Thursday, May 26, 2011

KNEE HEALTH: How To Keep Your Knees Healthy & Heal Them From Injury

"I just don't want to end up on something that bores the hell out of me. Otherwise, I'll fake a knee injury and get out of there." ~Sasha Alexander

Knee injuries. Unfortunately, something I see a lot of in my practice. Particularly in a town like Bend, OR. Bend has been called "Little Boulder" or "Mammoth North." It is a town full of not just "weekend warriors," but everyday gladiators. Residents make the most of having stellar snow conditions 30 mins. from town in one direction, while having access to "Smith Rock State Park" 30 mins. the other direction. Pulling a "double" or a "triple" is not unusual here. What form can that take the shape of? A morning trail-run, an afternoon climb, and an evening mtn. bike ride. Or...a morning of skiing (or snowboarding), a lunchtime kayak sojourn, and an evening road ride. "Bend-ites," as they're known, push their limits to the max., and love every minute of it.

However, with the local love of the outdoors can come a few "battle wounds" along the way. Knees enable "gnarly turns," steep terrain and downhill scrambling. On occasion, however, they rebel. When they rebel, they tend to rebel with a vengeance, making for a very unhappy patient. You see, when a "Bend-ite" is laid up from doing what s/he loves, lower lips begin to protrude and people get cranky (including their loved ones who have to live with them).

I hear it, week-to-week, in my clinical practice. "But, but...I was just getting on a roll with my training!" My practice is focused on sports medicine, and keeping the good people of Bend alive and kicking, so they can continue getting muddy, wet and bruised up. This makes for a very happy Bend-ite. :)

I have a personal vendetta: to get my patients well. Why? Because many of them are either my athletic inspirations or climbing partners. This means I'm emotionally invested, and actually it feels kind of nice to be. I enjoy seeing my patients run pain-free past me on the trails, or climb on the route next to me on the rock. I enjoy hearing their excitement as they recant a story of "the best mtn. bike ride yet!" This makes me happy. To see humans enjoying the Earth they live on. Living it up to the fullest in the beautiful high-desert.

However, for all of this to occur, knee health is paramount. There is no way around this. Maintenance and prevention are crucial for everyone, but particularly for an athlete. How to do this, though? I will share with you some tips to help keep your knees cruising those trails and hiking those hills with ease.

In Chinese medicine we treat "like with like." This is also a homeopathic approach as well. People take glucosamine, MSM and chondroitin supplements. Want the most bio-assimilable ingredients to help protect and treat your knees? Eat them. Sound strange? Indigenous societies functioned on a premise of zero waste. The entire animal was used from the hunt. Where is all the perfect cartilage, gelatin and collagen found that is specific for knee health? In the knees of the animal. Eat substance from knees to treat your own. Ever wonder why grandma made broth out of knuckle bones? Wonder what those bags of knuckle bones in the freezer section at your grocery store are used for? Bone broth (specifically, knuckle bone broth) has been called "nature's penicillin." It is a powerful nutrient source of the perfect collagen/gelatin/cartilage make-up that is a powerhouse for your knees. No man made supplement, or isolated ingredient will compare.

Traditional Chinese knuckle bone broth with lotus root. A staple in rural Chinese homes

By the way, principles of "Paleo" or "Primal" nutrition are the same for animals as for humans. Feeding your dogs a glucosamine supplement is pretty pointless. You're better off buying a bag of knuckle bones from your local butcher. You get 1/2 and they get 1/2. :) Their bodies (like ours) are governed by the same principles. We readily break down whole food compounds. Not isolate ingredients. Your body knows what to do with a lemon, but ascorbic acid that's been isolated from a lemon? Not so much. To isolate compounds, and extract them from the whole is a new thing in dietary history. Your grandmother ingested cod liver oil. She didn't take synthetic vit. D tablets. Bottom line: if grandma did it, its probably pretty good for you. If a lab made it, steer clear. If you're going to do additional supplementation (& I do suggest athletes do), then make sure what you're ingesting is a whole food based product. Otherwise, you're going to have very colorful, expensive urine that is excreting the majority of what you're hoping to absorb out of the body.

YOGA: Bikram Choudry could be considered a master of "therapeutic" or "medical" yoga. The system of yoga (asanas done in a heated room) is what is done in Ayurvedic hospitals in India. I've done an internship in 2 separate hospitals in India, and witnessed this first-hand. Yoga is their version of physical therapy. In America, we want someone else to stretch us, contort us, and and massage us. Why not take the responsibility of doing it yourself? You will begin to feel as though you're a musician tuning an instrument, and become incredibly self-aware of what your body needs, when it needs it. Rarely do mono-sport athletes take the time to incorporate other forms of fitness into their existing training regime. They want to do what they do best: run, bike, ski, etc. This is nice in theory, but relatively unrealistic if you want any form of longevity to your sport-of-choice training. Yoga must become a non-negotiable in your training, no matter what sport you're into. Stretching is always the element of fitness to go by the wayside, and the most important to maintain. You will be more susceptible to injury without it. Guaranteed. I've seen this, time and time again, in my clinical practice over the years. Want to run longer, faster and farther? Do yoga. Want to cycle those hills with greater efficiency? Do yoga. Want to maintain an injury-free lifting program? Do yoga. Period.

Bikram Choudry demonstrates the "Eagle Pose" (Garurasana), which opens the 14 largest joints of the skeletal system, and is powerful for treating knee pain

Having worked in a physical therapy sports clinic, where the U.S. Snowboard Team receives treatment, I've seen consistently the use of heat and stretching. This is "Bikram Yoga." As Bikram says: "Be your own physical therapist. Don't wait until you need one."

"Fixed Firm Pose" (Supta-Vajrasana) increases circulation to the knees, prevents varicose veins, and improves flexibility of all major lower joints

To stretch ligaments in a non-heated environment can be hazardous, particularly in the winter. When your ligaments and tendons are cold, they're like taught guitar strings. They can snap. They "open" and become more loose with the introduction of heat. You will be able to go deeper into each asana (yoga pose) with the elongation of muscles, ligaments and tendons due to the heat. People say "But can't you overstretch in the heat?" You will begin to become extremely "body aware," just like when you run, lift, climb or bike. You will know when you've reached, as Bikram says "The pain of stretching versus the pain of injury." Like anything active, to "tune out" is not beneficial. Listen to your body, and fine tune it like an instrument. Then you will be in "dialogue" with it, and you will know. In the practice called "Chi Running," this is called "body sense-ing." Which leads us to our next topic...

FORM: The folks that I've treated the most for knee injuries are runners. This is not to say that knee pain will be inevitable for runners. In fact, I believe it can be quite the opposite. This is also not to say that athletes who do other sports don't suffer knee injuries as well. Good form, in any athletic endeavor, is imperative. Again, a non-negotiable. Only recently, in the past few years, have runner's been discussing the importance of good running form. It is an ongoing practice of listening to your body, and "fine tuning" it as you clock the miles. I begin to feel my right knee if my running form is not in alignment. This, for me, is because I'm not engaging into the lean, referred to in good running form practices. We tune our bikes, re-sole our shoes, and wax our skis. Our body is the most important device to maintain proper maintenance of. If you're a runner, this means, not only finding your "sweet spot" running shoe, but diligently practicing a form of running that puts you in proper alignment as well. There are several forms out there that can teach you methods to maintain good running form. "Chi Running" is one, the "POSE Method" is another. There are others that are also beginning to crop up. The bottom line: they all hint at the same thing. Mid-foot (ball of the foot) strike, proper cadence, proper alignment. The way they may teach these things might vary a bit, but they all agree on these general principles. Talk to your local running store about classes they may offer, or local coaches they may suggest, to assist you with good running form.

VERTICAL FUNCTIONAL FITNESS: We live life moving on a horizontal plane. There is an old adage in Ayurvedic medicine: inversions (handstands, etc.) and vertical movement lengthens life. Why might this be? To give a simplistic metaphor, we are like a snow globe. We too need to be "shaken up a bit" from time to time. When we move purely on the horizontal plane, day in and day out, its like the snow gathering at the bottom of the snow globe. The sediment just collects there, and doesn't circulate properly. We are meant to literally "jump for joy!" as humans. Our knees should be as supple as springs in a mattress. Joseph Pilates often referred to this while training trapeze artists and professional ballerinas. "Use your springs!" he would say.

"Jumping For Joy!" is good exercise

Jumping and vertical movement is very strengthening to the knees. It keeps them supple, and the ligaments supporting them very strong. I recommend watching "YouTube" videos of gymnasts who do rebounding (a fancy name for jumping on a trampoline). Their knees are so strong. They have the legs of a speed-skater with the suppleness of a ballet dancer.

Rebounding strengthens your knees

Children intuitively jump on the bed. Parents instinctually bounce their child on their knee. Vertical movement is powerful, like shaking up the contents of a snow globe. Studies reveal it increases circulation, stimulates the lymphatic system (the garbage service for your body), and keeps your knees very strong.

Box-Jumps In "CrossFit"

Jumping on a trampoline (even a mini one), jumping rope, doing box-jumps, or using a jumpboard are all powerful (and FUN!) ways of strengthening your knees. They will begin to feel strong after only 2 weeks of consistent jumping, 3-4x per week. Due to the power of vertical movement, Joseph Pilates created the jumpboard to add to his reformers. They are fun, and intensive to work with. He knew that for his ballerina clients to be able to maintain proper posture and alignment on pointe shoes for hours, that not only was a strong core imperative, but strong knees as well. Hence, the birth of the jumpboard in Pilates.

Pilates Jumpboard

HILLS: The word gives people a sense of dread. People frequently experience knee pain, whether its going up them, or down. This is all the more reason to work on hills. Work in small increments and inclines, if you have a pre-existing knee injury. But do incorporate hill work, slowly but surely. If you need to use trekking poles to assist you then do. But actually going up and down hills will not only engage your core, versus working on a flat surface, but strengthen your knees over time as well.

Hiking hills, up and down, strengthens the knees

ACUPUNCTURE: You change the oil in your car. You get tune-ups for it. Why should your body be at the bottom of the self-maintenance list? Its kind of strange to go in for a "knee massage." That's not to say you can't have your knees massaged by a professional LMT if you're experiencing knee pain, but acupuncture is extremely effective at getting deep into tendons and ligaments surrounding the knee to not only quell existing pain, but to prevent it. Add electro-stimulation to the needles and you have a very powerful treatment indeed. Remember: Oriental medicine is not a medicine for "softies." Its is a viable part of any sports medicine treatment protocol. It really could be considered the world's first sports medicine. Honed, over the centuries, by sparring warrior monks, who suffered myriad injuries and blows, it is truly a cure for knee pain that is unparalleled.

Electro-stim. acupuncture is wonderful for prevention and treatment of knee pain

"Knee replacement is serious stuff. And it actually could have made me worse." ~Lee Majors

Monday, May 2, 2011

A Journey Through Darkness

(1984) "Well, we could put her in dance class, Bill. Perhaps that would keep her out of trouble?" I pulled the covers up around my face as the breeze from my window made a soft whistling sound. The breeze was cold. The type of cold that only carried itself on an ocean breeze. I could almost taste the salt on my lips as it brushed them.

"She's no athlete, Almine. Hell, why not? Put her in ballet. We've already got a teenager on our hands to deal with at the moment." I could feel my stomach clench. As if I had been punched.

"If I had a dime for every time that child scaled the back fence..." my mother's voice trailed off. "I can't keep replacing it, Bill. Its getting too expensive. Higher and higher, thicker and thicker. Its like she doesn't want to be kept inside of it. I'm concerned this is a preview of things to come for her."

"We have bigger issues on our plate right now," my father replied. "We need to get Brent glasses, and take him for another eye exam. Monique's rebelling every which way, and I blame us for all of it. I was too hard on her. Shit, she's just a kid. The oldest always gets it the roughest. Damn it, I wish I could've done things differently..." the voices trailed off as the wind picked up outside. The branches began to make a screaming sound as they scratched the window. My eyelids began to feel heavy as tears streamed down my face. Then...nothing...just blackness...

My parents put me in dance when I was very young. I loved it, but also felt like I needed something else.

(1991) "You know, you're just like you're sister, Almine," my high school P.E. teacher looked at me, narrowing her eyes. "I don't know what to do with you. Just like I didn't know what to do with her." She stormed off, leaving me alone in the locker room. I didn't understand what she meant, but I didn't feel good about it.

That night, as I sat by the fire doing my homework I asked my mom "Mom, do you think I can do things?" She looked up from the scrapbook that she was putting together for my sister's birthday. "What kind of things, honey?" "Ummm...I don't know. I want to do sports." "Well, you do cheerlead. Do you not like that?" she asked in her thick South African accent. "I like to make people happy, and get them to cheer for one another, but I want to do something else." "What are you interested in?" she asked. "I tried to lift some weights at school today, but the boys said that girls weren't allowed in the weight room." There was a long pause, and an uncomfortable silence.

"Sweetheart, you know your Oma was very strict with me. Private schools, tea at 4 pm, that sort of thing. I grew up in a world of lace and dolls. I've always known that you wouldn't be drawn to that, but I've been unsure as to how I can support you best. I don't know anything about weight rooms. This is something you should take up with your father, okay?" she let out a nervous sigh, and went back to her myriad tubes of colored glue and glitter.

The next morning, as I was getting ready for school I found my dad in the kitchen. "Hey dad, I was thinking..." My mom came in and swiftly moved to fix his tie. My father's unruly tie was about as irritating to my mother as a painting askew on a wall. "Hmmm???," he murmured. "Weights. I'm interested in the weight room at school," I said nervously. He grabbed his glass of juice in the right hand, his briefcase in the left, and exited the kitchen. My mom just looked at me, shrugged her shoulders and said "Honey, do you want to take a scone and some rose petal jelly with you to school?" I always thought it was sweet when my mom said "Scon." Anytime she heard the pronunciation of the word "scone" as "scone" you could see her wince.

As I watched the clock tick towards 11am I swallowed hard. P.E. I couldn't stand it. I felt awkward, always being barked at by the P.E. teacher and sport coaches out on the field. I looked at them with amusing disdain. They were barking orders at me? Am I supposed to be inspired by them? I watched them, as they talked amongst themselves, drinking milkshakes with their huge stomachs...a pinnacle of fitness and health? I was no one's dummy. I could see a person who didn't walk their talk then, and I can see it to this day. I felt no need to perform for them, or anyone. I didn't want to play for their team. I felt no allegiance to them and their early retirement. I wondered where I could be inspired?

"MOVE, Barton!" I heard accompanied by a whistle. "No!" I shouted back. The footsteps circling around the track fell silent. I realized an instant audience was born. My peers were watching me with round eyes and amazement. "What did you say to me?" the coach walked towards me with menacing eyes. She realized that the pressure was on. This was the moment she'd been waiting for. The moment she, once again, got to resurrect herself as authority figure. I could smell her hot breath, reeking of cheap fast food, as she got in my face. Her breath rapidly escalating with each passing second. "You heard me," I retorted. "I said NO!" "Who do you think you are?" she shot back. "Someone special?" "In fact, who do ALL of you think you are?" she said rotating around so that she got a glimpse of every student watching. "You're not special. You're not unique. In fact, I can't even figure out why I bother teaching teenagers." I stormed off. "Get back here, Barton!" I could hear snickers from my classmates, and her screeching in the distance. I kept walking. I walked from my high school down to the ocean at "Nye Beach." There I sat in my P.E. uniform and cried until my eyes stung. After an hour of sitting there, I couldn't tell if my eyes hurt from the salt of my own tears, or the salty air. I shivered a deep shiver. I realized it had been misting. My hair and skin were wet.

Newport, OR., where I grew up

(1992) As soon as I saw the sign I knew I wanted to be a part of it. "SURF CLUB" it read. I felt like jumping for joy! Finally, something that sounded interesting to me. I was getting more restless with each passing quarter. I couldn't put my finger on it, but could feel a need to move in a different way. I wasn't sure what that meant, but maybe the surf club was the answer. I inquired about it from a teacher. She looked me straight in the eye and said "Oh honey, girls don't join that club," and walked off. I began to ask around in school. I was directed to one of the junior boys, who was a member. I said "Hey, I'd like to be a part of the surf club." "Do you know how to surf?" he raised his eyebrow. "Well, no, but I'm eager to learn. I won't get in the way of you guys out there. I'm a quick learner," I was hopeful. This was it. I could feel a wave of excitement. "Don't bother," he said as he walked down the hall. That day, I felt a deep sense of sadness. A part of me began to leave my social peers emotionally. I felt bewildered, as to how there were very few opportunities for the things I was most interested in. I formed a plan. A plan to leave my school to find those opportunities. I wasn't sure where to look, or where to go, but I was determined to get out of Newport.

Surfing, OR. Coast, 2009

I began to work very hard. I took three 4-credit community college classes at the "Oregon Coast Community College" in the evenings, each quarter, to work towards early graduation. In 10 months I earned all the necessary credits to graduate from high school a full year early. I was so happy! I was managing both my high school classes, and my college classes in the evenings. I found my high school class homework dull and lifeless compared to the classes I was taking with the adults in the evening. I reveled in the adult discussions that were brought to each college class, filled with the life experience of those in their 30's and 40's. I loved the rich, creative environment and the stories that were shared by the returning adult students.

Finally, the day came. I received my OCCC transcripts with a 3.8 GPA, and a few credits over what was required for me to graduate early. I had my parent's reluctant approval to head to college one full year early. As I proudly walked down the hall towards the main office of my high school, transcripts in hand, a teacher stopped me in the hall. "Barton! Just what do you think you're doing?" he barked. "Actually, I'm really excited to show you this," I said pulling out my college transcripts. "Look what I've been doing in the evenings," I pointed to the paper excitedly. I was so proud to show one of my teachers all of my hard work. "Just what do you think you're doing? You think you're above your classmates? You think you're ready to leave this nest? I don't think you are, Barton. In fact, I don't think you'll amount to anything. You heard me. Anything!"

He turned on his heels, and stomped down the hall. I felt my knees buckle, as I steadied myself to sit on a bench. My eyes felt hot, brimming with tears." My transcript papers fell out of the folder, to the floor, like feathers.

(2000) I could hear her high-heels against the linoleum floor. They were coming towards the treatment room I was in. As the door opened I looked up. "Ms. Barton?" the doctor inquired. "Yes, that's me," I said softly. I'd like to go over your lab test results with you, if you're ready?" "I am," I said calmly. "Frankly, Ms. Barton, I'm a bit puzzled by some of your numbers. I don't see this thing often. Are you a vegetarian?" "Yes. Actually, I'm a vegan," I stated. "For how long have you been eating this way?" she asked. "I've been a vegetarian for 10 years, a vegan for 5 of those years. Why? Is something wrong?" I knew I felt "off," but didn't anticipate anything being wrong with my health overall since I pretty much lived off of salad, fruits, brown rice, beans and tofu. That was healthy, right? What could she possibly have to say to me that I wasn't already doing? "Ms. Barton, I'm not quite sure how to word this, so I'm just going to come out and say it. Your body is in the "red zone." What I mean by this is that everything is too low on your blood panel. "But, how can this be?" I inquried. "I eat all organic. I get check-ups regularly. I even have a naturopathic physician oversee my diet and menu plans, so I make sure I get what I need nutritionally speaking." I was dumbfounded. I was a member of the "Portland Vegan Society."

Sure, I was a bit overweight for my norm, but I had just gone through a divorce, was "couch surfing" from house-to-house, & starting graduate school. Okay, so maybe I had been stress eating a little bit, eating more than I really needed, but unhealthy? No. Not possible. "Ms. Barton, may I inquire about your monthly cycle?" "Its great," I said with a shakey voice. I haven't had one for four years. I'm loving not having any cramps, back pain, or PMS. Its like menopause without the hot flashes," I said jokingly. She looked back at me unamused. "Ms. Barton, what I'm about to share with you may sound bizarre, but I need you to hear me." Her voice got low, and she pulled out my blood panel notes. "You are in serious danger of doing damage to certain vital organs if you keep this up." "Keep what up?" I replied with indignation. Saving the animals? Doing good for the world? She didn't know what she was talking about. She was just jealous I didn't have a period. Maybe she was tired of her own menstrual cramps, and projecting on me that I should have them. Who did she think she was anyway? What do doctors know about nutrition? What a bitch.

As silence permeated the room, she said "Can I walk you through what I'm seeing here?" "Fine," I groaned. "But, I need to leave within 20 minutes for a class, so can we please just do this?" "Yes, certainly," she said firmly. "Do you see this number here? It indicates that your cholesterol is so low that you're endocrine system is beginning to go on strike. You're making barely the amount of hormones that we would need to even see a low-end number. This has taken a great toll on your body. I'm concerned certain gynecological processes maybe heading for the point of no return."

205 lbs., vegan, achy joints, migraine headaches, in this picture I had had no monthly cycle for 4 years. I was diagnosed with Fibromyalgia, Chronic Fatigue Syndrome, and Obesity 1 week after this photo was taken.

"In addition, you're not getting enough protein. Not even by a long shot. This has caused a 'neuro-endocrine response' that has triggered your body into retaining adipose tissue. It believes its starving. Your BMI test indicates you would be in the bracket, for your height and age, in a state of obesity. I realize how strange it must sound, to hear me using the term 'obese' when you eat nothing but 'rabbit food,' but truely, that's what has happened." I grabbed my coat with fury. "Thank you for your time, Dr. As I said, I have a class to get to." With the slam of the treatment room door, and a flushed face I drove off.

(2002) "You know I love you, I'm just not attracted to a woman, well, of your 'body type,' shall we say?" I couldn't believe what I was hearing! What? What did that mean, "body type?" "But, but...I love you so much," I said stuttering, tears streaming down my eyes. "Almine, I want to break up. I feel as if there will be someone out there...(long pause)...more attractive. I'm looking for someone shorter, and skinnier." I felt like I was floating out of my body, watching the scene below me. I was mortified, angry, devastated, embarrassed. I felt as if my world was crashing down around me.

Several months later I found out his new "shorter, skinnier" girlfriend was pregnant with his child. She was still married at the time to her husband of many years. I walked through a maze of hell, day in and day out, as I watched them together in our tiny graduate school program. They would flaunt their new-found status as "couple" together overtly. I was confused as to the level of pain they were willing to cause, not only to themselves, but to each other. She was my study partner in school. He and I had traveled to foreign lands together, had amazing journeys in primitive places, some which, doubtful, had ever been seen by anyone but the indigenous natives. I barely got through that year in school emotionally intact.

Still maintaining 205 lbs. 1 year later. stressed, short of breath, feeling more tired and achy by the week.

Medical programs are intimate. Draping, body-parts, palpation, practicing point location on the body. Its what any medical professional has to go through. I felt emotionally vulnerable and exposed, half-naked next to them for hours on end. So, I ate more to cope with my pain. There was nowhere I could run or hide. I had to hold my head up, and deal. Eating was the only coping mechanism I had. I justified my oversize portions because they were "healthy foods." Still sticking to the cheap bags of brown rice, and gallon buckets of tofu, I would eat two bowls, instead of one. I ate myself through graduate school until I reached 205 lbs.

A Time Of Darkness For Me, Emotional Eating, Energy at Zero, Felt Like I was barely Getting Through Each Day

A week after graduation I woke up to a reflection in the mirror. She looked tired. Her joints ached. She had dark circles under her eyes. She went back to sleep, and slept almost 2 full days straight. She woke up, ate something, and slept for another 24 hrs.

This picture was taken in 2005. I began to feel my soul stir from something deep within myself...

During that sleep, she felt her soul stir. Inside the darkness of that dreamlike cocoon her wings began to feel themselves. Her heart rested. Upon daylight a new creature was born. What had happened during that sleep I may never know. What I do know is this: a new woman emerged. A woman with hope in her heart, and determination in her mind. She has never looked back. Her wings turn different colors every year. The hues stay the same, but the iridescence becomes more brilliant.

I began to feel happy again, 2008

It has been said that a stained glass window only shows its brilliant colors when light is shown through it. We are all like this. The dark moments of our lives are really the greatest gifts. If we can take them, and use them as fuel for our journey, perhaps, we too can shine like the glass in the most beautiful of cathedral windows.

Sierra & I ;-} Sierra was the dearest companion I had for 9 years. She started my journey into camping with her, hiking, and generally being more active. She helped me find my sense of self, alone, in the wilderness. I began to feel unafraid being alone, in the dark, in the woods with her by my side. She allowed me to find a place of fearlessness in the natural world. Sierra passed Jan. 2010. Her passing broke my heart open. So open that it allowed for further journeys along the trails where her ashes are spread.

A lighthouse fulfills its purpose only when its light brings home the weariest of sailors. Until then, it continues to penetrate the darkness, ever constant, maintaining vigilance, providing a beacon of hope to all who see it.

Ice Climbing, Ouray, Co., 2011

My only wish in writing this post is that it may provide some shred of hope for the forlorn, the tired, the grief-stricken. May it provide a ray of light for young women everywhere who long to find their passion, who feel isolated, or not heard.

"Smith Rock State Park," Terrebonne, OR., 2010

I offer to you, snapshots of my life, that they may provide fuel for your journey. That you may provide fuel for others.