat oil on medium heat.
- Add ground turkey, onion, green pepper and garlic.
- Cook and stir, breaking meat apart until it is brown and vegetables are tender.
- Stir in the beans, pumpkin, tomatoes, broth, water, brown sugar and taco seasoning.
- Bring to a boil. Reduce heat, then cover and simmer for 1 hour.
- Refrigerate leftovers within 2 hours.
Notes
- Broth can be made at home, purchased in a can or box, or made using bouillon. For each cup of broth use 1 cup very hot water and 1 teaspoon or 1 cube of bouillon.
- Use leftover turkey cut in bite-size pieces instead of ground turkey. Sauté the vegetables, then add the turkey with the other ingredients.
- No Taco Seasoning? Mix together 1 Tablespoon chili powder and 1 teaspoon each cumin and oregano. Add some red pepper flakes if you like it spicier.
- This recipe can be made in a 5-quart or larger slow cooker for extra convenience. Put cooked ground turkey mixture and all other ingredients into the cooker, cover and cook on LOW for 7 to 9 hours or on HIGH for 4 to 5 hours.
Recipe from foodhero.org
by Guest | Nov 21, 2024 | Featured, Uncategorized, Why I'm In
Written by: Sarah Ermer, MPH, CHES; Prevention Specialist at Tillamook Family Counseling Center
What drew you/your organization to partner with Tillamook County Wellness?
I’m a recent transplant to Tillamook; I moved here at the end of January for my position at TFCC. When I was preparing to move, I was doing some searching online to learn more about health initiatives in the county. I distinctly remember sitting at my parents’ dining room table looking at the Tillamook County Wellness website on my laptop and thinking, “Wow, Tillamook County has a great system for health promotion!” After officially moving and starting at TFCC, I knew I needed to prioritize getting to know as many different people and organizations as I could in order to do my job well. One of the first people I talked to was Michelle Jenck, who is the coordinator for Tillamook County Wellness. My background and current position are well-aligned with Tillamook County Wellness, so she connected me with the Health Promotions committee. The rest is history!
What, if any, changes have you seen come about as a result of this work?
I haven’t been here long enough to say first-hand what larger changes have come about as a result of Tillamook County Wellness, so I’ll share about a moment that stands out to me. One of the first community events I went to was Healthy Kids Day at the YMCA, where the Tillamook County Wellness Access to Physical Activity committee held the Bike Rodeo. I was amazed by the number of bikes and helmets that were available to go home with families! After watching a long line of kids practice bike safety around the parking lot, I have no doubt that even that event alone created positive change.
What have you learned from being involved in this work?
One of my favorite parts of being involved in Tillamook County Wellness, and of Tillamook as a whole, is seeing how the community really does come together to make things happen. I’ve learned a lot about all the systems at play in the area, and the fact that Tillamook County Wellness brings so many of them together is an amazing model for any community that wants to build stronger coalitions. I’ve learned what it really looks like to work as a community!
What are your hopes for this work as it relates to you/your organization?
My work is focused on substance misuse/addiction prevention, and doing that work effectively means looking beyond substance use alone. If we want to prevent young people from drinking or using drugs, we have to be willing to go beyond telling them what NOT to do. It means creating an entire community that supports people who are struggling with their mental health, who need a place to go, or who need positive, healthy activities to help build their confidence. I’ve seen how effective Tillamook County Wellness is in mobilizing people to support health initiatives; I hope that we can continue to mobilize in building support for both physical and mental health access.
What are your hopes for this work as it relates to changing community health in Tillamook County.
Much like my hope as it relates to me/my organization, my hope for our community health is that our collective idea of health and wellness continues to expand. In so many communities, support for different areas of health is siloed. Mental health, physical activity, nutrition, healthcare, social connectedness, financial wellbeing… they all play into our quality of life. I hope that Tillamook County Wellness can continue to be a part of the bridge that connects all these areas of health.
Is there anything else you’d like to share?
Tillamook County has been such a wonderful place to live and work. Thank you to everyone who has been so welcoming! I’m excited to continue to be a part of this community 🙂
For more local health and wellness information, visit www.tillamookcountywellness.org or follow Tillamook County Wellness on Facebook and Instagram.
