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Summer Solstice 2021

Summer Solstice 2021, Rick DeTroye L.Ac. LLC in Northeast Portland, OR

Ridgefield National Wildlife Refuge   Ridgefield, WA   June 14, 2021

Solstice greetings to everyone! I hope you're having a smooth transition into summer and navigating your way through the early stages of re-opening from the pandemic. It is definitely a period of transition, not only seasonally, but culturally, politically, economically, and for many of us, personally. These times can be tumultuous and uncertain, but are also opportunities for change and renewal. Let's just say that after a period of stagnation and hesitation, there is a lot of energy available now. How we use it and how we move forward is up to each of us. I hope we can all use it in ways that benefit both ourselves and others.

On to the updates...

New Digs: The big news for me right now is I've moved my office! After nearly 15 years in the old place, it's a big change. Rest assured though, I didn't go far. I'm still in the same building, but now upstairs in Suite 220, Potentials Wellness Center. After spending a year by myself in the old space, I realized I needed to downsize and missed being around other practitioners. When the opportunity to move appeared and I seized it! Opening day was June 1, so I'm still in the honeymoon phase, but so far it's working quite well. I'm back to only one treatment room, however it's a large room and feels quite spacious. Feedback from patients is they like it: it's brighter, roomier, and has a beautiful wood ceiling. The days of lying on the treatment table while staring at old suspended ceiling panels are over!

The only apparent drawback to the move is having to climb a flight of stairs to get to the office. Though this is good exercise for most of us, the stairs could be a challenge for those with mobility limitations. Not to worry. I also have access to the main floor Potentials Wellness yoga studio for limited hours each month. If anyone can't climb stairs, I can make arrangements to schedule time in the studio for patient appointments. Let me know if that's something you need and I'll be happy to arrange your treatment time in the studio.

Lastly, my phone number remains the same, 503-484-3513, and online scheduling hasn't changed, so feel free to book an appointment whenever you like.

Insurance Coverage: As many of you know, I'm moving steadily toward establishing a cash-only business. My original plan was to end participation with all health insurers by the end of 2020, but due to the pandemic, that didn't happen. I have whittled my insurance participation down to only two plans: Kaiser/CHP and Regence BC/BS of Oregon. I plan to resign from Regence at some point this year, which will leave only Kaiser/CHP. Eventually, I will terminate participation with them as well. I'll keep you up to date when any changes occur. If you have any questions or concerns about why I'm doing this, please don't hesitate to ask. I'm happy to discuss it with you.

Covid-19 Screening Protocols: First off, I want to thank everyone for their diligence and integrity during the pandemic. Answering those Covid symptom questions time after time gets old and wearing a mask during a treatment is not easy! You all demonstrated great concern for me and others receiving treatment from me. I'm grateful for that. For the time being, all practitioners at Potentials Wellness will continue to do Covid-19 screening when patients arrive for treatments and ask patients to continue wearing masks. We will also wear masks. That will change at some point, but right now, we're just getting used to the idea of not wearing masks outside and having maskless visits with friends who are also vaccinated. We're easing into this very slowly...

Speaking of Covid-19: Here is a reassuring interview with Monica Ghandi, MD, MPH from University of California San Francisco, about the effectiveness of the Covid-19 vaccines and how to safely reopen our lives:
https://www.youtube.com/watch?v=tvQ3iWbfHpo

Take A Breath. Through You Nose, That Is: I've spoken to a number of people recently about the books, Breath by James Nestor and The Oxygen Advantage by Patrick McKeown. Both discuss the importance of breath, breathing, and breathing effectively, i.e., through the nose and not the mouth. I would recommend them to anyone dealing with asthma, allergies, insomnia, sleep apnea, snoring, hypertension, anxiety, stress, and/or fatigue. Did I miss anyone? Probably not. Most of us struggle with at least one of these issues. I know I do. I've been taping my mouth at night (I know it sounds like torture, but it's not that bad) and have been sleeping better than I have in years and my constantly congested nose is now open. Honest!

Before you buy the books (or get them from the library), watch all or part of these Youtube interviews with the authors. If they seem too long to sit through, break them up into brief "episodes" and watch or just listen to them over a few viewings. You owe it to yourself...

Patrick McKeown & Rangan Chatterjee: https://www.youtube.com/watch?v=FdXQ6K0zIj4&t=471s

Patrick McKeown & Robin Rothenberg: https://www.youtube.com/watch?v=4A0zOCfgfdg&t=872s

James Nestor & Rangan Chatterjee: https://www.youtube.com/watch?v=woyIhwomy1U&t=10s

James Nestor & Dr Mark Burhenne: https://www.youtube.com/watch?v=-oFeBMfGdP4&t=453s

Speaking Of Breathing: At the last class I took with Kiiko Matsumoto (my primary acupuncture teacher), she discussed the treatment of breathing issues and the difficulties people with Covid-19 can have in recovering their ability to breathe. I've used these treatment strategies in practice and have been impressed with their effectiveness, especially for people with asthma and those who suffer from anxiety-related breathing issues. So far, I haven't seen anyone with post-Covid issues to try them out on. If you know of anyone with breathing issues and they're open to acupuncture, send them my way. I'm excited to treat anyone who might benefit from these strategies.

And that, as they say, is it! Thanks, as always, for your continuing support and trust. I appreciate all of you. Continue to live smart and within the parameters you feel comfortable with. We will all re-open at different speeds and in different ways. Honor your speed and your ways.

Have a wonderful, healthy summer!

The Winter Covid-19 Surge

The Winter Covid-19 Surge, Rick DeTroye L.Ac. LLC in Northeast Portland, OR

"I read the news today, oh boy."
- John Lennon & Paul McCartney

Not too long ago, I met someone who questioned the seriousness of the Covid-19 pandemic. I had no idea how to respond. So I said nothing. As we approach 300,00 deaths nationally and 1,000 deaths in Oregon, I feel the need to speak up, both for your safety and mine. Because every time a patient comes in to see me, we're both rolling the dice, so to speak. We're each trusting the other has been wearing a mask, hand washing, socially distancing, staying at home, keeping to their social bubble, and most of all, hoping they're Covid-negative. We're also hopeful the people we've encountered daily in stores, at work, and on the street have been playing it safe. And wondering what the outcome may be for us if they haven't.

Oregon hospitals are ramping up for a possible onslaught of Covid-positive patients following Thanksgiving, Christmas and New Year's Eve gatherings. Gatherings which were and still are recommended against, but many participated in and will participate in regardless of the outcome. Surge tents are being set up at Portland-area hospitals and refrigerated trailers have been brought in as makeshift morgues. It's appears we're anticipating a surge like last spring's in New York and that's sobering.

In October, I was diagnosed with a deep vein thrombosis (blood clot) in my right lower leg. Four veins, fully blocked. I'm being treated for it, but the cause is still to be determined. The leg will be reassessed in January. This is not a great time to have a clotting issue, as Covid-19 could lead to more severe clotting and complications. I don't want to catch Covid-19 and will avoid it any way I can.

So, I'm doing my best to provide a safe office environment for patients and myself. I clean each room after every treatment. Linens are changed, tables and all working surfaces are sanitized, pillow covers are replaced, door knobs and light switches are cleaned. Bathrooms are sanitized daily. I wear two masks while treating. I wash my hands repeatedly before, during, and after treatments, as well as use hand sanitizer between washes. My only mask-free, non-distanced interactions are with my wife. Five times since March I've met up with a friend for a masked, socially distanced walk or conversation. Other than that, my main contacts are with patients.

It's worth repeating that masking, social distancing, hand washing, and minimizing contact with people outside the home are still the standards of prevention and care during this pandemic. I encourage all of you to adhere to these guidelines, both for your health and the health of everyone you come into contact with, including those you love and care for. And including me.

Which brings me to some requests:

- If you're planning on attending holiday gatherings with people outside your immediate household or social bubble, please reconsider. These people may include children, grandkids, parents, other relatives and/or friends who don't live with you. If you do attend and you plan on scheduling an appointment, please let me know and allow at least ten days between that contact and your next appointment.

- If you've tested positive for Covid-19 and have an upcoming scheduled appointment, please contact me as soon as possible.

- If you have symptoms of an illness or even a suspicion of illness, and have an upcoming scheduled appointment, please contact me before your appointment.

- If you've been exposed to someone with Covid-19, whether you test positive or not, and have an upcoming scheduled appointment, please contact me before your appointment.

- If I treat you within ten days of developing symptoms of Covid-19, testing positive for it or suspecting you were exposed to it, please contact me as soon as possible.

- If you regularly spend time in a location outside your home where people don't wear masks and don't socially distance, please contact me before scheduling an appointment. These locations include work places, churches, restaurants, bars, gyms, and social gatherings, to name a few. All of these situations put both of us at increased risk.

- If you're spending time in a social bubble with people outside your home, please be very careful. I know two people with bubble mates who visited outside their bubbles. These bubble mates were exposed to Covid-19 by individuals during their "out of bubble experience", putting the people in their bubble at risk. Each of the people I know had to self-quarantine for two weeks and be tested twice before they could return to their regular activities.

- As a courtesy to me and other patients, please wear a mask that fits snugly over your face and will stay in place during appointments. It should cover both your nose and mouth comfortably and securely, and require minimal adjustment if any. The less touching of a mask, the better both for yourself and me.

I know people are encouraged by recent vaccine news. However, we're a ways off from vaccines being widely available to the general public. Undoubtedly, there will be numerous things to work out with delivery, effectiveness, and side-effects of these vaccines once they're released. In the meantime, we need to do what we can with our available resources to keep Covid-19 in check. Hopefully, clear-headedness and good decision-making will guide us in utilizing these resources.

I believe all of us are caring people and concerned for everyone's welfare. I appreciate everyone's continued efforts to stay healthy and help others do the same. I just felt the need to voice my concerns, to reinforce good practice of personal safety, and to restate the parameters I hope we're all striving toward during this pandemic.

Think smart, reduce your risks. And may we all stay healthy!

Helping Others In Need During Covid-19

by Rick DeTroye, LAc, MAcOM

Helping Others In Need During Covid-19, Rick DeTroye L.Ac. LLC in Northeast Portland, OR

Chicory   Columbia Sough, Portland, OR   August 2, 2020

I'm not sure how many of you read Street Roots, Portland's award-winning, weekly street newspaper? I try to buy one from each vendor I come across, even if I've already bought the same issue. All the vendors have a history of living on the streets and buying a paper is one way of lending support and helping them choose a different life. Besides that, the newspaper also prints some great stories.

Recently, I read a Street Roots feature about Lana Jack, a member of the Celilo Wyam tribe who is gathering and distributing supplies for Columbia Gorge tribal members dealing with Covid-19. These people live at traditional fishing sites along the river in poverty level conditions and, like many Native Americans, have limited access to running water and medical supplies. As many of you may know, indigenous people have experienced some heavy hits from Covid-19, with some of the highest per capita infection percentages, as well as mortality rates, in the U.S. Lana is trying to make sure Columbia tribal members have a fighting chance during the pandemic by delivering masks, hand sanitizer, soap, gloves, sheets, towels, bleach and laundry detergent.

Here is a link to the Street Roots article about Lana Jack:
https://www.streetroots.org/news/2020/05/17/celilo-wyam-activist-delivers-relief-indigenous-villages-columbia-river

For many of us, the Gorge is a special place. I've always felt a deep connection there. Now, I also recognize a need to help it's original inhabitants, who were sadly displaced by the damming of the Columbia River and the politics that ensued. These people still lack social support and I'd like to lend a hand.

I'm sending out this email to ask for your assistance in doing this. Through the end of August, I will be accepting donations of PPE and sundry cleaning supplies at my office. I'm also happy do the legwork of buying supplies if anyone wants to contribute a cash donation. To be clear, there is no non-profit organization connected with this endeavor, so I can't reciprocate your generosity with a tax break. I'm just trying to offer help to as many people as possible and your donations can help me do this. It will definitely give us both a good feeling to do this and, right now, we can all stand to feel good about something!

Here are items I will be accepting at the office:
- unused cloth or paper protective face masks
- hand sanitizer in any size bottles
- liquid soap in any size bottles
- liquid bleach in any size bottles
- nitrile or vinyl medical grade gloves
- clean used or new bed sheets of any size
- clean used or new towels of any size
- laundry detergent.

I've already received a kind offer of discounts on masks from Dana Herbert Accessories and Dana has also offered a number of factory seconds masks at no charge. I will be contributing these masks, as well as other supplies on the list. Please check out Dana's masks the next time you're at New Seasons or online at www.danaherbert.com. Her masks are well made and quite beautiful. And for every mask she sells, one dollar is contributed to Oregon Food Bank.

You don't have to be a current patient to join this effort. I will welcome any and all contributions, no matter how large or small. Please help me make this happen.

Also, if you have friends or family members who would be interested in contributing, they can call me at 503-484-3513 for more information.

As always, I hope everyone is doing well. Remember to wear a face mask (wash it daily and make sure it covers your nose), wash your hands and face frequently, maintain social distance, minimize social contacts with others and do whatever you can to promote a healthy immune system!

Lastly, thank you for your continued business and support through this challenging time. I value and appreciate all of you!

Clinic Re-opening Policies in Response to Covid-19

by Rick DeTroye, LAc, MAcOM

Clinic Re-opening Policies in Response to Covid-19, Rick DeTroye L.Ac. LLC in Northeast Portland, OR

Conboy Lake National Wildlife Refuge   Glenwood, WA   May 21, 2020

As many of you know, I've been busy preparing for the re-opening of my clinic on Tuesday, June 9.  At this point, and to my surprise, the schedule is full for my first week back! I've made some changes to office operating procedures and there will probably be a few more that develop over the coming weeks. This new world of COVID-19 is all uncharted territory for me. The biggest thing I ask from everyone is a bit of patience as I figure things out because, really, everything has changed and will continue to as I adapt to this re-entry. In many ways, it's like starting a new business, which means it's both exciting to get going again and somewhat daunting. That said, it will be good to see everyone and to start treating again!

In order to provide a safe clinic environment both for you and me, I'll be abiding by specific interaction and hygiene protocols when you come for a treatment. If you've been to other health care offices, you're probably familiar with these, but for those of you who aren't, here is the upshot of how things will work:

- If you suspect you're sick, even if you suspect it's just a cold or flu, please do not come in for treatment. Just call or text me to let me know. I will not enforce a late cancellation fee in this instance, so don't worry about that.

- If you know or suspect you've been in contact, within two weeks of your scheduled appointment, with someone who's sick or has been diagnosed with COVID-19, do not come in for treatment. Again, just call or text me. If you give me at least 24 hours notice I may be able to fill your spot, so please give me advanced notice if you can.

- Please wear a mask or face covering. Simple cloth masks are fine, but everyone is required to have a face covering on when they arrive and to wear it throughout the duration of their treatment. As a reminder, you're wearing a mask to protect me and I'll be wearing a mask to protect you. It's a win-win situation. If you don't have a face covering on when you get here, you won't be allowed to enter the office, you won't receive a treatment, and you will be charged a no show fee.  Much as I'd like to provide masks for patients, the cost and difficulty in obtaining masks makes this impossible.

- Please come alone to your treatment if you can. Friends and family will not be allowed to wait in the reception area. If someone accompanies you to your appointment, they will have to wait in the car during the duration of your treatment.

- If you arrive early, please remain in your car until your scheduled appointment time. When it's time, come up to the door, ring the doorbell and I'll let you in.

- Please turn your cell phone off before you enter the clinic. Eliminating the distraction of a phone will make it easier for masks to stay in place and will likely enhance your ability to relax during treatments.

- Until further notice, I'm observing a "no handshakes/no hugs" policy. When you come in, a simple hello or even a joke will suffice. Make sure it's a good joke though...

- After you enter the clinic, I'll take your temperature and review a list of questions to help me identify people who may be exhibiting symptoms of COVID-19. If you have any of those symptoms, I won't be able to treat you, but there won't be any late cancellation/no show fee assessed.

- Before we proceed with the treatment, I'll have everyone wash their hands in the bathroom. Only one bathroom will be available for patients. I'm hoping it will be marked by Tuesday. There is a chart on the wall in the bathroom outlining proper hand washing technique. Even if you think you know how to wash your hands, please check the chart to see if you're missing anything. Hands should be washed for a minimum of 20 seconds and some sources even recommend 40-60 seconds. I'm okay with 20 as long as it's done properly. Yes, I did go to Catholic school and I am three-fourths German, but I can still be flexible!

- I will continue to have the table warmer and heat lamp available for your comfort during a treatment. However, blankets will not be available, so if you think you might need one on these cool days, please bring bring your own blanket or covering.

- The water cooler/heater will no longer be available for patient use. If you need a drink, just ask me and I'll get you a cup of water.

- Though I enjoy talking with everyone after treatments, I won't have the available time to do that now. I've scheduled 30 minutes between patients to guarantee sufficient time to change linens and clean treatment tables, treatment rooms, door handles, table tops, light switches, payment devices, phones, my hands, etc. Just wanted to let you know I'll be on a tighter time frame and if I cut you off mid-sentence, it's only because I have to get ready for my next patient.

- As if that's not enough, I'm still working out payment systems to minimize handling of credit cards. Right now, I'm still only using Square, but now have a Square reader which should take chip cards, ApplePay and GooglePay, and is freestanding so you can do all the swiping without me touching your card. I just received it, so will spend Monday trying to get it set up and available for use on Tuesday.

Okay, whew! That's about it. I'm hoping to get out another brief newsletter soon to pass on information about Vitamin D, infections and inflammation. There are many interesting ideas developing about the possibility of Vitamin D reducing the effects of COVID-19 for all people, but especially for people with dark skin. In the meantime, check out YouTube for videos by Dr. John Campbell and Dr. Ryan Rehl, specifically those discussing Vitamin D.

Hope you all are doing well and navigating the journey life is taking us on right now. Remember to stay as calm as you can, get plenty of rest and exercise, meditate if you like, and treat yourself and others with patience and kindness.

Best to you,
Rick

Clinic Re-opening June 9

Clinic Re-opening June 9, Rick DeTroye L.Ac. LLC in Northeast Portland, OR

Nootka Rose   Columbia Slough, Portland, OR   May 17, 2020

Just a quick note to let you know I plan to start seeing patients again on Tuesday, June 9. In terms of the Covid-19 pandemic, I believe anything could happen between now and then, and I will keep this date flexible depending on local and national infection statistics. If numbers indicate a continued reduction in positive cases, I will stick with the June 9 re-opening. If numbers begin to trend significantly upward and another peak infection phase begins, I will remain closed. For the time being, however, you can look forward to acupuncture treatments again beginning June 9.

At this point, I have almost everything I need to operate with the new safety requirements. I'm still waiting for a no-touch thermometer to be delivered, as I'll be taking everyone's temperature when they arrive for appointments. This is now standard operating procedure in all medical offices, so it probably comes as no surprise to you. As I get closer to re-opening, I'll send out another update with information about additional office safety protocols and what I'll need patients to do to ensure a safe treatment environment for everyone.

I'm also hoping to streamline payment interactions with people as much as possible by setting up multiple options for copays and treatment fees, including ApplePay and Venmo. And much as I like cash and checks, it's unlikely I'll be accepting them, at least for the time being. I never thought I'd say that!

Lastly, with so much talk about re-opening and "getting back to normal", I encourage everyone to continue washing hands for a minimum of 20 seconds with soap and warm water, wearing a mask in public, and maintaining six feet of social distancing when in public and meeting with friends. The reason we were able to keep Covid positive numbers down was because so many people observed these practices during the shutdown. According to all reliable sources we are not out of the woods and won't be for quite some time. We can't beat this pandemic, but we can maximize our ability to stay safe. And, thanks to everyone for your continued patience with and mindful concern for others. That's what it's all about...

Clinic Closure Update: March 23, 2020

by Rick DeTroye, LAc, MAcOM

Clinic Closure Update: March 23, 2020, Rick DeTroye L.Ac. LLC in Northeast Portland, OR

Columbia Slough   Portland, OR   March 21, 2020

Three weeks ago, I thought I'd be visiting an old friend in New Mexico right now. How quickly plans change. These past weeks, life as we know it has been shifting moment by moment. Coronavirus has impacted all of us in ways we didn't expect and will continue to do so in ways we may not anticipate.

As it looks now, the forecast for Covid-19 is not good and we appear to be bracing for the brunt of it here in Oregon. My chief concern is to avoid possible exposure for both patients and me.  The only way to do this is to eliminate close physical proximity and, in my opinion, the most responsible way to do this is to not treat patients. This is a difficult choice, but I believe the best for everyone.

So, as of today, I am closing my practice until further notice. I will reopen as soon as I'm able.

My apology to those of you who are scheduled for the upcoming weeks. To avoid confusion, I'll be removing all previously scheduled appointments from my schedule. You should receive a notice of cancellation. If you don't, let me know and I will call you to confirm.  

At some point, hopefully sooner than later, I will send another update with an "all clear" message letting you know when I will be back in practice.

In the meantime, I encourage everyone to practice social distancing and maintain a minimum of 6 foot distance from all people except those you live with. It appears Governor Kate Brown will be issuing a shelter in place order today. Please take this seriously. We need to slow down the progression of this disease so our medical services are not overwhelmed and can deliver life-saving treatment to those who need it. These measures will help achieve that goal.

And by all means, wash your hands (and face) regularly through the day. Even if you don't think you're in contact with the virus, you may be. What you can't see can kill you and your loved ones as well.

I also encourage everyone to read as much as you can about Coronavirus. Not sensationalist accounts, but the facts of the disease: how it spreads, what it does, how to prevent it. Knowledge can be life-saving, now more than ever.

Two very good resources for information are Centers for Disease Control and Oregon Health Authority:

CDC: https://www.cdc.gov

OHA: https://govstatus.egov.com/OR-OHA-COVID-19

If anyone has any questions about the closure or about Coronavirus, feel free to call or email me.

Most importantly: Stay healthy!

I look forward to seeing all of you in the not too distant future.

Winter Solstice 2018

Winter Solstice 2018, Rick DeTroye L.Ac. LLC in Northeast Portland, OR

Yachats, Oregon. Thanksgiving 2018. It was an amazing sunset.

Season's Greetings & Happy Solstice!
I hope this note finds you healthy, relatively unstressed, enjoying get togethers with friends and family, and finding a bit of quiet time amidst the holiday frenzy. This time of year is wonderful, in between rain and wind storms of course, and offers us opportunities to slow down in so many little ways. I sometimes need reminding to take advantage of them! Maybe it's my age, but in the past few years I've relished the long, dark days much more than when I was younger. For some reason, getting up at 5:30 is easier than it used to be and I actually look forward to sneaking out of bed to sip on hot tea by the light of a Christmas tree. It's quite comforting.

A late friend of mine (who was very wise) once spoke with me about Winter. He said the world slowed down and nature's deeper qualities, masked by activity in Spring, Summer and Fall, reveal themselves more readily and more clearly in Winter. Like when trees lose their leaves and you begin to see what's underneath and hidden in their branches. Maybe that's what I sense in the darkness of Winter. It lets me look a little deeper than I normally would, to be a little quieter, to listen more clearly and closely. It forces me to move more slowly and deliberately, both on foot and while driving, and especially with streets and sidewalks wet and slippery and sometimes covered with snow. It affords me the opportunity to step back and look at life and be grateful for all that comes my way.

All in all, I'd say it's been a great year. Thanks to all of you for helping. I appreciate your continued trust, referrals, and allowing me to assist you with your health care.

And now, on to a few updates and health tips...

We Are All Receptionists At Heart: The transition to on-line appointment scheduling has gone pretty smoothly. Most people have found it easy to use and it's saved everyone time, including me! Thanks for giving it a try. The only glitch seems to be with cancellations. In order to cancel or reschedule an appointment, save the original appointment confirmation notice that comes to you via text and/or email. A link on that notice will take you to a page for appointment changes. If you delete the notice, you lose your ability to cancel or make needed changes. As always, I'm happy to set up appointments and make needed changes for those who deleted their confirmation or would rather not use the online service.

Don't Forget Your New Cards: Most health insurance plans provide calendar year coverage, which means some people will be changing plans. For those folks who have acupuncture coverage and are changing plans, please bring in your new insurance cards so I can make a copy for your chart and double check your benefits.

Warning! Please Read The Fine Print: Sorry to be the bearer of less-than-glad tidings, but for patients with insurance coverage from Moda and Regence, please read the details of your acupuncture coverage carefully. Though they do offer plans with more liberal acupuncture benefits (such as City of Portland and Federal Workers Benefit), both companies sell plans (usually individual plans) that require pre-approval for treatment and have specific restrictions. When I treat someone with this type of policy, I have seven days to submit a treatment plan requesting approval for that treatment and subsequent follow-ups. Treatment is only approved for acute conditions related to musculoskeletal pain. No treatment will be approved for chronic conditions or issues outside the scope of musculoskeletal pain. In truth, many companies are reluctant to cover acupuncture for chronic conditions, but some allow a bit more flexibility. In the case of pre-approval, Moda and Regence do not. They expect to see musculoskeletal pain improve and resolve in a relatively short amount of time. And, payment for charges is possible only when they approve treatment. If approval is denied, payment for the service becomes the responsibility of the patient. I know these are rather blunt facts, but they're important to know if you're choosing or have already signed up for one of these plans.

Black Is Not A High Visibility Color: A few years ago, a different friend scolded me for not wearing reflective clothing when walking at night. I was a little defensive at first, but after mulling it over I realized how invisible I must have been to bikers and drivers. My wife and I immediately bought reflective vests and have worn them ever since. Since then, a number of people have commented on how visible we are at night while wearing them. I'm convinced the vests saved us from getting hit more than once. If you're riding or walking at night, please spend the little bit it costs to insure your safety. Wear a bright yellow reflective jacket or vest, carry a flashlight, put fresh batteries in your bike's headlight or taillight, wear a headlamp, put reflective bands on your wrists and ankles. I realize every time I walk into New Seasons wearing my reflective vest, carrying a flashlight and lugging a daypack with a blinking red light attached, I look like a crossing guard. I also know that a trip to the store without getting hit by a car makes my lack of fashion sense well worth it. Black may look great in a restaurant, but it is not a high visibility color!

Haramaki Love: In cold weather, wearing a hat will keep you warm. Wearing a hat and scarf will keep you even warmer. But, wearing a hat, scarf and a haramaki provides the ultimate in warmth. A haramaki? Yes, a haramaki. I can't say enough about the benefits of wearing a haramaki. It's like wearing a neck gator around your waist, trapping body heat while sealing out cold and wind. On cold days at work, I'll even wear one in the office. It gets chilly in there sometimes! Check them out here: https://haramaki-love.myshopify.com. I recommend the Luxe Black model. I own three of them! Also, check out the Benefits section of their website for more info on how a haramaki helps your body stay warm and how it can help you stay healthy.

Pray For Snow: No, really. Pray for snow. Portland is so beautiful when it snows...

And, Lastly: Whatever holidays you celebrate this season, I wish you well and hope you're able to enjoy them with friends and family. Since I celebrate three holidays, I'll also wish you Happy Solstice, Merry Christmas and Happiest of New Years. Have a great Winter and remember, the days get longer from here on out!