This is a fairly easy and healthy family favorite for entertaining guests or making delicious leftovers. Originally a recipe by Shelley Adams, a British Columbian chef that named the recipe after a favorite Whitewater ski area run "Glory Bowl". Definitely a tried and true year-round dish that holds up to its hyperbolic namesake. 
COOKING TIME:15 minutesPORTION SIZE:6-8 servings

INGREDIENTS:

•  2 tablespoons vegetable oil
• 2 cups cubed extra-firm tofu
•  8 cups hot cooked brown or white rice
•  2 cups grated or sliced carrots
•  2 cups grated or cubed beets
•  2 cups packed baby spinach  leaves  (or whatever leafy greens you have around)
•  2 cups slivered and toasted almonds 

​
Glory Bowl Dressing (or use whatever dressing you have on hand that looks like it would mix well):

•  1/2 cup nutritional yeast flakes
•  1/3 cup Tamari or soy sauce
•  1/3 cup apple cider vinegar
• 1/3 cup water
•   2 tablespoons tahini
• 2 cloves garlic crushed
•  1 1/2 cup vegetable oil
•  1/3 cup apple cider vinegar
•  1/3 cup water
• 2 tablespoons tahini
•  2 cloves garlic crushed
•  1 1/2 cup vegetable oil

METHOD:

• In large skillet, heat vegetable oil over medium-high heat.
• Fry tofu, stirring often, until brown and crispy, ~10 minutes. 
• Pad fried tofu on a paper towel–lined plate.

GLORY BOWL DRESSING:

• In a blender, purée together nutritional yeast flakes, tamari, vinegar, water, tahini and garlic. 
• With motor running, add vegetable oil in slow, steady stream. 
• Blend until smooth. 
• Cover and refrigerate for up to 1 week

TO SERVE, DIVIDE RICE AMONG 6-8 BOWLS

• Drizzle each with 1-3 tablespoons of the dressing
• Top each with tofu, carrots, beets, spinach and almonds
• Drizzle each with 3 tablespoons of the dressing

CREDITS:Canadian Living Magazine, July 2011
https://www.canadianliving.com/food/recipe/glory-bowl

Full disclosure, I get most of my recipes from the internet, especially on Food & Wine.  I have a few cookbooks, but aside from using my “How To Cook Everything” by Mark Bittman every time I roast a chicken, I almost exclusively use my phone for recipes.  Recently, for some reason I was perusing my library app (yes, I also read library books on my phone, really what would I do without it!!) and saw the cookbook called “Cravings: Hungry for More” by Chrissy Tiegen (not that I follow her, but she’s a big famous internet influencer and married to John Legend, who by the way is a pretty good musician) and I just downloaded it on a whim.  Well so far I’m impressed!  This recipe I’m sharing today was SUPER easy and a delicious cold salad for a hot summer day.  Maybe you’ve caught on that I like easy and tasty, so this was a big win.  I’m already excited to try some more.  

ENJOY!


Ingredients (serves 4 as a main dish, but would be a great potluck salad also...):

8 oz soba noodles
3 tablespoons sesame oil
2 tablespoons canola oil
2 teaspoons finely grated lime zest
3 tablespoons fresh lime juice (about 1 ½ limes)
2 tablespoons of unseasoned rice vinegar (mine said “sweet and  tangy” on it and it was fine)
1 ½ tablespoons honey
Salt and pepper
2 skin-on salmon fillets (about 6oz ea)
1 firm-ripe mango peeled and cut into small chunks
1 medium cucumber cut into small chunks
4 scallions, sliced
1 medium fresh red or green chile, thinly sliced  (I planned on using an Anaheim because they
are flavorful but not too spicy, but I forgot to buy it and the salad was still delish, so you can alter spice up or down with this ingredient depending on your preference)
3 tablespoons toasted sesame seeds 

Instructions:

Set up a large bowl of ice water, then bring a pot of water to boil for the noodles.  Cook until tender, about 6 minutes.  Drain the noodles and rinse, then place them in the ice water and slosh them around a little, until the water becomes cloudy.  Drain them again.

In a small bowl whisk together the sesame oil, canola oil, lime zest, lime juice, vinegar, honey and 1 teaspoon of salt.  

For the salmon, position a rack about 8 inches from the broiler in your oven and pre-heat the broiler to high.  Season the salmon with salt and pepper and arrange the salmon skin-side up on a pan.  Broil the salmon for 6-7 minutes, or until just cooked through.  Let the salmon cool and peel off the skins.  Break up the salmon into bite sized chunks.
**Crispy salmon skin option: If you want (I did and it was pretty good) you can make crispy salmon skins at this point.  Lower the broiler heat to low, place the skins you just peeled off cooked side down, you will notice they already got a little crispy in the first step, and broil them again until browned but not burnt.  Then chop them up, and sprinkle on top of the salad when it’s all mixed up.

In a large bowl combine the noodles, mango, cucumber, scallions, chili, salmon and dressing, toss gently.  

Divide the noodles into bowls and sprinkle with sesame seeds (I totally forgot these, but added them to the leftovers and they added a nice little crunch!) and the salmon skins.

​

Summer is walking, hiking, and biking season in Missoula and there are so many beautiful trails to choose from! As physical therapists, it's our mission to keep our community moving and enjoying the outdoors. In that spirit, this week we are sharing a few of our favorite local trails around Missoula. Happy summer! 

Relatively easy hiking with some uneven terrain. Dog friendly! I walked this 25 min loop twice a week with my dog when I was pregnant (even in the winter!) so it's a nice beginner hike with great views of Missoula and lots of dogs to meet. Watch out for the occasional mountain biker zipping down the trail. 
​
Park in the Blue Mountain lot and head up the middle trail (straight ahead) at the trail head. Take the first right to cut across the field. Take the next right and then head down the hill back to the lot. So easy! 

Good for kids, good for dogs, no shade, some incline and some decline. Can get muddy/slippery in the winter. 

This is not a particularly rugged single-track "trail", but it is fantastic, accessible and a sweet new addition to my bike commute through the Franklin To Fort / Southgate Triangle neighborhoods. It is a relatively new 4-acre park located between North and South Avenue, Johnson Street, and the Bitterroot Rail line. It has lots of open green space, a playground, a community garden, a dog park, a multi-use pickleball/basketball court, and a pavilion. ​

Limited Resources And The Need To Innovate
In wilderness emergencies, a health care provider may have a large array of equipment specifically designed for medical care. For example, professional backcountry rescue teams might carry "jump kits" that have monitors, oral and injectable medications, equipment for oxygen administration, dressings, splints, and supplies for wound closure. This equipment allows rescuers to perform evaluations and procedures equivalent to what could be provided in a fully stocked ambulance. At other times, however, rescuers might only have what they are carrying in their backpacks — or perhaps just a water bottle and bandana. These situations lead to creative exercises and applications.

There are endless possibilities for confabulated medical equipment. An inverted baseball cap may be used as a cervical collar. A rain jacket might be used as a sling. Fill a baggie with clean water and squeeze it out of a small puncture hole to provide high pressure wound irrigation.

A person's life can be saved by a "hypothermia wrap" using basic backcountry equipment such as sleeping bag on top of a foam sleeping pad that is completely wrapped in a thermal space blanket and tarp to create an insulating "burrito." This wrap will help prevent further heat loss, but it requires an external heat source. One way to provide this is to heat water to near boiling using a portable camp stove. Then fill plastic bottles with the water, seal tightly, and cover with wool socks. Position these hot water bottles near the patient's axillae and groin to facilitate increasing core body temperature.

Making a fire in rain can be challenging. A great backcountry trick is to light petroleum gauze from a first aid kit on a piece of aluminum foil. Small wet sticks will easily catch fire, quickly resulting in flames. When you extinguish the fire, the aluminum foil can be picked up, leaving no trace of the fire.

The Wilderness Physical Therapist
Based on successful involvement in the military and during humanitarian relief operations, PTs can add great value to the field of wilderness medicine. Their nonpharmaceutical and noninvasive core skill sets are useful in virtually every backcountry medical encounter. For example, "wheelhouse" PT skills include in-depth musculoskeletal assessment as well as comprehensive examination of the central and peripheral nervous systems. In addition, the PT examination of the cardiopulmonary and vestibular system can be of profound importance in the backcountry.

Wound care and splint confabulation frequently are needed, as is skillful patient handling and transport. Also important is the PT's ability to provide effective communication for history taking and to keep the patient and rescue team calm and focused. The therapeutic alliance between the provider and the patient is critically important in the wilderness medicine environment, especially when extended emergency care time is needed.

So, what would be good qualifications for a wilderness PT? While the basic physical therapist skill set alone can add great value, wilderness care providers also need advanced first aid skills and must be able to survive in challenging environments.
Advanced first-aid skills include primary assessment, triage, CPR or basic life support, and hemorrhage control as well as management of dehydration, shock, heat illness, hypothermia, blood sugar emergencies, chest wall injuries, and abdominal and pelvic trauma.

Basic backcountry skills include knowledge of survival techniques such as shelter and fire building, water purification, knowledge of hiking and trekking, care of the feet, and land navigation. Climbing and water rescue skills also are desirable.
An additional critical skill is the ability to communicate professionally with emergency personnel off-site to integrate with support systems, remote clinics, and mobile treatment facilities. Interestingly, this communication is starting to be facilitated using drones and telehealth technologies, as reported by Christopher Van Tilburg in the June 2017 issue of Wilderness and Environmental Medicine.

Beyond providing immediate care to someone in the wilderness, PTs can help return patients to their high-demand activities in remote environments with limited resources. Unique functional rehabilitation considerations include carrying a pack over irregular terrain, paddling, and climbing. Other less obvious but hugely important considerations include hygiene and wound care in the backcountry as well as adequate hydration and nutrition.

PTs also can provide backcountry care at adventure races or ultra-marathons. In addition, being an on-site PT for wilderness therapy groups has the potential to be rewarding. Wilderness therapy describes a spectrum of outdoor-based adventure activities geared toward mental health and wellness. Traditionally these programs have been developed for adolescents and young adults to help them address and overcome mental health challenges. More recently, these programs have been offered to returning veterans who are experiencing traumatic brain injury, posttraumatic stress disorder, or other stress disorders.

The backcountry's rough terrain has limited access for people with mobility challenges. In the past several years, however, extraordinary achievements in hiking and climbing by people with substantial physical impairments have inspired others. As barriers to participation drop, individuals with physical challenges are having an opportunity to venture far into the backcountry to enjoy the healing effects of nature. A PT on-site could help make this happen.

It is difficult for most of us to discuss health issues related to pelvic health. Not only does pelvic health encompass traditionally uncomfortable topics such as urinary incontinence, fecal incontinence, pelvic pain, sexual dysfunction and many other diagnoses but it also requires the observation of “private areas” of the perineum.

For people in the trans community, this reticence is magnified by issues of gender dysphoria (psychological distress that results from an incongruence between one's sex assigned at birth and one's gender identity), provider discrimination and a general lack of knowledge on the healthcare needs of the trans community.

I have found, through discovering and pursuing pelvic health as a profession, that my community is often a force for bringing a voice  to those who are marginalized. 

Here are the facts regarding discrimination in heathcare: 

• The National LGBTQ Task Force found that “more than 50% of LGBT people experience some form of healthcare discrimination” 
• National Center for Transgender Equality and the National Gay and Lesbian Task Force found “beyond overt discrimination, more than half of trans individuals report encountering a significant lack of provider knowledge.” 
• ​This healthcare discrimination leads to patients being three times more likely to postpone care for that year. 

​Not only does the research show healthcare disparities but also the benefits when people are provided proper healthcare. Gender affirming surgeries are linked to improved mental health in the transgender community. Recovery from these surgeries, like many surgeries, can be met with complications and can be significantly improved through seeing and working with a physical therapist.

I remember seeing these types of statistics and thinking I needed to do my part in closing this gap. I needed to seek out education and help create a safe space for all individuals. I have had many rewarding experiences treating people within the LGBTQIA+ community and specifically in the trans community. I hope to continue my education and bring the best healthcare possible to this community

I believe that everyone should feel safe and welcomed in their healthcare settings.

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