1
Learning Through Arthritis
2
Talking to Youth About Marijuana
3
Be Tick Smart
4
10 Tips to Eat Healthy During Summer Travel
5
Spring Caution
6
Can We Do More For Our Neighbors?
7
National Volunteer Month
8
Stroke Awareness
9
Protecting Your Smile
10
DULCE – An Innovation in Health Care Delivery

Learning Through Arthritis

By: Daniel Regan

arthritis_tips_Live Well Lamoille

At 72 most of my squash-playing days are behind me. Although I took up the game, a fast-moving racquet sport, too late in life, there was plenty of time, apparently, to pound on my joints. Soccer, before squash, had taken its toll too. Arthritic changes started showing up at least ten years ago on my ankle. In 2016, osteoarthritis of my left hip was bad enough for me to walk away from a consultation carrying a binder entitled “Preparing for Your Hip Replacement.”

I returned it to the clinic two months later. In the meantime, I had decided to try physical therapy combined with modest amounts of over-the-counter medication. Today, more than two years later, I have “graduated” to a prescription medication, but continue to work out one to two hours almost daily. Luckily, my current schedule allows that. I check in with a superb PT, who is an acute observer and listener, every three or four months for a “tune up.” Although others will choose differently, my road to an eventual joint replacement will be as gradual as she–and I–can make it.

No one chooses arthritis, although worse afflictions can be imagined. More than 54 million Americans, plenty of whom live in Vermont, live with doctor-diagnosed arthritis. Of those, more than 30 million have osteoarthritis, the most common form of disability in adults. If arthritis sufferers conveyed what they’ve learned from their experiences, the pooled knowledge would constitute a valuable life studies curriculum.

Here are some of the life lessons I think I’ve learned from living with arthritis:

  1. Revel in a good day, do what you can to endure a worse one; but try not to read too much into either. Unless one is extraordinarily lucky, or unlucky, the day-by-day trajectory is neither clearly up nor down. I don’t need a weather app, for instance, to provide painful confirmation that the barometric pressure is falling; but tomorrow the skies may clear. An overall trajectory may well exist, but each particular day need not reflect it.
  1. Appreciate the small pleasures of life. I take real pleasure in walking even short distances with something like the stride I remember. There are analogues in every sphere of life.
  1. Learn to accept assistance, but try to gauge what you really need. I use a sock aid, but only for the foot I struggle to reach, and am considering using a single hiking pole for longer walks. For life in general as for arthritis, it’s important to accept necessary assistance; but it’s also worth remembering that the Beatles sang about “a LITTLE help from my friends.” It’s a good idea, to the extent possible, to push yourself.
  1. Move! When life is less than stellar, passivity and inaction are apt to take over. Long-term, this is exactly the wrong response to life as to arthritis. On the other hand, although I try to move through the initial pain in anticipation of relief, if it’s too much and I need an easier day, I take it—without second guessing myself.
  1. Relax. Time is especially precious, compared to when I was 20; but no particular moment is indispensable, really. In particular, not every second must be used productively. Waste some time, shamelessly, allot extra time for tasks; and minimize multitasking, unless you really, really like having the news on all the time. Arthritis and life require a dual sense of time–as both precious and dispensable–and the ability to move back and forth between them.
  1. Seize any opportunity to examine what is at the core of your identity. I had to ask—am still asking—myself to what extent my sense of self is wrapped up in moving as I had before. More generally, what makes you you? And without a particular attribute or capacity, how could you reinvent yourself? That act of remaking oneself is also an exercise in humility.

It is also an exercise in empathy. Overall, living with arthritis has heightened my empathy for those—the many people–who move as gracefully as they can through life with pain either external or internal.

Talking to Youth About Marijuana

By: Jessica Bickford

It is widely known that Act 86, which legalizes possession of marijuana by adults, takes effect on July 1st.  In my work with Healthy Lamoille Valley, I’ve had the opportunity to speak with community partners and there is an overwhelming concern for our youth as this law increases opportunities for youth access to marijuana. With this in mind, I want to share a few well-vetted resources to help youth, parents and community members.

What are we talking about? The first step in understanding the impacts of marijuana is to understand the drug.  This site from the National Institute on Drug Abuse for Teens is particularly helpful and is designed be shared with your teen.  https://teens.drugabuse.gov/drug-facts/marijuana

How do we talk to youth about it?  Talking with youth can feel difficult. Parentupvt is a great tool that provides sound advice and suggestions: http://parentupvt.org/how-can-i-help-prevent-it/talk-about-it. They also have infographics on marijuana: http://parentupvt.org/resources/infographics.

On the evening of June 5th, the Lamoille County Sheriff’s Department, Healthy Lamoille Valley, and Blueprint for Health are partnering with area middle and high school students to share a community forum: “Effective Communication with Youth.”  Learn more at https://www.eventbrite.com/e/3rd-annual-opiate-forum-presents-communicating-effectively-with-youth-tickets-45909426330.

Partnership for Drug-Free Kids has a Youtube tutorial with communication tips for parents: https://www.youtube.com/watch?v=FThKH0SEDeI

What are the guidelines around use and storage of marijuana? As with any legal drug, including alcohol, tobacco, prescription drugs, and soon to be marijuana, we all have a role to play in safe, responsible storage and use. Act 86 provides very specific details on how and where adult use marijuana can be used and stored, as well as the quantities an individual can possess. In a nutshell, Act 86 only allows for use in a home residence, with some restrictions. Users are responsible to keep it away from anyone under the age of 21. (In fact, providing marijuana to minors has the same penalties as providing alcohol to a minor – up to a $2,000 fine and up to 5 years of prison time, per minor.) Those who have it or grow it are required to keep it secure where children and youth cannot access it, meaning locked up and out of sight. Users are not to drive impaired. Marijuana cannot legally be sold. https://legislature.vermont.gov/assets/Documents/2018/Docs/ACTS/ACT086/ACT086%20As%20Enacted.pdf

What do you need to know about marijuana and pregnancy? We know that alcohol and tobacco can cause some serious risks and complications to unborn children. It’s logical that marijuana can have risks as well. Check out more information at https://www.cdc.gov/marijuana/pdf/Marijuana-Pregnancy-508.pdf

How can I learn more and do more to prevent youth use? Healthy Lamoille Valley is working with Michelle Salvador at the Vermont Department of Health to host a community evening in June. Watch Healthy Lamoille Valley’s website for emerging details! Join us as we review the implications of Act 86 and then break into interest groups (parents, youth, educators, landlords, employers, etc.) to explore how we can prevent youth use and support area children and families.

Looking for more resources?

CDC Marijuana Use and Teens: https://www.cdc.gov/marijuana/pdf/Marijuana-Teens-508.pdf

CDC Marijuana Use and Driving: https://www.cdc.gov/marijuana/pdf/Marijuana-Driving-508.pdf

SAMSHA’s Marijuana Page: https://www.samhsa.gov/atod/marijuana

Vermont’s Marijuana Impact Assessment: http://www.healthvermont.gov/sites/default/files/documents/2016/12/ADAP_HIA_Marijuana_Regulation_in_Vermont_Exec_Summary.pdf

Our partners at Mount Ascutney Hospital created a good summary of Act 86 legalization.  If you would like a copy please send your request to Jessica@healthylamoillevalley.org.


Jessica Bickford has worked as Coordinator of Healthy Lamoille Valley for a little over two years, where she has enjoyed writing for their blog. Writing for Copley’s community blog is a natural extension of this experience! Healthy Lamoille Valley focuses on making healthy choices easy choices, realizing that when we have access to healthy options we are less likely to choose behaviors that are harmful. Prevention is really a lifestyle of wise choices that enable us to live life to the fullest.

Be Tick Smart

From the websites of the Vermont Department of Health and the Centers for Disease Control and Prevention

The Vermont Department of Health has an active campaign to help educate people about ticks and how to avoid being bitten which in turn prevents the spread of tickborne diseases. In Vermont, ticks are most active between early spring and late fall.

Before You Go Outdoors

Know where to expect ticks: Ticks live in grassy, brushy, or wooded areas. They may live on animals as well, including your pet dog or cat.

Treat clothing and gear, if you can, with products containing 0.5% permethrin: It remains protective through several washings.

Cover up: Wear long sleeves, long pants and tuck your pants into your socks.  Wearing a hat and a bandana around your neck helps, too.

Use EPA-registered insect repellent: It should contain one of the following: DEET, picaridin, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. Caution!  Don’t use insect repellent on babies younger than 2 months old. Don’t use products containing OLE or PMD on children 3 years old and younger.

When Outdoors

Try to avoid ticks: Ticks don’t jump, they grab on when you brush against them.

Avoid wooded & brushy areas with high grass & leaf litter. Or at least cover up exposed skin when you do. Walk in the center of trails.

After You Come Indoors

Check your clothing for ticks. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks.
Cold and medium temperature water will not kill ticks.

Shower soon after being outdoors. Showering within 2 hours of being outdoors may reduce your risk of getting tickborne diseases.  Showering may help wash off unattached ticks and it’s a good opportunity to do a tick check.

Use a hand-held or full-length mirror and your hands to check:

  • In and around your hair
  • In and around your ears
  • Under your arms
  • Inside your belly button
  • Between your legs
  • Behind your knees

Check your pets for ticks. 

If You Find a Tick Attached to You

Remove it. The best way to remove a tick is to use fine-tipped tweezers to pull straight up until all parts of the tick are removed.

Watch for symptoms. Symptoms may include fever, headache, joint pain, muscle aches, fatigue or a rash soon after a tick bite. You may see symptoms as soon as three days after a tick bite, but they can appear as long as 30 days after.

Call your health care provider immediately if you do get symptoms. Tell them about the tick.

The Vermont Health Department has a number of free, evidence-based materials available. You can download them here.

 

10 Tips to Eat Healthy During Summer Travel

By: Rorie Dunphey

The weather is finally improving and it is finally beginning to feel like summer. For many of us, summer means adventures and traveling. Is it possible to eat healthy when we are on the road having fun? Yes! Here are 10 simple tips to eating healthy when away from home;

  • Consider your drink – Choose water, unsweetened tea or drinks with no added sugars. Avoid drinking calories.
  • Savor a salad – Start your meal with a salad packed with vegetables to help you feel satisfied sooner. Ask for dressing on the side and use a small amount.
  • Share a meal or dish – Divide a main entrée between family and friends. Ask for small plates for everyone at the table.
  • Select from the sides – Order a side dish or appetizer as a meal. It is usually more than enough food!
  • Pack your snacks – Pack a cooler with ready-to-eat fruit, vegetables or unsalted nuts to eat on road trips. It can help you avoid stopping for junk food when you need to stop to fill the gas tank.
  • Fill your plate with vegetables and fruits – Stir-fries, kabobs or vegetarian options can be healthy and delicious. Order meals without gravy or sauces. Select fruits for dessert.
  • Compare calories, fat and sodium – Many menus now have nutritional information. Look for items that are lower in calories, saturated fat and sodium. You can also ask your server about for healthier options.
  • Pass on the buffet – Order individual items from the menu and avoid ‘all you can eat’ buffets. Steamed, grilled or broiled dishes usually have fewer calories than fried or sautéed foods.
  • Get your whole grains – Ask for 100% whole grain bread, rolls and pasta when eating sandwiches, burgers or entrees.
  • Quit the ‘clean plate club’ – Be mindful of how full you feel and stop eating when you have had enough. Slow down and savor each bite. Pack leftovers away immediately to avoid nibbling and refrigerate them for tomorrow’s meal.

It can be often be challenging to eat balanced and nutritious foods when away from home, but with a little effort and planning, you can still have fun and be healthy. Enjoy and safe traveling!


Rorie Dunphey works under Vermont’s Blueprint for Health as the RN Chronic Care Coordinator at Family Practice Associates in Cambridge. She works one-on-one with people and also leads classes to promote health and help people better manage their chronic diseases. She also assists patients in accessing community and state resources to better coordinate their health and wellness needs. Rorie has a particular passion for promoting a healthy diet and exercise routine to inspire people to live their best life.

Spring Caution

By: Caleb Magoon

spring sports_Live Well Lamoille

It’s spring and boy is it nice to have some wonderful sunny days, even if it’s only a few. Our inkling is generally to get right out there and get after our favorite activities. The bike comes out, we lace up the running shoes or hiking boots or put the kayak in the water. Tough to resist, right?

Yes, go out and do those things. But I encourage you to exercise some caution. This is a dangerous and injury-prone time of year for several reasons and it’s important we slip into spring activities slowly. Few of us get the same activity level through the winter and spring as we get through the summer. Spring is probably the worst for me because once the snow goes, my ability to cross-country ski, snowshoe or do other winter-based fitness activities goes away. My fitness level, in general, is low.

That said, I sure do want to jump on a bike. I’ll want to bike like I did in the fall, though physically my body has changed quite a bit in the last few months. It’s important that you go easy during those first couple of rides, runs or activities. The last thing you want is an injury to stifle your spring and set you back well into June or later. Make sure your first activities are shorter and easier than your max or even your average. Ease your way into activity and be ginger while finding your limits.

Make sure you are making healthy choices leading up to your first activities. Ensure your fuel levels match the activity you have chosen. Eat enough before the workout and drink more water than you think is needed.

You may not be much for stretching, but if you ever took a swing at it, this is the time of year. Look up a few Youtube videos of dynamic stretches. They’re super easy and only take a few minutes. Post workout, you should also stretch or use a foam roller to roll out your muscles. This will speed your recovery.

Lastly, be aware of your body and if you feel pain or discomfort, stop activity immediately and take a couple days off. If it feels like a bonafide injury, consult a doctor or physical therapist. Above and beyond all else, go slow and easy!

One more note about easing into spring: We need to not only protect our bodies, but also our recreation assets. Roads and trails are particularly tender this time of year and can be damaged quite easily. This applies not only to mountain biking and hiking trails, but also access roads to bodies of water etc. This time of year is when we can do the most damage to trails. Please don’t hike or mountain bike until local experts give the “all clear”. Consult the Green Mountain Club for hiking trails and the Vermont Mountain Bike Association to find your local chapter if you don’t know them. I know the wait is tough, but it’s essential to ensuring these recreation assets don’t need repairs, taking them offline during the best parts of the year.

Have a great spring!


Caleb Magoon is a Hyde Park native who grew up hiking, hunting, biking and exploring Vermont’s Green Mountains. His passions for sports and recreation have fueled his career as the owner of Power Play Sports and Waterbury Sports. Caleb encourages outdoor activity and believes it is an essential element to a healthy lifestyle and the Vermont way of life. Caleb serves the Lamoille Valley by volunteering on numerous community boards such as the Lamoille County Planning Commission, The Morrisville Alliance for Commerce and Culture, Mellow Velo, and the state chapter of The Main Street Alliance. He lives, plays and works in Hyde Park with his wife Kerrie.

Can We Do More For Our Neighbors?

By: Sarah Williams

I was moved to speak at our Town Meeting in Stowe when our neighbors were debating the comparatively large recreation budget versus the nearly nonexistent social services budget. I made the life choice to pursue a career in supporting our most vulnerable neighbors. I do it because if we don’t care for those who are struggling, for those who are in crisis, for those who need a pathway up and out of their trouble, I feel that we all—as a community and as a society—are only as strong as our lowest common denominator. When kids don’t have what they need to be successful in their early years, their chance of success as adults, community members and employees is greatly challenged. The success of our community is what we make of it. Recreational paths are nice, sure, but what makes a strong economy are the people who participate in it. The strength of the people in Stowe is what will make our community rise.

The strength of the people in Stowe is what will make our community rise.

When the public thinks about mental health, often their mind goes straight to emergency rooms and the state hospital—a vision of a person being locked away under a guard of nurses. In reality, the mental health system is infinitely more nuanced. 90% of mental health is supporting people to live healthy, productive and self-directed lives. We do this a number of ways:

  • After a tragedy in schools or at fire stations through grief support
  • creating support systems with foster and adoptive families to ensure permanence for children
  • helping people with developmental disabilities to build relationships and hold meaningful work
  • providing support for someone to return to work after a decade of doubting that they are able to get and hold a job
  • helping someone who is struggling with an issue with a family member or friend, who doesn’t know what steps to take to next; we have a system in place that helps people figure out the steps to ease their troubles and to know that they aren’t alone in figuring out a solution.

The emergency response budget that we passed in Stowe on Town Meeting Day is going to continue to rise unless we start doing things differently. Reactionary response is both expensive and debilitating to the population who are struggling day to day. Consider the economic impact of each of these individual lives:

  • This winter, St. John’s in the Mountains Episcopal Church in Stowe erected an emergency homeless shelter that welcomed over 100 people—many of them children from Stowe. How does the lack of stable housing affect the ability of the parents of these children to hold a job, and for their kids to excel in school?
  • Consider the long-term, compounded costs of children going hungry over the summer due to lack of access to the free lunch program. How does this affect their long-term physical and mental health?
  • When the police are responding to mental health calls instead of being available emergencies, how does this affect both the safety of those calling the police, as well as the cost of the police budget? Wouldn’t that money be better spent on social services that get at the root of the problem rather than on emergency services?
  • Our elderly struggling to maintain their independence at home, while battling isolation, physical and mental health challenges. Don’t we owe it to our community elders to support the home share program?

The Stowe social services budget is 0.4 % of the town budget this year, while Morrisville contributes 1.3%–$82,469 to the community partners who help our neighbors, including CapStone, Lamoille County Mental Health Service, Home Share, the food shelf and Meals on Wheels. That is almost two times the amount we contribute to these programs that support our town.

So when I ask the question “Can we give more to our town social services budget?” I am asking you to not only think of Stowe as a great place to vacation and to have fun, but as a great place to live, work and raise a family.  To do this, we need to support the people who live in here who are struggling silently. If you need to hear it will save us money, it will. If you need to hear that giving back is showing your gratitude that you are one of the lucky ones, it is.  Our select board wants to hear that our town cares what happens to those who cannot speak for themselves.  Please contact your select board today and tell them that you support an increase in the social services budget in your town.


Sarah, an LNA who works as a Medication Coordinator for Lamoille County Mental Health Services, lives in Stowe with her two teenage sons.  She is a runner and garden enthusiast.

National Volunteer Month

By: Valerie Valcour, PHN

April is National Volunteer Month and I would like to take this opportunity to say thank you to all who have taken time to volunteer. Volunteering can take on many forms; for example, delivering meals Live Well Lamoillethrough Meals on Wheels,  working at the Lamoille County Food Share, or volunteering with Vermont’s Medical Reserve Corps.

I am the Coordinator for the Lamoille Valley Medical Reserve Corps and if you are a medical professional, past or present, or have no medical experience but would like to explore how you could volunteer your time to support public health, then I invite you to take a look at what the Medical Reserve Corps has to offer.

The National Medical Reserve Corps (MRC) is a network of local volunteers with a mission to strengthen public health; reduce vulnerabilities; improve emergency preparedness, response and recovery capabilities; and build community resilience. MRC volunteers include medical and public health professionals, and other community members interested in improving the health and safety of their local communities.

Live Well LamoilleThe Lamoille Valley Medical Reserve Corps is the newest unit in Vermont. We recently joined eight other existing units throughout the state. Volunteer training has been our most recent focus. For example, we learned ways to personally prepare for all types of emergencies and provide psychological First Aid, and we explored the roles MRC volunteers can have during public health mass medication or vaccination distribution clinics. Future training topics will include Stop the Bleed and You Are the Help Until Help Arrives. Soon the Lamoille Valley MRC will offer these and other training to the public, so check the Vermont MRC Event Calendar and your local media sources.

For more information about the Medical Reserve Corps and how to become a volunteer please contact Valerie Valcour, PHN at the Vermont Department of Health 802-585-4434 or Valerie.valcour@vermont.gov.


Valerie Valcour is a Public Health Nurse and specializes in chronic disease prevention and emergency preparedness at the community level for the Department of Health in Morrisville. Valerie has lived in Lamoille County most of her life. She graduated from People’s Academy in 1983 and worked as a nurse at Copley Hospital for several years. Recently Valerie has volunteered as a board member of both Community Health Services of Lamoille Valley and the Lamoille County Planning Commission.

Stroke Awareness

By: Nancy Wagner

Stroke is a leading cause of death in the United States, killing nearly 130,000 people per year. Approximately 800,000 strokes will occur this year, one every 40 seconds, and taking a life approximately every 4 minutes.

Copley Hospital will be holding a 2-part Stroke Awareness class the first week of May. Class one will be held on May 1st from 6-7pm and again on May 2nd from 12-1pm.  Class two will be held on May 8th from 6-7pm and again on May 9th from 12-1pm. To register, call Copley Wellness Center at 888-8369. There is no cost for the class but please pre-register so that we have enough handouts available. Classes will be held in the Stevens Conference Room at the hospital.

Take a moment to learn about risk factors for having a stroke, as well as preventative steps you can take.

Types of strokes:

  • Ischemic stroke: caused by a blood clot that blocks a blood vessel or artery in the brain. About 87% of all strokes are ischemic.
  • Hemorrhagic stroke: caused by a blood vessel in the brain that breaks and bleeds into the brain. About 13% of all strokes are hemorrhagic but more than 30% of all stroke deaths happen with hemorrhagic strokes.

Risk factors for having a stroke?

High cholesterol, high blood pressure, uncontrolled diabetes, previous stroke or TIA (mini-stroke), atrial fibrillation, carotid artery disease, obesity, physical inactivity, drinking too much alcohol and smoking.

Preventing a stroke:

Some of these risk factors you can’t control, but many you can. If you smoke, work on quitting. If you drink too much alcohol, cut back or quit. If you are overweight or obese, get more active and seek out a registered dietitian for help with eating. Healthy eating, increased activity and smoking cessation will help to improve your blood sugar, blood pressure and cholesterol numbers, which will further decrease your risk of a stroke.

Signs of a stroke?

  1. Sudden severe headache with no known cause
  2. Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
  3. Sudden trouble walking, dizziness, loss of balance or coordination
  4. Sudden trouble seeing in one or both eyes
  5. Sudden confusion, trouble speaking or understanding speech

What to do if you or someone with you is having a stroke:

Many people don’t realize they are having a stroke. It is often more obvious to those around them. Time is important as quick treatment helps to prevent serious long-term effects of the stroke. Remember the word FAST which stands for:

FACE: Ask the person to smile. Does one side of the face droop?

ARMS: Ask the person to raise both arms. Does one arm drift downward?

SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

TIME: If you observe any of these signs, call 9-1-1 immediately!

 

Have questions? Want more information? Visit:

Protecting Your Smile

By: Wendy S. Hubbard, RN, MCHC and Linda Greaves, Dental Hygienist, Vermont Department of Health, Morrisville Office

Pregnancy is a busy time for a woman. Remembering to take time for yourself is important. One item that is easy to overlook during the excitement is maintaining your oral health. Going to the dentist during your pregnancy is safe and one of the first things you can do to provide for the health of your baby.

In a recent Pregnancy Risk Assessment Monitoring System (PRAMS) report, only 63% of women had their teeth cleaned in the year prior to their pregnancy and only 62% of women had their teeth cleaned during pregnancy.

Dental care is so important during pregnancy that in Vermont if you are insured by Medicaid there is an expanded dental benefit through pregnancy and continues for 60 days after the baby is born. The PRAMS report stated 28% of women with Medicaid that had a dental problem did not think they could afford to go to the dentist. The Medicaid expanded dental coverage has no required co-pay or cap on services. You are fully covered!

Twenty-eight percent of women enrolled in Medicaid that needed a dentist according to the PRAMS report could not find a dentist who accepted Medicaid. Women can call the Vermont Department of Health (VDH) at 800-464-4343 for assistance in finding a local dental provider.

This website http://www.healthvermont.gov/local/morrisville has links to the twelve local health offices for the phone number to the office closest to you.

For further information on oral health resources for the whole family please visit the VDH website: http://www.healthvermont.gov/wellness/oral-health/resources-health-professionals.

DULCE – An Innovation in Health Care Delivery

By: Scott Johnson

The healthcare sector is experiencing rapid changes. Vermont is on the cutting edge of reform – leading the country in exploring alternative payment systems and finding better ways to measure success for patients and quality of care.

These reform efforts are also impacted by the fast-growing science related to how adversity in childhood impacts health care. Research at Harvard’s Center on the Developing Child reveals the significant impact of early life experiences on the growing brain and other biological, physiological, and neurological systems. According to the Center, in the first few years of life, more than one million new neural connections form every second. This critical developmental stage creates the architectural foundation for the rest of the infant’s life. Chronic stressors on the developing brain impact the quality and quantity of those neural connections.

Activation of the stress response produces a wide range of physiological reactions that prepare the body to deal with threat. However, when these responses remain activated at high levels for significant periods of time, without supportive relationships to help calm them, toxic stress results. This can impair the development of neural connections, especially in the areas of the brain dedicated to higher-order skills. (https://developingchild.harvard.edu/science/key-concepts/brain-architecture/)

Our earliest life experiences can impact how we respond to circumstances and challenges for the rest of our lives. In our region there is an innovative program to assure infants and their families have what they need to get off to a strong start. Appleseed Pediatrics, the Lamoille Family Center, and Vermont Legal Aid are working as a team to support Lamoille area families with newborns. The program is called DULCE (Developmental Understanding and Legal Collaborations for Everyone) and is about to enter its third year of operation.

The DULCE model embeds a family specialist from the Lamoille Family Center into the pediatric practice. The family specialist works with every family who wants her support to assure children in Lamoille get off to the best start possible; reducing the likelihood infants’ fast-growing brains and bodies are exposed to toxic stress and its lingering impact on the child.

Carol Lang Godin – LFC Program Director
and supervisor to DULCE family specialist –
with two DULCE graduates

Lamoille’s DULCE site is the only Vermont site and the only rural model in this national research project (six other sites are in Florida and California). While it’s a free and voluntary program, 98% of families have accepted the offer for support, and since inception in March 2016, DULCE has worked with almost 240 Lamoille families. A detailed and comprehensive evaluation process will begin in the coming months, and early indicators from family surveys tell us that families are benefiting from the support and information they receive from the program. The team, including the family specialist and the attorney help families with a range of issues parents of newborns may face that can impact the family’s health and well-being, including: child development, landlord-tenant challenges, child custody, family court issues, mental health, substance use, housing, economic well-being, safety, food security, and transportation.

The Lamoille Family Center is working with its local and state partners to expand DULCE in other practices in Vermont. This promising innovation that links health care, community services, and legal supports started here in Lamoille and could be a core component of all pediatric practices in Vermont within a few years. Giving children their best chance for a healthy and prosperous future starts with a family-centered approach like DULCE.For more information, contact Scott Johnson at sjohnson@lamoillefamilycenter.org, or Carol Lang-Godin at clang-godin@lamoillefamilycenter.org.


Scott Johnson is Executive Director of the Lamoille Family Center and has worked in Lamoille Valley in human services and education for nearly his entire career. The Family Center has served our community by encouraging, educating and celebrating children, youth and families for forty years.

Scott writes about early care and education, adolescent development and strengthening families that improve conditions of well-being.