Skin cancer is the most common cancer in the U.S., but regular sunscreen use can cut the risk of squamous cell carcinoma by 40% and melanoma by 50%.

Choosing the right product matters:

• SPF 30 or higher
• Broad-spectrum protection (UVA + UVB)
• Water-resistant lotions work best
• Mineral-based formulas are great for sensitive skin

Check out these helpful guides:

• Consumer Reports Sunscreen Ratings
• Wirecutter’s Best Sunscreens
• EWG’s Skin Deep Database

And remember—sunscreen is just one part of sun safety. Hats, shade, and avoiding peak sun hours (10 a.m. to 4 p.m.) are just as important.

Vaccine Updates: What’s New in 2025

Forget Dementia? The Shingles Shot Might Help

Recent research published in JAMA has shown that people over age 50 who received the shingles (herpes zoster) vaccine had a lower risk of developing dementia later in life.

Another study published in Nature supports the idea that viral infections may contribute to cognitive decline. While more research is needed, this is another reason to stay current with recommended adult vaccinations.

Shingles (Herpes Zoster) Vaccine

Recommended for all adults aged 50 and older to prevent shingles (the painful rash that results from reactivation of the chicken pox virus you had as a kid). Safe, up to 97% effective, and like we mentioned, it’s now shown to have possible benefits beyond shingles prevention.

Pneumonia Vaccine: PCV20 vs. PCV21

Adults aged 50+ who have never received a pneumococcal conjugate vaccine should now get either Prevnar 20 or the new Prevnar 21. Both offer excellent protection from pneumonia, a leading cause of death in older people.

• CDC guidance allows either vaccine as a single dose.
• PCV21 includes 8 more serotypes than PCV20, offering slightly broader coverage.

No need to follow up with PPSV23 (Pneumovax) if you receive either of these vaccines.

Flu, Covid, and RSV Vaccines

We’ll offer updated flu, Covid, and RSV vaccines this fall as updated formulations and guidelines become available.

Taking Medications Past Their Expiration Date

We get a lot of questions about what to do with medications past their expiration date. Many medications remain safe and effective long after the printed expiration date. The primary concern is reduced potency, not danger.

One big exception? Tetracycline and related antibiotics, which can degrade into harmful compounds. These should be discarded after expiration.

If you need to dispose of unused medications, many can be taken back to the pharmacy for disposal. If you do not have a safe take-back option available to you, consult the FDA’s drug disposal tool to find out when to safely throw away or flush your medicine down the toilet.

When in doubt, ask us if you can retain or use an out-of-date medication –we’re happy to help.

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As always, we like to leave you with a treat for reading this far. This skit had us in stitches Medcast – SNL. While your Baskin Clinic physical may not be quite as fun as Saturday Night Live, at least we don’t post them on the internet.

Stay well and enjoy the season,
Baskin Clinic

For better or worse, body fat tends to dominate health conversations—how much there is, where it’s located, and what it means. But when it comes to longevity, mobility, and independence, muscle mass does the heavy lifting.
Muscle mass plays a critical role in maintaining health and function, particularly as we age. And when we say “age” this really applies to anyone over the age of about 30, when the body starts losing about 5% of muscle mass per decade without intervention. Here’s why it matters:

• Maintains Strength and Mobility: Muscle is essential for physical strength and movement. As we get older, maintaining muscle mass helps us perform everyday activities like walking, lifting, and climbing stairs.
• Supports Metabolism and Weight Management: Muscle burns more calories at rest than fat, helping to keep metabolism efficient and prevent weight gain. It also improves blood sugar regulation lowering the risk of type 2 diabetes.
• Promotes Bone Health and Reduces Injury Risk: During weight-bearing activities, muscles place stress on bones, stimulating growth and reducing the risk of osteoporosis. Additionally, muscle helps cushion and protect bones and joints, minimizing injuries from falls or accidents.
• Aids Recovery from Illness or Injury: Muscle atrophy is common during periods of illness and inactivity, as the body requires more protein to heal at a time when nutrition and exercise are also interrupted. Maintaining healthy muscles ensures the body has a reserve to draw from during recovery and speeds return to normal activities.

And you thought muscles were just for showing off at the beach! Combining regular strength training with proper nutrition, particularly adequate protein intake, can help preserve muscle and overall health as we grow older.
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Protein Intake for Older Adults

As we age, maintaining muscle becomes more challenging due to a natural decline in muscle-building efficiency. This can lead to sarcopenia, the age-related loss of muscle mass and strength. Protein is essential for combating this decline, as it provides the building blocks for muscle repair and growth.

While the general recommendation for protein is 0.8 grams per kilogram of body weight per day (about 0.36 grams per pound), older adults often benefit from higher intake. Research suggests 1.2 to 1.5 grams per kilogram (approximately 0.54 to 0.68 grams per pound) to maintain muscle and overall health. For example:

• A 150-pound (68 kg) adult may aim for 82–102 grams of protein daily.
• A 180-pound (82 kg) adult may aim for 98–123 grams daily.

Spreading protein intake evenly across meals—about 25–30 grams per meal—helps maximize muscle protein synthesis. Practical tips include building meals around a high-quality protein source, like lean meats, fish, eggs, dairy, tofu, or beans, and complementing it with colorful fruits and vegetables. By centering meals around protein, other components (carbs, fats, and sweets) naturally fall into balance.

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The Role of Weight-Bearing Exercise

Alongside proper nutrition, weight-bearing exercise is key to maintaining and building muscle as we age. These exercises involve working against gravity while standing, which forces muscles and bones to support body weight. Examples include walking, hiking, stair climbing, dancing, and strength training.

Combining weight-bearing activities with at least 2 days a week of resistance exercises—like lifting weights, using resistance bands, Pilates, or performing bodyweight movements such as squats and lunges—improve both muscle strength and balance. This combination is particularly effective for reducing fall risk and enhancing functional mobility.

Starting gradually and progressing over time, with an emphasis on proper form and safety, ensures sustainable results. Even small, consistent efforts can significantly improve strength, stability, and quality of life. If you’re new to exercise, consider working with a physical therapist or personal trainer experienced in working with older adults to create a safe, effective routine tailored to your needs.

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By focusing on protein-rich nutrition and weight-bearing exercise, adults of any age can preserve muscle mass, maintain strength, and enhance their overall health. It’s never too late to get started!

And for an additional nudge in the right direction. Here are two more videos from Babs Dalbey, one of our favorite Pilates instructors, to get you moving!

Check out Creative Core: Episode 2 – The Squat & Episode 3 – Beyond the Crunch

From all of us at Baskin Clinic, we wish you a safe and happy New Year!

Many respiratory illnesses peak during the winter, but Covid doesn’t like to follow that trend. New variants and decreasing immunity from previous infections and/or vaccinations help to drive these waves. According to wastewater monitoring, Oregon is coming off the peak of the largest wave of Covid infections since February 2023.

What should we do about it?

The CDC’s respiratory virus guidance was updated recently with steps you can take to protect yourself and others from Covid this summer.

These “Core prevention strategies” are surely familiar by now. So let’s instead spend a moment on the use of vaccines and tests.

Booster now or booster later?

An updated Covid vaccine for 2024 is still awaiting approval, and we don’t expect to get it for at least another month. Once it’s available, it will still take a couple weeks to convey its full protective benefit. For that reason, if you have never been vaccinated, or feel you need additional protection now and are eligible for another dose, you might consider getting the currently available 2023 vaccine.

If you do choose to get a dose of the current vaccine now, you will need to wait 4 months for another booster dose. That could result in a delay if you’re eager to get the newest formulation, which is better tailored to the variants circulating now.
Those who might benefit from additional doses of vaccine this summer include:

• people 65 years of age and older
• those who are moderately or severely immunocompromised or have underlying medical conditions,
• people living in long-term care facilities,
• people of any age who have not received any doses of Covid vaccine,
• pregnant individuals, especially those in late pregnancy.

Talk with your provider if you have any questions about if this is right for you.

What are the experts saying now about testing and isolation?

An estimated 98% or more of the population has some immunity to Covid. So the CDC is no longer treating Covid like it did in 2020 – a time when the virus had free reign to attack naive immune systems, the medical establishment had few tools to treat the condition, and little was known about the course of the disease. Today, Covid is considered similar to other respiratory illnesses.

Additionally, the days of using testing as the green light to return to normal activities have passed. Studies have shown that some people may continue to test positive well past the time they are infectious. Still others may spread the virus while never testing positive. For these reasons, the CDC’s guidance is to use symptoms as your guide, returning to normal activities with caution (such as wearing masks) once they subside. And if your normal activities put you in close contact with people who are at high risk of serious illness, it’s reasonable to consider testing as an added precaution.
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This is often the place where we leave you with something fun. And today is no exception! Babs Dalbey is a superb Pilates instructor to many of our doctors and patients (and longtime friend of the Clinic). She operates BABS Body And Balance Studio, and has graciously recorded this Creative Core exercise series for you. We debut the first one here, and our next newsletter will feature follow up videos as well as a focus on strength and physical health. Enjoy!

Spring is in the air, and with it the romantic antics of plants, looking for mates. Pollen – clouds of it – is their love language. While some might dismiss the yellow powder as nothing more than a messy nuisance, pollen is, well, amazing stuff. It lasts forever, is uniquely regional and as a result it’s been used to convict murder suspects, trace counterfeit goods, and even give us insight into our distant past. Pollen grains have been found dating back 470 million years ago – quite a feat of bio-engineering.

In susceptible individuals, all that foreign protein floating on the breeze sets the body’s immune system off on a giant false alarm. Eyes water, noses run, throats itch, airways constrict. And climate change is only making the situation worse. After all, the key features of climate change (warmer temperatures and plenty of CO2) are exactly what plants need to grow.

Our advice to patients: use a multilayered defense, and start at the first sign of symptoms. Allergies are like supertankers – they take time to get going, and a long time to stop. Here’s our recipe:

1. Nasal steroids: if you can control symptoms at the nose, you hit a lot of bases. And skip the generics here – the branded versions (Nasonex, Flonase, Rhinocort) tend to create less irritation. Costco (like everything they sell) has the best price.

2. Eyedrops: Lots of options here including ketotifen, olopatadine, naphazoline, and more. Try a few until you find your favorite.

3. Non-sedating daytime oral antihistamine: we consider these third-line since they cover a lot of territory but don’t do anything really well. Examples include: Cetirizine (Zyrtec), levocetirizine (Xyzal), loratadine (Claritin), desloratadine (Clarinex), and fexofenadine (Allegra). Still better than the old stuff (Benadryl), which puts everyone to sleep.

4. Don’t ignore the value of good old irrigation. Nasal rinsing with the SinusRinse, or even a full shower and change of clothes after being outside in the yard is highly effective.

Still having problems? Please give your doctor a call to discuss!

Navigating care

We know there’s a lot of dysfunction in the health care system at large. Here are some tips for navigating common pain points outside of our doors:

Pharmacies and drug shortages

There has been a cascade of pharmaceutical shortages in recent months and years, and to further complicate matters, pharmacies are short-staffed. Unfortunately, we don’t have the resources to locate drugs for all patients all the time. Our solution: find out what mail order pharmacy is associated with your insurance plan, and sign up. Mail order pharmacies tend to have more reliable supply chains and customer service communications. So save yourself some time and money by subscribing.

Specialty office referrals

Just like pharmacies, specialty provider offices are in high demand. We encourage you to call for scheduling as soon as we issue the referral – you’ll find that contact information on your discharge summary from our clinic. We do what we can to refer you within our network of trusted providers, which often enables patients to get in for visits much quicker than they otherwise would. If you are getting stymied by a referral location – either unclear staff instructions or extended hold times – please let us know. You may actually need to visit that office to make your appointment when phones are overwhelmed.

Covid update

Here’s some good news. Covid hospitalizations in Oregon are at their lowest level since June 2020! We still recommend masking in high-risk situations (planes, trains), especially if you have underlying health problems.

Vaxcare

If you get a large, unexpected bill from Vaxcare, please contact us before paying. Sometimes it just requires Vaxcare re-running insurance to make sure your coverage is verified.

Tualatin office

Welcome to our newest team member, Shelbie Tanner! With her on board, we’ll be opening up in-office availability 5 days a week beginning in June. Just in time too, as our long-awaited remodel nearly underway, and our footprint will shrink a bit during the first phase of construction.

Breast cancer screening guidelines change

The US Preventive Services Task Force has updated the guidelines for breast cancer screening, again. • For those at average risk, mammograms are recommended beginning at age 40 and continuing every other year until age 74. • Those with a first-degree relative who’s had breast cancer or those who’ve had a past breast biopsy may qualify for supplemental screening. Talk with your doctor to learn more. ________________________________________

As always, we want to save something fun for the end… like Pilates!

Regular dose flu shots are an included benefit of your Baskin Clinic membership. Call us to schedule an appointment, or get one at your next visit. There is no need to space out your flu shots from COVID, RSV, or any other vaccines. Speaking of which:

New COVID-19 Vaccines

The CDC has approved a new, 2023-24 formulation of COVID vaccine for people over six (6) months of age. And yes, you should get it, regardless of the number of prior COVID shots you might already have under your belt. From a vaccine design perspective, COVID is now treated similarly to the flu: The virus is continuously evolving, so new formulas will provide updated protection against the latest strains each year.

Due to their high cost, we do not carry COVID vaccines in the clinic, but your insurance will cover 100% of the cost at any local pharmacy. We recommend making an appointment online with your preferred pharmacy now.

Many of our patients, staff, friends, and family have gotten COVID in recent weeks. If you’re in that group, you should wait three months from symptom onset or positive test before getting a dose of the new formulation. Why? You’ve already developed immunity through the recent infection, but that will wane over time. So in 3 months, you’ll need a refresh.

Full COVID vaccine guidance is available here.

Free COVID tests are available from the federal government here. Each household is eligible to receive up to 4 tests.

RSV Vaccines

The CDC has approved RSV vaccine for adults 60 and older, but the guidance is pretty tepid with a lot of qualifying language (as opposed to their flu vaccine advice, which is unequivocal). The CDC recommends that individuals make this decision in consultation with their doctors, taking into account their unique circumstances. Part of this is due purely to numbers; there are more than four times as many annual flu deaths (34,000) as RSV deaths (8,000).

The population most at risk are infants, so for them it’s a no-brainer. For adults, the key lies in your risk factors. Like the CDC, we recommend vaccination if you have any of the following:

• Lung disease (such as chronic obstructive pulmonary disease [COPD] and asthma)

• Chronic cardiovascular diseases (such as congestive heart failure and coronary artery disease)

• Diabetes mellitus

• Neurologic conditions like MS

• Kidney disorders

• Liver disorders

• Hematologic disorders like leukemia or lymphoma

• Compromised immunity (either due to immune suppressive medications or underlying illness)

Bottom line: if you’re over age 60 and want every possible protection, get it. But it’s low-yield unless you have underlying health problems.

We do not carry RSV vaccines in the clinic, but a trip to the pharmacy is also an opportunity to catch up on vaccines for other diseases and conditions. Age 50 or older? You should receive the new shingles vaccine (Shingrix). Age 65 or older? There are 2 pneumonia vaccines, the PCV20 and the PPSV23, both of which should be administered a year apart. Feel free to schedule a virtual vaccine checkup with your Baskin Clinic doctor to review your status before you go.

  In closing, here’s a little peek behind the curtain at Baskin Clinic. While some members of our staff may not appreciate his brilliance, Dr Lester always likes to end our all-hands meetings with a dad joke. So here’s a few minutes of highlights from another kind of Doc Talk for your amusement. Enjoy!

Take care,

Baskin Clinic

As of today, April 3rd, Oregon is lifting the mask mandate in medical settings. At the Baskin Clinic, this will mean that patients, staff, and providers at Baskin Clinic will largely be making their own choices about whether to wear masks. However, we will continue to require masks at our discretion, like for those who may be presenting with symptoms of a respiratory infection.

We encourage those who wish to wear a mask to continue doing so, and we will continue to provide masks for your use. If you’d like your provider to wear a mask during your appointment, just ask.

Wearing a mask remains an effective way to reduce the transmission of respiratory viruses. We encourage you to wear a mask in any setting if you are sick, have a health condition that puts you at high risk for severe illness from a respiratory virus exposure (or you live with someone at high risk), or in situations where wearing a mask makes you feel more comfortable.

Baskin Clinic – Tualatin is Open for Business

In case you missed it, we opened our second clinic location in January on the Legacy Meridian Park campus in Tualatin! We’ve been sharing space with RMA (a local physiatry group) for the first few months, as we work on remodeling our own clinic down the hall. We are excited to move into the permanent space this summer.

Dr. Joseph Amavisca and Dr. Elizabeth Reding are accepting new patients. So please feel free to share this information with anyone you know who might be interested. Shannon Fisher, our fantastic lead MA at Tualatin, will be happy to set up a meet and greet with them.

And for patients at Baskin Clinic – Tualatin, please consider leaving us a review on Google or Yelp. Online reviews really help new patients find their way to us!

Pharmacy Updates

Walgreen’s recent acquisition and subsequent closure of Pharmaca has left some patients in a bit of a lurch. If you haven’t already, please make sure we know your preferred pharmacy before you need your next prescription or refill.

Also, there are a number of pharmaceutical shortages in the market right now (such as stimulant drugs). If your pharmacy is out of your prescription, we encourage you to call around to find it at another location, and let us know if we need to send your script somewhere else.

As always, we like to leave you with something fun. Spring is in the air here in the PNW, and that means more flying golf balls. Stay safe out there!

Take care,

Baskin Clinic

The office will be open to accepting patients of all ages. At Baskin Clinic – Tualatin, you can expect the same excellent service and care we provided in the Northwest location, but in a new home that’s more convenient for those who live or work in Tualatin, Lake Oswego, Tigard, and beyond. 

We are also excited to introduce you to our new Baskin Clinic – Tualatin Drs. Elizabeth Reding and Joseph Amavisca. Both doctors come to us with years of experience and superb reputations in the community.

Meet our Team:

Dr. Joseph Amavisca is a family physician.

Dr. Elizabeth Reding is an internal medicine physician.

Shannon Fisher is our lead medical assistant.

Find Us:

Address:

19250 SW 65th Ave, Suite 240, Tualatin, OR 97062

Phone:

503-808-9213

Hours:

Clinic Hours: 8am-4:30pm Mon-Fri
Urgent or additional days and times can be made available by appointment

FAQs:

I’m already a Baskin Clinic patient. Can I switch to the new office?

Current patients of Baskin Clinic – Northwest who would like to transfer to the Tualatin office are free to do so. Call us in January to set up a meet and greet with one or both of our new doctors.

Are there any discounts for current/former patients of Dr. Amavisca or Dr. Reding?

For a limited time, we will be waiving the enrollment fee for patients of our new doctors who come with them to Baskin Clinic – Tualatin.

Can I get an appointment at either Baskin Clinic location? 

Not really, no. Your Baskin Clinic doctor will hold regular clinic hours from their home office. There may be certain circumstances where an exception is necessary. But, you should expect to be cared for at your doctor’s clinic.

As we lean full swing into this winter holi-daze, we want to make sure to take a minute to share some great news: We have an excellent new addition to the team at Baskin Clinic – Tualatin! Dr. Elizabeth Reding was born and raised here in the PNW, and received her college and medical degrees here in Oregon as well. We are thrilled to welcome her aboard! We invite you to join us and take a minute to get to know Dr. Reding in her own words:

When did you figure out that you wanted to be a doctor, and why?

Both of my parents were nurses, so having discussions about bodily functions, medical procedures, and interesting medical cases was standard dinner time conversation in my house growing up. I first knew I wanted to become a doctor in 7th grade science class when we were studying the human heart. I was absolutely fascinated and couldn’t wait to learn more about the human body.

What do you love about being a doctor now?

I love getting to know my patients on a personal level: I enjoy hearing about their lives, families, hopes, and dreams. And I also love the intellectual challenge of being a primary care physician.  

What facet of science or medicine are you currently most excited about or learning about?

I am really excited to see what we keep learning about the gut microbiome! 

What makes Baskin Clinic a good fit for you?

The Baskin Clinic is a good fit for me because I can spend time with my patients getting to the root causes of their health concerns or counseling them on ways they can improve their health. This is distinctly different from other models of care, where what limited time you have is spent putting bandaids on problems, rather than actually solving them. I will be able to form stronger relationships with my patients at the Baskin Clinic, which leads to better patient outcomes, a reduction of unnecessary testing and medications, and better continuity of care.  

What do you want everyone to know about health?

Exercise is medicine for the brain! It helps improve mood, sleep, and is one of the most effective tools to reduce the risk of dementia. 

Tell us about one of your role models.

Without question: My parents. As nurses, they both dedicated their working careers to the service of others. They are two of the most hardworking, loyal, and loving people I know, and I wouldn’t be where I am today without their guidance and influence. 

What’s the last book you read?

The Radium Girls by Kate Moore.

What’s an ideal weekend look like for you?

My ideal weekend includes waking up without an alarm clock, having slow coffee (not rushing out the door with a travel cup!), going for a run, and then spending time (ideally outside) with my kids and husband.  

What’s your favorite joke?

I don’t really have a favorite joke but I discovered Dr. Glaucomflecken on YouTube and really appreciate his medical humor!  

What’s the most “Portland” thing about you?

I love GOOD coffee and the Portland Timbers.

Call the Tualatin office (503)808-9213 to schedule an appointment with Dr. Reding, and please give her a hello and a warm welcome when you see her around the clinic!