Archive for the ‘Articles’ Category

Take a Kid Fishing—Safely

Tuesday, June 25th, 2019

Childhood fishing trips make memories that will last a lifetime. Ensure they are good memories by being safety conscious, prepared and child-focused.
© iStock/auldist

The Hole. The nickname always sent shivers down my spine when Dad said that’s where we were going.

The Hole was a prime fishing spot, but it was also treacherous to get to. Anglers had to scramble down a steep, precarious, 300-foot ravine to get to the water.

For an 8-year-old first-timer, it was the thing of nightmares—even after the first few trips.

Dad loved to take his kids fishing, but safety wasn’t always part of the equation.

Safety should be a priority.

Here are tips to help keep kids safe while fishing.

  • Wear a life vest. In a boat, children must wear life vests. They should also wear them while fishing from shore.
  • Use barbless hooks—at least to start. They are easier to remove if a child accidentally hooks themselves or someone else.
  • Consider using barb tip covers. They protect from accidental pokes. They sell for $10 to $15 per hundred.
  • Wear protective eyewear. Sunglasses will suffice. Not only will they shield young eyes from harmful UV rays, but they also protect against errant lures and branches.
  • Prepare in advance. Make sure the fishing spot is kid friendly. Teach kids to float and swim in a life vest. Practice casting in the backyard. Pack a first-aid kit.

An Egg-traordinary Hack
Never worry about broken eggs again. Simply crack the eggs beforehand and pour into a water bottle. A water bottle is more durable than eggshells and takes up little space in a cooler. Water bottles with wider-than-normal mouths work best. Shake the eggs before use.

‘Bee’ Aware Outdoors
Often when people think of dangerous animal encounters, they think of bears, mountain lions and venomous snakes. Think again. Bees and wasps injure and kill far more people each year than those other three animals combined.

Stay alert and pay attention to the signs. Buzzing is a signal to be careful. Bees bouncing off your head or body is a warning to get away—quickly.

Bees and wasps can be relentless, so if attacked by a swarm, run away and keep running. Run through brush to confuse and disorient them. Don’t seek refuge in water. They likely will wait for you to resurface.

The Stinky Fish Two-Step
Remove the smell of fish from your hands with the two-step method. The first step: Use an abrasive cleaner, such as pumice soap, to remove surface slime. Step two: Neutralize remaining odor with lemon juice, vinegar or baby wipes.

Hot Weather Bike Tire Tip
Tire pressure will increases as air temperature rises, and as friction between tires and road surfaces increases.

Extreme heat can lead to air loss in tires. In rare cases, it may also cause blowouts.

Check tire pressure before each ride. In hot weather, keep tires inflated at the low end of the manufacturer’s recommended pressure range.

Notable Days in July
July 5, National Bikini Day.
July 14, Shark Awareness Day.
July 16, World Snake Day.
July 22, Hammock Day.

Got a Tip or a Whopper?
Send us your favorite outdoor tip, photo or story. If selected for publication, we will send you $25 for one-time use. Email your submission to gro.etilarurnull@ofni.

Many of Curtis Condon’s fondest memories involve outdoor adventures with friends and family—whether fishing with school buddies, backpacking in the mountains of the Northwest with his sons, or bird watching along the Gulf Coast with his wife. He feels fortunate to have written about the outdoors and other subjects for more than 30 years.

Coming out of the Dark

Tuesday, June 25th, 2019

Survivors shine a light on the opioid epidemic

When Michelle Frizzell broke her foot in 2000, her doctor prescribed the powerful narcotic Vicodin. It was Frizzell’s first introduction to any kind of opioid pain killer.

“I really liked the way it made me feel—the buzz it gave me,” says the 44-year-old mother of two. “I felt this euphoria.”

At the time, Frizzell had no idea how highly addictive opioids were, nor that her personal background put her at even higher risk for addiction.

Two years later, after delivering her first child, Rory, via cesarean section, her doctor prescribed Percocet—another opioid—to deal with the pain during recovery.

“I knew I’d have to be on it only a short time, but once I was, I didn’t want to stop,” she says.

When her prescription ran out, Frizzell began stealing OxyContin from her mother, who was already abusing opioids, alcohol and cocaine.

As Frizzell’s tolerance increased and her need grew out of control, she turned to the illicit market.

By the time she became pregnant with her second child in 2008, the black-market price of OxyContin had grown to about $55 a pill. Needing a cheaper alternative, she turned to heroin, which she used heavily throughout her pregnancy.

In December 2008, her son, Kody, was born addicted.

“I remember crying while using because I was so disgusted that I couldn’t stop, and I didn’t understand why,” says Frizzell, now a clinical supervisor at Grand Ronde Recovery in La Grande, Oregon. “But when you’re addicted, drugs are the only thing important to you—more than your bills, your job, your kids. All that matters is your next fix.”

Clean for seven years now, Frizzell is one of countless Americans swept up in a national opioid epidemic.

From 1999 to 2017, the number of Americans killed by opioid overdoses increased nearly 600 percent, from 8,048 deaths annually to 47,600, according to the National Institute on Drug Abuse. In 2017, opioid overdoses accounted for 67 percent of all deaths from drug overdoses of any kind in the U.S. That year, for the first time, opioids killed more Americans than car accidents.

As a certified drug and alcohol counselor and certified recovery mentor, Frizzell is one of the thousands of counselors and other health professionals battling a national epidemic and helping victims navigate the road to recovery.

While no area of the U.S. has gone untouched by the opioid crisis, “the impact on small towns and rural places has been particularly significant,” according to the U.S. Department of Agriculture’s website.

Dr. Joel Rice, psychiatrist at Grand Ronde Recovery, says rural Americans are especially vulnerable to the risk factors that lead to opioid abuse. Rural communities tend to have a lot of working-class people who suffer injuries at work or in their personal lives, and many suffer with depression from lack of economic opportunities.

“The greater your number of social stresses, the more likely you are to get addicted,” Rice says. “Things like poverty, level of education, abuse history, current abuse, etc., greatly increase the risk of developing opioid use disorder and other addictions.”

Housing and food insecurity, financial difficulties, unemployment, emotional problems, and lack of or limited health insurance all increase a person’s risk of addiction. So can a family history of addiction, a traumatic childhood and being around addicts.

Both of Frizzell’s grandfathers were alcoholics, and her mother and father were both addicts.

Larry Howell, a certified recovery mentor in Roseburg, Oregon, also came from a family of addicts. When his parents divorced, he and his mother bounced from place to place.

Eventually, he fell into a familiar pattern, using drugs like cocaine and methamphetamine.

After a motorcycle accident 17 years ago, Howell’s doctor put him on opioids. Like so many others, he quickly became addicted and eventually turned to morphine and heroin.

Now 50 and clean and sober for six years, Howell works as a peer recovery specialist at The Alliance in Roseburg, which serves patients with HIV/AIDS in 13 Oregon counties.

He runs weekly support groups for Self-Management And Recovery Training, or SMART. Unlike 12-step programs’ focus on a higher power, SMART is built on science, stresses self-reliance and helps people with all types of addictions manage their emotions, thoughts and behaviors.

“It’s not because you’re weak, lack willpower, or are morally defective that you become addicted, but because the drug reprograms your brain,” Howell says. “Drug addiction is a disease.”

Opioids trigger a user’s brain to release high amounts of the feel-good chemical dopamine. Over time, the brain adapts to the drug, and users develop a tolerance to it, needing more of it—and more often.

“If you reintroduce the drug over and over, you begin to get physically dependent on it,” Frizzell says.

A recent poll sponsored by the American Farm Bureau Federation and National Farmers Union says the opioid crisis has struck farm and ranch families much harder than the rest of rural America. While nearly half (46%) of rural Americans said they have been directly impacted by opioid abuse, 74% of farmers and farmworkers said they had been directly impacted by the crisis.

Origins of the opioid epidemic have been traced to 1996 when Purdue Pharma introduced OxyContin and aggressively marketed it to doctors, claiming the drug posed minimal risk of addiction and could safely be prescribed for non-cancer-related pain.

Purdue’s sales grew from $48 million in 1996 to nearly $1.1 billion by 2000. By 2002, doctors had written more than 14 million prescriptions for OxyContin.

Drug users quickly figured out they could crush the tablet and swallow, snort or inject the powder to get even higher.

By 2004, OxyContin had become one of most-abused drugs in the U.S.

In May 2007, Purdue Pharma’s parent company and three company executives pleaded guilty in federal court to misleading regulators, doctors and patients about the drug’s risk of addiction and its potential to be abused. The company paid $600 million in fines, and Purdue President Michael Friedman, Howard R. Udell, the company’s top lawyer at the time, and Dr. Paul D. Goldenheim, the company’s former medical director, agreed to pay $34.5 million in fines.

Meanwhile, doctors kept writing prescriptions, and the death toll kept rising.

Eventually, as the worsening crisis drew greater media attention and public awareness, doctors became increasingly concerned about prescribing opioids.

In 2016, the CDC stepped in with guidelines for prescribing opioids for chronic pain. The move resulted in fewer prescribed opioids and pushed many abusers toward the illicit market’s more potent and cheaper alternatives, such as heroin and the powerful synthetic opioid fentanyl.

Fentanyl—the drug that killed Prince and Tom Petty—is 50 to 100 times more potent than morphine. It is typically prescribed to treat patients with severe pain, especially cancer patients, according to the U.S. Drug Enforcement Administration’s website. Fentanyl is often added to heroin to increase its potency or is disguised as highly potent heroin. Users often believe they are buying heroin instead of fentanyl, which often results in overdose deaths.

In 2010, fentanyl was involved in 14.3% of opioid-related deaths. By 2017, that number had risen to 59%.

Since Purdue’s plea deal in federal criminal court in 2007, 1,600 lawsuits alleging culpability in the nation’s opioid epidemic have been filed by cities, counties, states and Native American tribes against Purdue Pharma and dozens of other drug companies.

In March, Purdue agreed to a $270 million settlement with the state of Oklahoma. The agreement requires Purdue to contribute $102.5 million to establish a foundation for addiction and treatment research at Oklahoma State University. Purdue will also provide the state $20 million worth of treatment drugs, such as Naloxone and Buprenorphine (also known as Suboxone).

Naloxone is an opioid antagonist that can reverse and block the effects of opioids and quickly restore normal respiration to a person whose breathing has slowed or stopped due to opioid overdose. Police and paramedics often carry it and can administer it by injection or nasally.

Buprenorphine is an FDA-approved opioid doctors and clinicians often prescribe to control withdrawal symptoms by blocking certain receptors in the brain.

Frizzell says Buprenorphine was a crucial factor in her recovery because the pain from opioid withdrawals is overwhelming.

“Your muscles ache and your skin hurts,” she says. “You’re vomiting and feel hot and then cold. It’s like the worst emotional pain, the worst physical pain and the worst anxiety you’ve ever had at the same time.”

Frizzell and her husband, Brent, who used heavily together for 10 years, got clean through medication-assisted treatment, which combines Buprenorphine doses with counseling and behavioral therapy, such as 12-step and other recovery programs.

“Had I not been on Suboxone—something to really manage the pain and discomfort that I would experience—there’s no way I would have stayed in treatment,” Frizzell says. “I would have left within 24 hours.”

Last year, Congress passed legislation to allow nurse practitioners and physician assistants—often the only primary care providers in rural communities—to prescribe Buprenorphine.

“In treatment, I learned coping skills, and I discovered I was worth it,” Frizzell says. “Learning that addiction had altered my brain wiring took the shame and guilt out of it.”

Frizzell says shame and guilt are among the biggest reasons people don’t seek help.

She remembers vividly the moment her life turned a corner in early 2012 after she walked into a pharmacy to buy more syringes in Eastern Oregon.

“I was so tired, and I felt such shame and guilt,” she says. “I didn’t want to be high anymore, but I couldn’t stop either.”

Seeing that Frizzell was in bad shape, the pharmacist handed her the syringes she came for along with a piece of paper with a note: “Dr. Joel Rice—this man can help you.”

That simple gesture was the starting point on Frizzell’s road to recovery.

“I came to La Grande with hopes of having someone help me because I couldn’t stop,” she says. “The withdrawal symptoms were so painful, and I would do anything to avoid withdrawal. It didn’t matter what it was, I would do it.”

In La Grande, Dr. Rice referred Frizzell to a 6-month inpatient treatment facility.

“I went to a mommy-and-me program, and I was able to take my son with me,” she says. “I ended up tapering off Suboxone within about 60 days.”

Frizzell says family support was another important factor in her recovery.

“My family visited me while I was in treatment, and they were always loving, saying, ‘We believe in you.’ They were scared and nervous, but they truly believed I could do it,” she says.
Howell agrees that family is important to recovery. He says his responsibility as a parent motivated him.

“I didn’t want my kids to have that father that was a junkie who died,” he says. “I wanted them to remember me as other than an addict.”

Howell says he became a counselor because his personal road to recovery was a rocky one that “was not handled well by a lot of people.”

“I wanted the people behind me to be treated better,” he says. “I wanted to help change the recovery culture and do something that was greater than myself.”

Providing for people’s most basic needs is one of the first and most important steps toward recovery. That’s where nonprofits such as the Northeast Oregon Network and the Northeast Oregon Housing Authority in La Grande come in. The network serves five counties, connecting addicts seeking recovery to community health providers and social services. The housing authority finds subsidized housing and works with programs in the area to fund it.

“The first goal is to stabilize,” says Kate Gekeler, family self-sufficiency coordinator at the housing authority. “It’s hard to stay clean if you don’t have a place to sleep or the income to support it. You want to have permanent, affordable housing as quickly as possible, then connect to support in the community so you retain that housing. Otherwise, everything else in life is incredibly difficult.”

After years of suffering with addiction, Frizzell turned her life around after one person cared enough to offer help instead of judge her. Like Howell, she found her calling in helping others realize they don’t have to suffer alone.

Her message to anyone suffering with addiction is simple: “Ask for help. You can absolutely recover with hard work and determination.”

“Now, recovery is my medicine,” she says. “It keeps me healthy. The longer I’m clean, the more grateful I am for each breath, because it could’ve been so much different. Every day I wake up and don’t want to use. It’s a gift.”

About the series: This Ruralite-produced initiative spotlights health challenges in rural communities, efforts to address them and the unsung heroes behind the work. The series receives support from the M.J. Murdock Charitable Trust, which funds projects and programs in Alaska and the Northwest. The sponsorship helps fund journalism that makes a difference. Send us story ideas at gro.etilarurnull@swenhtlaeh.


Where to find help

Grand Ronde Recovery
bluemtassociates.com

SMART Recovery
www.smartrecovery.org

Narcotics Anonymous
www.na.org

Oregon Health Authority Addiction Services
oregon.gov/oha/HSD/AMH/Pages/Addictions.aspx

Northeast Oregon Housing Authority
neoha.org

Northeast Oregon Network (NEON)
neonoregon.org

Nar-Anon
www.nar-anon.org

 

Stay Clear of Electrical Hazards

Tuesday, June 25th, 2019

Warn youngsters not to play around or climb on the green transformer boxes that house underground electrical facilities.
Photo courtesy of Touchstone Energy Cooperatives

Whether at work or play, be aware of electrical safety risks when outdoors

Warm summer weather draws people outside. Whether taking a dip in a pool, boating, playing outdoors, planting flowers or tackling home improvement projects, it is important to remember you are surrounded by electricity.

Practicing good habits around electricity helps ensure your family, friends and neighbors safely enjoy the outdoors.

Below are tips to help reduce the number of electrical deaths and injuries.

Power Lines and Utility Equipment
Before starting any project, identify the location of power lines. Look above for overhead lines. Be aware that some power lines are buried underground.

  • Call 811 before you begin any digging project. A local call center will send out a crew to identify underground lines.
  • Metal ladders conduct electricity, so use wooden or fiberglass ladders outdoors. Keep ladders at least 10 feet away from overhead power lines, and carry them horizontally.
  • Always look up before raising any long piece of equipment—a ladder, irrigation pipe, antenna or pole—to make sure it won’t come near a power line.
  • Don’t fly kites or drones near power lines. Reserve these for flight in wide-open spaces, such as a field or park.
  • Do not attempt to retrieve balloons, kites or other objects stuck on power lines or other electrical equipment.
  • Leave tree trimming to the professionals, particularly when the tree and its limbs are anywhere near a power line.
  • Never play near or touch a power line with any part of your body, a toy, a stick or any other object. Assume all power lines are live and dangerous.
  • Do not climb or play around a utility pole, an electric substation or a transformer box containing underground electrical facilities.
  • Never climb a tree that is close to power lines. Even if lines do not touch the tree, they could touch when more weight is added to a branch.
  • Do not post signs, hang banners, or tie ribbons or balloons onto utility poles or other electrical equipment. This can be dangerous to you and utility workers.
  • Never try to rescue a family member, friend or pet that has come into contact with electrical equipment. Stay at least 35 feet away from downed power lines, and call 911.

Swimming Pools and Boating
Water and electricity do not mix. Inside and outside, electrical devices and cords should be kept at least 10 feet away from pools, spas and other water sources.

  • Have an electrician inspect the pool, spa or hot tub. Make sure all equipment meets local codes and the National Electrical Code, which specifies that all electrical wires and junction boxes must be at least 5 feet away from the water.
  • Use battery-operated instead of cord-connected devices around water.
    Cover all outdoor receptacles to keep them dry. This is especially important around pools and other water sources.
  • Use a ground-fault circuit interrupter on outside outlets, especially those near water. A GFCI will shut off power to the outlet if the circuit is compromised.
  • Make sure all electrical equipment used for swimming pools—even the cleaning equipment—is grounded.
  • Never touch electrical devices when you are wet, either from water activities or from perspiration.
  • Do not swim or hang out near the water before, during or after a thunderstorm. Water and lightning are a dangerous combination.
  • Know the location of all electrical switches and circuit breakers.
  • Post a detailed emergency plan around the pool, spa or hot tub area, outlining what to do if someone is suffering from electric shock.

Boating and Open-Water Fun
Docks and boats carry sources of electricity. Faulty wiring or damaged cords and other devices can cause the surrounding water to become energized.

Just like your home, it is critical a licensed electrician inspects your boat and that you are familiar with its electrical system so you can identify hazards.

  • The National Electrical Code requires marinas and boatyards to have ground-fault protection. Test GFCIs and equipment leakage circuit interrupters monthly. Make sure electrical current is not escaping from the vessel.
  • Check for nearby power lines before boating, fishing or swimming.
  • Never swim near a marina or a boat while it is running. Residual current could flow into the water, putting anyone in the water at risk of electric shock drowning. There is no visible warning. As little as 10 milliamps—1/50th the amount used by a 60-watt lightbulb—can cause paralysis and drowning.
  • If you feel tingling sensations while in the water, swim back in the direction from which you came, and immediately report it to the dock or marina owner.
  • Know where main breakers are on both the boat and shore-power source so you can respond quickly in an emergency.
  • If you see an electric shock drowning in progress, turn power off, throw a life ring and call 911. Never enter the water, or you also could become a victim.

Power Tools, Cords and Outlets
The U.S. Consumer Protection Safety Commission reports there are nearly 400 electrocutions in the United States a year. About 15% are related to consumer products, with 8% attributed to electrical accidents with electric power tools. Lawn and garden equipment and ladders coming into contact with overhead power lines account for 9% of consumer product-related electrocutions each year.

  • Inspect power tools and appliances for frayed cords, broken plugs and cracked or broken housing. Repair or replace damaged items.
  • Never use power tools near live electrical wires or water pipes.
  • Check that each outlet has its own weatherproof outlet cover, and keep it closed when not in use.
  • Use GFCIs with every power tool to protect against electric shocks.
  • Do not use corded power tools in wet or damp locations.
  • Use tools with insulated grips to avoid the potential of electric shock.
  • Use only extension cords rated for outdoor use. Indoor cords cannot withstand outdoor weather conditions, and may become a fire or shock hazard.
  • Before using an extension cord, inspect it carefully for damage. Discard cords with cracks or exposed wires.
  • Use extreme caution when cutting or drilling into walls where electrical wires or water pipes could be accidentally touched or penetrated.
  • If a power tool trips a safety device while in use, take the tool to a manufacturer-authorized repair center for service.
  • Do not use power tools without the proper guards.
  • Unplug outdoor tools and appliances when not in use.

Salute to Parades!

Tuesday, June 25th, 2019

Look at a parade from the perspective of the participants and the spectators.
Photos by David LaBelle

“Where are the floats and the marching bands?” the editor asked the newspaper photographer. “Readers expect to see a grand view of the parade.”

The photographer had documented the parade for years. This time he ignored the predictable overall picture of the parade and instead focused on preparations and colorful individuals in the procession.

It’s great to be interpretive. As an editor and instructor, I encourage photographers to take risks—after first making the literal event picture.

Here are a few tips to help you make parade pictures:

  • Find a high or low vantage point on an incline to see the long string of participants and record the overall view.
  • Arrive early so you can meet the participants. When possible, stick around after the event. My best pictures from parades are almost always before and after the parade.
  • Do your homework. Know who will be there: the oldest person, king or queen, or a local hero or celebrity.
  • Challenge yourself to do more than make a lifeless document that says you were there. Leave your comfort zone and try new techniques—perhaps long shutter speeds to produce swirling colors of movement, or lower angles that give your pictures a surprising or fresh view.
  • Dare to take your eyes off the marching participants and scan the sidelines. Look for animated subjects with great faces and uninhibited emotion. Choosing good subjects is more than half the success of making interesting pictures. If I notice an excited, engaged family, I position myself across the street and wait for their reactions.
  • When people ask for pictures, give them a business card with your contact information rather than taking down theirs. Put the onus on them to get in touch.
  • Challenge yourself to interpret. I teach students to dig deep and learn to make pictures that go beyond showing what people are doing, instead revealing how they feel about what they are doing. Anybody with a camera can make a decent picture of people doing things. An artist looks deeper for the emotion that reveals the love of the action. Make the overall, scene-setting picture first, then look for things that catch your eyes or reveal stories.
  • Focus on a theme: a specific color, flags, or people’s hands and feet. The possibilities are endless.
  • Give yourself permission to photograph. People expect to be seen and photographed. This helps young photographers learn to feel comfortable photographing strangers.

As always, have fun!

Photographer, teacher, author and lecturer David LaBelle has worked for newspapers and magazines across the U.S. Visit www.greatpicturehunt.com.

A Tasty Reward

Saturday, May 25th, 2019

Photo credit Brandon Pomrenke.

Turn your kitchen into an herb garden

Large, sprawling gardens may be a great home for a plethora of tasty greens, savory root vegetables and myriad herbs, but what if large unused space is difficult to come by?

For those lacking the outdoor space but not the drive to grow, an indoor herb garden might do the trick. All it takes is a countertop or small section of wall to get started.

“No matter where you live—house, apartment or condo—if you don’t have room for outdoor gardening, there’s a lot you can grow indoors,” says Adrian Hunsberger, an urban horticulture agent at University of Florida’s Institute of Food and Agricultural Sciences extension office in Miami-Dade County. “Herbs are a perfect match for indoors. The most important thing is the sheer joy of growing your own edible crops.”

When it comes to size, material, aesthetic and variety, there is virtually no limit to indoor herb gardens. Common herbs include basil, chives, marjoram, mint, oregano, parsley, rosemary, sage and thyme. Many grocery and hardware stores sell startup kits, seeds and supplies consumers need to get started.

You can choose a traditional soil-based growing method using potted plants or water-based hydroponics.

Because it involves less mess, fuss and maintenance, hydroponics is growing in popularity. Instead of soil or fertilizer, this method uses water and nutrients. Because nutrients are in the water, they are absorbed directly into the roots, resulting in faster growth than with soil.

Weston Miller, community and urban horticulturist for the Oregon State University Extension Service, extolls the many benefits to growing your own herbs.

“Fresh herbs will hopefully be eaten, increasing one’s intake of nutrients and fiber-rich plants,” he says. “Hands in the soil and growing plants also have therapeutic benefits.”

Weston says learning how to grow in a small indoor space comes with a nice perk: enjoying the aroma of herbs such as basil and mint.

Establishing a Healthy Crop
While rewarding, starting an indoor herb garden requires plenty of thought and planning.

How you pot the herbs matters.

“Use sterile containers and potting soil,” Weston says. “If reusing pots, they should be sterilized—submerged in bleach—and rinsed before use.”

Whatever growing method you select—soil or water—the key to success after planting is to provide adequate light and the right amount of water, with good drainage if using soil.

Figuring out optimal light and water is not an exact science. It often requires trial and error.

“Growing herbs indoors can be challenging because most windows do not have enough daylight to grow healthy plants,” Weston says.

Adrian reiterates the need for light, whether natural or artificial.

“The more light you get the better,” she says. “A nice window is best, but some people don’t get enough natural sunlight. You can buy grow lights that have a special color spectrum that is best for plant growth. Those are easy lights to get, especially online.”

If you decide to use mostly natural light, remember that east- or west-facing windows get the most light in summer, and south-facing windows have the brightest light and most sun in winter.

Adrian says most herbs are tolerant of indirect light or some shade.

Light kits can help alleviate the aggravation of replacing constantly dying plants. If you decide to rely on or supplement with artificial lights, place them about a foot from the plants.

According to gardeners.com, keep the lights on for 12 to 16 hours for full-sun plants, and adjust as necessary. Once the roots are established and your plants are strong and healthy, aim for about seven hours of sunlight.

Add Water, But Not Too Much
Indoor plants need less water than outdoor plants, but not all novice growers understand that.

“The No. 1 problem people have is they overestimate how much water plants need,” Adrian says. “That’s why a lot of plants—especially indoor plants—don’t succeed.”

To determine if a plant needs water, lift the pot. Well-watered soil will be dense and heavier, so the pot should not be light.

Adrian says novice gardeners can determine how much water different herbs need through some experimentation. Mark on a calendar when you water a particular herb. When it starts to look droopy, water it and take note of how long it takes to look healthy again.

Another way to check if a plant has enough water is to stick a finger about 2 inches into the soil. If the soil is dry, water the plant.

But Adrian warns that if a plant gets too much water, it can get root rot and die.

“It’s better to err on the side of being a little dry,” she cautions. “A lot of herbs prefer their leaves dry, so you’re only going to water the soil. For people who have to really heat or air condition their home, if they feel they need to add humidity to the air, they can just have a shallow saucer of water near the plant.”

Because most herbs are from the Mediterranean, they like it a little on the dry side, Adrian adds.

Misting with water is not a good idea, she says, noting it encourages fungal disease.

“One challenge people might face is damping off fungus,” Weston says.

The horticultural condition is caused by pathogens that can kill or weaken seedlings.

“The fungus rots seed in the soil, or will make a brown spot on the stem of seedlings, which then die,” Weston explains.

To avoid damping off, plant seeds at the correct depth—which varies plant to plant—and do not crowd the seeds.

Good drainage is important because overwatering is common.

Harvesting Your Bounty
Today’s indoor gardening methods make it possible to have fresh herbs for homecooked meals year-round.

Gardeners get to pick their herbs at the peak of freshness and flavor, Adrian says, noting when used right away, you cannot get any fresher.

Once a healthy plant has been established, using fresh herbs is as easy as snipping off a piece. Rinse and dry before adding to a dish.

While fresh herbs are great, you can dry them for later use. The trick is to harvest and dry them at the right time, preferably when they begin to flower.

Many prefer to air-dry herbs indoors because it is believed to better retain flavor and color. Bundle herbs only with the same variety, since drying times may differ.

Placing herb bundles in a paper bag speeds the drying process, but some growers prefer to hang dry plants. Keep hanging herbs out of direct sunlight.

Air-drying herbs outdoors can cause loss of color and flavor as a result of the direct sunlight. To decrease color loss, use a paper bag, which also catches seeds for future growing.

If drying seems too time-consuming, consider freezing fresh herbs. Rinse them well, pat dry and set on a flat tray in the freezer. Once frozen, store them in an airtight bag.

Help is Plentiful
Whether you prefer tried-and-true soil or simpler, no-fuss hydroponic systems, there is an indoor garden suitable for everyone and resources to help you succeed.

Cooperative extension services are available throughout the United States. Adrian says agents often are the best sources for local information.

“Almost every county has an extension office,” she says. “In Alaska, it’s by territory. Local extension offices can usually get an answer quickly. Use whatever search engine you prefer and just type in your county and the word ‘extension,’ and you’ll get straight to your local extension office.”

Keeping active and busy are great, and indoor gardening is less strenuous, so anybody is able to do it, Adrian says.

“No matter how old you are or your experience and background, it’s the magic of creating your own food or plants,” she says.


Indoor Herb Kits
If the idea of starting an indoor herb garden from scratch seems intimidating, consider an herb kit. Options vary. Some include seeds and fertilizer, while others use pods that contain both. Hydroponic set-ups also are available.Some kits even include overhead lights and automatic watering systems.

“These stand-alone systems are relatively straightforward to use and can grow great veggies and herbs indoors,” says Weston Miller, community and urban horticulturist for the Oregon State University Extension Service.

 

Click and Grow Smart Garden 3

Back to the Roots Water Garden

Mountain Valley Seed Co. Culinary Indoor Herb Garden

Click and Grow Smart Garden 3. This miniature countertop herb setup takes care of watering and lighting the plants. Seeds are contained in a K-cup style pod that simply clicks into the holder. Available for $74.95 at Amazon.

Back to the Roots Water Garden. This self-cleaning aquarium is a scaled down hydroponic system that uses fish waste to fertilize the plants, while the plants filter the water. Available for $99.99 on Amazon.

Mountain Valley Seed Co. Culinary Indoor Herb Garden.
Everything you need to get started is included with this 18-herb kit that works on a countertop or windowsill. Just add water and watch your new garden grow.
Available for $29.47 on Amazon.

“If you are looking for a fun and easy way to grow herbs and small veggies, then these kits are a great way to go,” Weston says.


My Personal Experience
If at first you don’t succeed, don’t despair.

In preparation for this story, I decided to create my own indoor herb garden. I bought dryer vent brackets to mount my glass jars to the wall. That went well. Then I filled the jars with soil, planted the starts—and watched them die.

But I needed to have healthy plants to photograph, so I started over. This time, I did my best to not drown the herbs. I used a method similar to urban horticulture agent Adrian Hunsberger’s recommendation, minus the calendar. I let the plants get a bit droopy, and then added water directly to the soil. Unfortunately, I was not aware that herbs want water directly on the soil, not the leaves. Let’s just say my basil and purple basil were beyond saving.

What surprised me, however, was how resilient the chives and parsley are. I don’t think a single piece of my chives was upright when I came home after four days away, which meant no water and no direct light. After a little water and about five hours under two small grow lights, the chives are alive and well.

To my surprise, it turned out too much water is worse than not enough light.


Which Should You Grow?
Which herbs you choose may depend on your favorite foods, but it also may simply be what is easiest to grow.

“There isn’t really any limitation as far as which herbs to grow,” urban horticulture agent Adrian Hunsberger says. “It’s pretty easy to get seeds or seedlings from a local garden center. Most have a nice selection, especially for those that grow well in different regions. People from other parts of the world may want to grow something they are familiar with. Online is the way to do that.”

Basil is a popular choice, but can be difficult because it needs a lot of warmth and light. Keep the soil moist to the touch, but well drained.

Mint is easy to grow, and may work best in its own pot indoors because it tends to spread. Use mint in teas or to spice up yogurts, vinegars, salads and beverages.

Chives can be used as a baked potato garnish, but also to add flavor to breads, salads and salad dressings. Chives grow best in full sun, but can grow almost anywhere.

While it needs plenty of light, parsley is considered easy to grow. If growing from seeds, soak them in warm water first. Cut parsley on the stem, preferably near the base. Use it to season chicken, salads, pesto and fish dishes.

Like basil, cilantro is not a long-lasting plant. Your best bet is to plant seeds at three- or four-week intervals to ensure a steady supply. Cilantro thrives in full light, but can grow in part shade.

Thyme can be added to many dishes, and has a decorative appeal. Mix it with garlic and rub on pork, beef or lamb for a distinctive flavor. You can sprinkle thyme in a variety of sauces and soups, or mix in vegetables for a new taste.

An Idaho Town’s Little Clinic That Could

Saturday, May 25th, 2019

Nursing student Quincy Heithecker treats Allen Hardman’s thumb, which was injured in “a wrestling match with a pallet.”

In early 2014, when the global commodities market softened, the tiny central Idaho town of Challis braced for massive layoffs at the local mine.

As the largest employer in the area, the mine provided health insurance for about 400 of the town’s 1,000 residents.

Kate Taylor, executive director of the Challis Area Health Center—the only medical clinic within 60 miles—knew the potential loss of revenue from the layoffs could be lethal for the clinic. It had enough financial reserves to survive for about 18 months before it would have to close its doors.

“The thought of going broke brings a lot of mental clarity,” Taylor says. “We needed to come up with a new and sustainable financial way forward.”

Taylor reached out to the Idaho Primary Care Association, a state organization of Federally Qualified Health Centers, also known as community health centers. The centers combine the resources of local communities with federal funds to establish clinics in both rural and urban areas around the nation.

Approximately one in five rural residents is served by a center, according to the Health Resources and Services Administration.

Health centers provide comprehensive health services including primary care, behavioral health, chronic disease management and preventive care. These outpatient clinics qualify for grants through HRSA to serve an underserved community or service area and receive specific reimbursement under Medicare and Medicaid.

Realizing Challis met the HRSA definition of a medically underserved area, Taylor worked with the clinic’s board of directors, community members, health care providers and other stakeholders to develop a proposal for how to meet the community’s needs.

“I had all kinds of scabs on my knees from reaching out and begging for help,” she says.

One month after Taylor submitted a grant application for the clinic in October 2014, the mine laid off more than 80 percent of its workers.

While the number of clinic visits dropped, volunteer EMTs—many displaced workers from the mine—moved out of town, and the local ambulance service struggled to respond to emergency calls.

The community’s health services were on life support, and the prognosis didn’t look good.

In August 2015, 10 months after submitting its grant proposal, Challis’ clinic was awarded the funding it needed.

Today, the clinic provides comprehensive primary and preventive medical care and behavioral services for residents of Challis and North Custer County. Its integrated care model means residents can receive services in one location regardless of their ability to pay.

“We see everything,” says Steve Rembelski, who took over as the clinic’s executive director in 2016. “Primary care, seizures, heart attacks, strokes, broken legs, lacerations—I can’t think of anything we haven’t seen.”

Challis has no full-time physicians, but thanks to grant funding, the clinic added two physician assistants, bringing its total to four. The advanced-practice medical providers work under the supervision of Dr. Richard Paris, a family medicine physician who has served as the clinic’s medical director since 1999.

Paris makes the 30-minute flight from Hailey, Idaho, in his single-engine Cessna twice a month to supervise and consult with the PAs in Challis. He also follows obstetrics patients and arranges to deliver their babies at the hospital in Hailey, a 2.5-hour drive away.

Dr. Kathryn Woods, a family practice doctor and Paris’ spouse, travels with him once a month to provide women’s health services.

Paris says the community’s needs have always fluctuated.

“I’ve seen it go from two full-time doctors to barely enough work for one PA and me,” he says.

Each PA in Challis works a four-week rotation—two weeks in the clinic seeing patients, one week answering calls from the Care Line, which patients can call for health advice 24/7, and one week off. The PAs also provide backup at the clinic when things get busy. If necessary, they sometimes meet patients at the center outside of usual business hours to save them the 120-mile round trip to the closest ER.

“The whole idea of our care model is to support the community from within,” says Danny Fife, one of the PAs.

During their on-call week, providers also work as ambulance-based clinicians, riding with volunteer EMTs. Danny has flown with backcountry pilots, worked with the area search and rescue team and delivered a baby in the back of an ambulance. The PAs also arrange air transport for critically ill or severely injured patients to one of Idaho’s large hospitals.

“We are doing everything we can to care for patients,” Danny says. “It’s what I love about my job. It is what a PA is made for—extending the reach of physicians. This is how medicine should work—collaboration, not competition.”

In 2017, Challis added a full-time licensed clinical social worker who assists people with mental health and other issues, including grief, anxiety, depression and substance abuse.

A community health paramedic manages the volunteer EMS program, collaborates with the PAs and makes follow-up home visits to patients who would benefit from extra monitoring and instruction to prevent future 911 calls. The community health worker provides health education, prevention and outreach in the community.

When Challis’ only pharmacist retired, the clinic partnered with the Idaho State University School of Pharmacy to create a telepharmacy so patients could continue to get their medicine in town.

“With our new care model, there is camaraderie and teamwork,” Paris says. “There is so much power and enthusiasm.”

The once-struggling clinic has become a health care lifeline for its community, ensuring Challis residents can find the care they need when and where they need it.

Landscaping for Energy Efficiency

Saturday, May 25th, 2019

Dense evergreen trees or shrubs provide continuous shade and can block heavy winds.

Proper plants in the right locations can save money for years to come

The approach of summer has many gardeners turning their attention to planting plans. If your goal is energy efficiency, landscaping can not only beautify your home, but help you control future energy costs for years to come.
According to researchers at the Depart-ment of Energy’s National Renewable Energy Laboratory, trees carefully positioned around a home can save as much as 25% of household energy consumption for heating and cooling. Shrubs can help control costs by diffusing wind or solar heating, thereby moderating the transfer of heat.

Meet Your Microclimate
For years, gardeners have used the U.S. Department of Agriculture’s Hardiness Zones as guidelines for plant stock selection, seasonal cultivation and projected harvest. But understanding the impact of nearby vegetation, topography and soil science will help you know your yard better, providing flexibility for landscape planning and potentially more options for using plants to control energy costs.

Other factors influencing microclimate are the duration and intensity of sunlight over areas considered for planting, and proximity to topographic or vegetative wind breaks or wooded areas, which can regulate local temperatures by several degrees.

Trees at the Top
No matter how much you love trees, you will want to plant them at a distance.

Placed too close to foundations, pavement and plumbing, root systems or maturing branches can damage foundations or roofs.

Never plant trees close to power lines. Always consider their mature height, and make sure they will not grow into lines.

Planted in the right place, in five to 10 years a fast-growing shade tree can reduce outside air temperatures near walls and roofs by as much as 6 degrees Fahrenheit on sunny days. Surface temperatures immediately under the canopy of a mature shade tree can be up to 25 degrees cooler than surrounding shingles or siding exposed to direct sunlight.

According to the Department of Energy, deciduous trees—those that lose their leaves in autumn—are great options for seasonal summer shade. Tall varieties planted to the south of a home can help diffuse sunlight and shade the roof.

Shorter varieties of deciduous trees can be planted near exposed west-facing windows to help shade homes on summer afternoons. Mass plantings of evergreens selected for their adaptability to regional growing conditions can be planted further away on a north or northwest section of a yard to form a windbreak, shielding the home from winter winds.

Deciduous trees with high, spreading crowns—leaves and branches—can be planted to the south of your home to provide maximum summertime roof shading. Trees with crowns lower to the ground are more appropriate to the west, where shade is needed from lower afternoon sun angles.

Trees should not be planted on the southern sides of solar-heated homes in cold climates. The branches of deciduous trees will block the winter sun.

Using shade effectively requires you to know the size, shape and location of the moving shadow your shading device casts. Homes in cool regions may never overheat and may not require shading. You need to know what landscape shade strategies will work best in your climate and microclimate.

Trees are available in the appropriate sizes, densities and shapes for almost any shade application. To block solar heat in the summer, but let much of it in during the winter, use deciduous trees. To provide continuous shade or to block heavy winds, use dense evergreen trees or shrubs.

Although a slow-growing tree may require many years of growth before it shades your roof, it will generally live longer than a fast-growing tree. Because slow-growing trees often have deeper roots and stronger branches, they also are less prone to breakage by windstorms or heavy snow.

Trees, shrubs and groundcover plants can shade the ground and pavement around the home. This reduces heat radiation and cools the air before it reaches your home’s walls and windows.

Use a large bush or row of shrubs to shade a patio or driveway. Plant a hedge to shade a sidewalk. Build a trellis for climbing vines to shade a patio area.

To ensure lasting performance of energy-saving landscaping, use plant species that are adapted to the local climate. Native species are best because they require little maintenance once established and avoid the dangers of invasive species.

Properly selected, placed and maintained landscaping can provide excellent wind protection, or windbreaks, which will reduce heating costs considerably. The benefits from these windbreaks will increase as trees and shrubs mature.

Painting With Light

Saturday, May 25th, 2019

Photos by David LaBelle

Ever thought about light as a beautiful, God-given paint to be gently applied to your pictures? We can learn much about light by standing quietly and watching nature’s artistry.

Think of light as a glaze carefully applied to a ceramic piece to enhance its color and shape—just as morning light crawls across an awakening valley, painting trees, rocks and grasses in fine gold.

I had a vivid dream where a photographer was showing how to create tone separation and depth by light painting grave markers in a Civil War cemetery. I have no idea what prompted this dream other than my subconscious working overtime while sleeping.

It reminded me I have not shared the technique of light painting—using a flashlight or cellphone light to illuminate the subject of a photograph during long exposures.

Beyond being a practical way to illuminate an object or subject, this seldom-used technique might be just the accent needed to turn an ordinary-looking photograph into something special, with mood or even attitude.

Because the concentration and application of light is different from what we see from flash or continuous broad light sources, light-painted pictures feel more like works of art than static documents.

Light painting also can be an effective technique to draw emphasis to a portion of your subject. How does one do this?

  • Determine exposure before adding illumination. Underexpose your subject by at least one, preferably two, stops at the lowest ISO possible.
  • Use a tripod.
  • Exposure needs to be at least 30 seconds to give you time to paint. Experiment. Two to three minutes might give you more time to paint.
  • If using a cellphone camera, download an app (https://bit.ly/2Dgp9kE or https://bit.ly/2IrNyb5) to allow you to manipulate ISO and shutter speed manually.
  • Experiment with different light sources and strengths—from the LCD flashlight on your cellphone to a more powerful flashlight with a directional beam.
  • Put a colored gel over your light source to give your subject a different feeling.

Remember: Light from the side reveals texture. Light from behind shows shape.When painting with a small light, play with angles.

Photographer, teacher, author and lecturer David LaBelle has worked for newspapers and magazines across the U.S. Visit www.greatpicturehunt.com.

Eating On the Run (and Walk)

Saturday, May 25th, 2019

Sports bars—whether store bought or homemade—are a light, portable, concentrated food source you can’t easily replicate with bulkier foods. They also are more convenient, and make getting a meal or energy boost quick and easy. © iStock

Many of us don’t have the time, space or inclination to pack a meal before setting off on a run, hike, bike ride or fishing trip. If anything, we prefer to grab a snack and go, a proclivity that has fueled the multi-billion-dollar sports bar and gel industry.

The first sports bar arrived in the mid-1980s. For years, it was the only game in town, even though it wasn’t especially tasty and had the consistency of cold tar.

Things have changed a lot since then. Today, there are dozens of brands and hundreds of tasty choices.Choosing the one that’s right for you is the biggest challenge and depends in part on your favorite activity, its duration and intensity.

Sports bars and gels come in two basic categories: energy boosters and meal replacement or supplement bars, which are commonly called protein bars.

Energy bars and gels provide quick energy. They work best for short, intense activities. The main ingredient is fructose or high-glucose carbohydrates, supplemented with vitamins, minerals and electrolytes.

Meal replacement or supplement bars contain mostly protein, healthy fats, fiber and some carbohydrates. They also contain vitamins and minerals. They work best for longer-duration activities, when you want a no-frills bite to eat or a meal in motion.

One downside is sports bars and gels are not cheap. Trying to figure out which one is right for you can take a bite out of your wallet.

Fortunately, many sports bar companies offer coupons or free samples. For the cost of postage, get free samples from MammothBar and Verb Energy.

How to Keep Fish Fresh
For best results, keep your catch alive. A properly outfitted live well is optimal—but not always available—so many anglers keep fish on a stringer or in a dunk basket in the water. An alternative is to put fish on ice.
The idea is not to freeze them, but to activate a fish’s natural reflex to go dormant in freezing temperatures.

National Park Stats
The National Park Service offers a useful tool for planning and timing trips to sites operated by the NPS: https://irma.nps.gov/stats.

Got a Tip or a Whopper?
Send us your favorite outdoor tip, photo or story. If published, we will send you $25. Email your submission to moc.stnerrucadirolfnull@ofni.


June Catch of the Month Around the State

  • The Keys: bonito, barracuda, swordfish, shark, marlin, tarpon, snook, snapper and wahoo.
  • Central: bluegill and sunfish.
  • Northwest: jack, amberjack, bluefish, bluegill, cobia, catfish, drum, bonito, seatrout, snapper, barracuda, tuna, triggerfish, sheepshead, mackerel, pompano, sailfish, shark, sunfish and wahoo.
  • Central West: amberjack, bass, flounder, bluefish, bluegill, drum, seatrout, sunfish, cobia, grouper, tarpon, snapper, barracuda, ladyfish, mackerel, permit, bonito, pompano, porgy, grunt, snook and shark.
  • Southwest: jack, ladyfish, barracuda, tarpon, bass, bluegill, snook, permit, shark, pompano, sunfish, seatrout, grouper, tripletail and snapper.

A Life-Changing Legacy

Thursday, April 25th, 2019

Oral health professionals examine a patient at the RAM clinic in Pahrump.
Photos by Robert D. Lambert

At 74 and 76, Patty and Stu Wineman aren’t likely to camp out in line to buy concert tickets or the hottest new toy or video game. But there is something the couple is eager to wait all night for: health care.

Last October, the Winemans were first in line at the pop-up Remote Area Medical (RAM) clinic when it visited Pahrump, Nevada—a community in the southeast corner of Nye County about 60 miles west of Las Vegas and 60 miles east of Death Valley.

RAM is a Tennessee-based nonprofit that provides free, quality health care to underserved and uninsured individuals. RAM’s corps of more than 135,000 volunteers—licensed dental, vision, medical and veterinary professionals—has treated more than 785,000 individuals and 68,000 animals, delivering $135 million worth of free care.

“The first year (2016) I got there around 1:30 a.m.,” says Patty Wineman. “I found out you need to get there a lot sooner.”

In 2018, Wineman took her place at the head of the line shortly after lunch the day before the clinic opened. With a Harlequin romance in hand and a chair to rest in, she was content to pull an all-nighter.

“I have no complaints,” she says. “Yes, you have to wait a long time. So be it. It’s free. That’s the way I feel about it.”

Every October, hundreds of people line up to seek treatment from the pop-up clinics at the Nye Communities Coalition campus. At 3 a.m. each clinic day, organizers estimate how many patients health care providers can serve and hand out tickets to those in line. While few are turned away, patients sometimes have to prioritize one treatment over another. At 6 a.m., clinic gates open.

Coalition CEO Stacy Smith says her organization teams with more than 15 partners to host the gargantuan events that have provided free medical, dental and vision services for around 450 people each of the past three years.

While patients only see the hive of activity at the clinic three days a year, the behind-the-scenes preparation is an all-year endeavor with planning meetings, advance recruitment efforts, grant writing and more.

The clinic taps resources from the entire community. From the Disabled American Veterans and local law enforcement to the Nye County School District and Valley Electric Association, everyone steps up, loaning equipment, fundraising and contributing labor.

Students studying in dentistry and medical programs and professors from the University of Nevada Las Vegas and the College of Southern Nevada pitch in too.

Smith says there’s no way the Nye Communities Coalition could pull off the event on its own.

“All of us have skin in the game,” she says. “That’s the way it is in rural communities. No agency tends to have enough resources, so it always takes all of us. Across the board, we are medically underserved for primary care, mental health and dental.”

Smith adds that the relatively new community lacks many of the safety nets that a more established community might have. Plus, Nye County—and especially Pahrump—tend to be transient and lack stability. The senior population is large but not wealthy, and many younger workers are in mining or construction, which have highs and lows.

“It’s just that general boom and bust that many people think is gone in the West but still exists for many of us,” she says.

In many medically underserved areas, the services patients need are often a few miles away in neighboring communities, but that’s not the case in Pahrump.

“If you don’t have a working vehicle, you’re not going to get to Las Vegas from here,” she says.

RAM representative Robert D. Lambert says Pahrump’s clinic last year was the organization’s 970th clinic, and RAM recently celebrated the milestone of launching its 1,000th clinic.

Lambert says in 2018, RAM provided care for 45,566 patients at more than 90 clinics around the world. Although they only have about 40 staff members, RAM tapped the talents of 17,837 volunteers to provide care valued at $15,386,013.

RAM ships in supplies and equipment, provides core personnel to help run the clinics and posts staffing needs in an online forum to attract medical professionals willing to help.

Pahrump clinic co-chairman Ryan Muccio says RAM provides vital support, but the 10 to 12 core team members that come from RAM are just the foundation of a massive volunteer effort. For each of the three days it runs, the

Pahrump clinic requires 150 to 200 volunteers—from doctors and nurses to kitchen staff. Muccio says 95% are recruited from Pahrump and Las Vegas.

“The majority came from just pounding the pavement and going into doctors’ offices and telling them about it and asking if they’d join,” Muccio says, noting that some volunteers “catch the RAM bug” and follow the organization around the world.

Dr. Carl DeMatteo, a semi-retired internist and infectious disease specialist for Dartmouth-Hitchcock in New Hampshire, travels with RAM whenever he can. When he’s the lead physician at a RAM clinic, the organization helps with travel expenses. When he’s not, he pays costs himself.

“I just love the organization,” he says. “I love working with patients. I love working with folks who aren’t getting a fair deal from the American health care system. It’s just very rewarding. The people who volunteer are wonderful folks.”

While some health providers come from a distance, others help with planning year-round. Pahrump-based Nurse Practitioner Sherry Cipollini oversees women’s health at the Pahrump clinics.

Cipollini says she’s seen myriad diagnoses at the clinic, including high blood pressure, diabetes, heart disease, chronic illnesses and abnormal pap smears. They even caught a case of breast cancer. Cipollini also talks to patients about birth control and safe sex.

Case workers are on hand to help people apply for health benefits. The Nye Communities Coalition has secured a women’s health grant to help provide follow-up care.

“There are so many barriers to care, and this helps break down those barriers and gets care to people who wouldn’t otherwise get it,” Cipollini says. “A lot of these people haven’t seen a provider in years, and they’re afraid. They don’t even realize there are resources available.”

Muccio says it’s not just people who don’t have insurance that RAM serves.

While some are homeless or jobless, many have insurance but can’t afford deductibles or co-pays.

“There was a small business owner last year who couldn’t afford the deductible for the dental work his family needed,” Muccio says. “There are so many stories—things they’ve caught, things they’ve helped people with. It’s truly amazing.”

Dr. John Quinn and much of the staff from Smiles for Life Family Dentistry volunteer at the Pahrump clinic every year. Quinn initially learned about RAM through a former classmate.

“I did it on a whim, and when I arrived there were so many patients and only two of us dentists,” he says. “So they asked me to stay the next day and the next.”

At the last clinic, he says they had three dentists plus dental students and assistants pitching in. Together they saw about 100 patients, which is 10 times what he sees on a regular day in his Las Vegas-based practice. Quinn says nine years in the Army National Guard helped prepare him to serve crowds. Among the common ailments he sees at the clinics are severe gum infection and infected teeth.

“I don’t think they have fluoridated water out there because it’s on well systems,” Quinn says. “They generally have less access to dental education and treatment, so things are pretty far gone by the time we see them there.”
Quinn says RAM brings in first-rate supplies to meet the community’s needs.

“Generally, when you go to one of these triage clinics, it’s very low budget—really crummy materials—but RAM actually has really great stuff.”

Dr. Michael Kozlowski, an optometrist, and his wife, Roni, a registered nurse, drive in from Glendale, Arizona, to volunteer at the Pahrump clinic every year.

“If we find ocular disease, we’re also equipped to be able to address that,” Kozlowski says. “We’re not just doing refractions and giving prescriptions for glasses. We’re actually doing complete ocular health examinations.”

RAM brings ocular exam equipment and a mobile lab to cut the lenses and dispense eyeglasses right away. Kozlowski says that ensures people who have unstable housing situations don’t have to worry about missing notifications to pick up their glasses at a later date.

“Patients can have their glasses right away and begin seeing better when they walk out of the building,” Kozlowski says. “They have a really nice selection of frames, and patients can get single-vision or multiple-vision glasses—whatever they need.”

Kozlowski says a lot of people try to make do with reading glasses from a drugstore or even a family member’s glasses.

“The fact that they can get a pair of glasses made to their prescription as good as they would get from any optometrist is really a gift,” he says.

The RAM clinic is scheduled to return to Pahrump October 4-6. It’s rare for RAM to continue to visit an area every year, but Smith says RAM officials recognize the need and the passion of the community.

“Their heart’s in the right place,” she says. “They’re all about service, and they go where the need is.”

While Smith is grateful to everyone who helps make the RAM clinic possible, she says she appreciates the clients most.

“They are so patient, so tolerant and understanding and so appreciative,” she says. “I’ve literally watched people have every tooth pulled out of one side of their mouth, and they show up and line up back the next day to get the other side done. The strength and grace that they have while they’re getting this done, I just can’t tell you how much I respect them.”

GET INVOLVED. To donate to RAM or inquire about volunteering as a licensed health care provider, medical or dentistry student or general-support volunteer, visit ramusa.org.