Health 8

M O N U M E N T

H E A L T H

Issue 08

Inspiring Innovation Physicians from Monument Health support a local Ph.D. candidate in her research in advanced medical technology.

Fall 2022

FREE COMMUNITY HEALTH SCREENINGS One of Monument Health’s top priorities is impacting our communities. Our goal this year is to provide over 10,000 health screenings to our friends and families in the Black Hills.

From blood pressure checks and prediabetes screenings to mental health assessments, our focus is to provide preventive care, close to home.

Find us at one of these upcoming events: December 14-18, 2022: Lakota Nation Invitational at The Monument January 27-February 4, 2023: Black Hills Stock Show & Rodeo Rapid City

monument.health/communityhealthscreenings

JOIN US FOR MONUMENT HEALTH’S

SPECIAL

A Remarkable Rodeo Event Compete on the same dirt as the professionals.

Saturday, Jan. 28, 2023 The Monument | Rodeo Rapid City - Black Hills Stock Show

12-3:00 p.m. | Free event | Lunch provided

For participant registration or to volunteer: monument.health/specialrodeo All participants must register by Monday, Jan. 23, 2023.

Events for individuals with disabilities of all ages

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W E L C O M E

F R O M

Paulette Davidson

President and Chief Executive Officer, Monument Health

O Bri Edwards, PA-C, helps others heal by sharing her story of grief.

ur lives are composed of the experiences we have. Some are tragic and others exhilarating, but it’s these experiences that shape who we are, how we spend our time and what we’re passionate about.

As you thumb through this issue of Monument Health Magazine, you’ll notice that passion is a theme that runs throughout the stories.

Laura Brunmaier left a successful career to help people suffering from cardiovascular conditions. She was drawn to this area of research because of family history. And her work will change many lives for the better.

Bri Edwards faced one of the most tragic things a person can face — the loss of a child.

She compared the experience to having one thousand pounds dropped on her chest, but instead

of succumbing to grief, she chose to use her experience to help others who have experienced loss.

You’ll have an opportunity to learn more about the Monument Health Military Veterans Group and the ways that they make connections with veteran patients.

Meet Whitney Driscoll and his son, Ryan, who share their gratitude to Monument Health physicians and caregivers after receiving treatment for heart conditions less than one year apart.

You can read about the history of vaccines, which Brandi Tackett, PharmD., refers to as, “the biggest success story in the history of public health.” Read about the symptoms, causes, treatments and risks associated with concussions, and learn what you should do if you suspect you or someone you know has suffered a concussion.

We hope you enjoy the stories of passion in this issue of Monument Health Magazine as much as we enjoy sharing them with you.

Any feedback, story suggestions or questions about health care are always welcome. Send your ideas to us at magazine@monument.health.

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C O N T E N T S FALL 2022

Regulars

In Case You Missed It This is our roundup of all the latest news and happenings throughout Monument Health. page 4 Awareness Months Highlights of key health issues and medical staff. page 6 My Space Deb Himrich, RN, is a certified Diabetes Care and Education Specialist who helps guide people living with diabetes. page 9

H E A L T H Managing Editor Melissa Haught Editor Stephany Chalberg Senior Writers Wade Ellett David Scott Contributors Karlee Baumann Jennessa Dempsey Dawn Kocina Ronda Neugebauer Anna Whetham Art Director Stacy Brozik Photographer Allison Geier-Barlow Social Media Manager Breanne Canaday Production courtesy of Rapid City Hospital Volunteer Auxiliary Published in association with Evergreen Media Creative Director John Edwards Photographer Jesse Brown Nelson Senior Writer Stephen Simpson Monument Health Magazine. All rights reserved. Reproduction of any part of this publication without the expressed consent of the publisher is prohibited.

The information included in this publication is believed to be accurate at the time of publishing. Additional articles are available online at magazine. monument.health Monument Health Magazine is a free, quarterly publication distributed throughout the Black Hills.

Follow us on Facebook and Instagram for updates. ©

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Ask the Doc Joy Mueller, M.D., talks about what happens when germs resist antimicrobials. page 10 Caregivers Who Volunteer Caregivers Rhonda Schaffer and Mark Harder discuss the importance of volunteering. page 12 The Home Team Holly Perli, RN, discovers a way to combine her teaching and nursing background. page 14

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Vaccines: A Love Story Brandi Tackett, PharmD., shares her passion for the science behind vaccines. page 24 The Beat Goes On Father and son Whitney and Ryan Driscoll received the care right when they needed it most. page 26 Dignity and Grace Monument Health has a rich history of hospice, palliative and home care. page 28

Introducing Get to know physicians who have recently joined Monument Health. page 33 Physician Spotlight Meet Rachel Michael, M.D., an orthopedic surgeon and Rorak Hooten, M.D., the Medical Director for Respiratory Therapy. page 34 My Space Sarah Wolfe offers comfort to patients and their loved ones while they wait to see their clinical provider. page 37 Calendar Upcoming events at Monument Health. page 39 Directory Find a Monument Health provider near you. page 40

Features and Stories

Research and Development Laura Brunmaier is a doctoral candidate working with Monument Health physicians. page 16 Concussion Monument Health specialists discuss the causes and symptoms of concussion, and how they should be treated. page 20 Giving Sorrow Words Bri Edwards, a caregiver at Monument Health, shares how SIDS shook her world and how she’s helping grieving parents today. page 30

NEWS // EXCELLENCE

GOLDEN GUITARS: HELPING OUT BY ROCKING OUT The Monument Health Foundation held its first Golden Guitars Gala in June. The gala raised more than $263,000 for Children’s Miracle Network (CMN). Golden Firefly Guitars were signed by a variety of bands and artists, ranging from Alice Cooper to Morgan Wallen, as part of the event. One guitar, signed by the Zac Brown Band, sold for $11,000.

Kory Van Sickle developed the event as part of his company’s philanthropic program. He also provided live music for the evening with his band Kory and the Fireflies.

The gala was attended by more than 220 people and is planned as an annual CMN event. Seventeen guitars were auctioned off, including one surprise celebrity guitar. Each year, more one-of-a-kind guitars will be signed by visiting musicians and auctioned off. All money raised will support local children.

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New Vice President of Diversity, Inclusion and Belonging In June, Monument Health announced Sandra Ogunremi’s promotion to Vice President of Diversity, Inclusion and Belonging. As Vice President, Sandra will work to ensure Monument Health celebrates diversity, inclusion and belonging within the workplace and throughout the communities served by the health care system.

EXPANDING CARE FOR MOTHERS, BABIES AND CHILDREN In May, plans for the next phase of the multiyear Rapid City Hospital expansion were announced. The planned construction expands services for mothers, babies and children at the Monument Health Rapid City Hospital. Construction of a three-story building will include a new Neonatal Intensive Care Unit (NICU) and postpartum care areas offering more room and privacy for families, as well as a multipurpose educational center for classes, workshops and other events.

FALL 2022 // HEALTH

INVESTING IN NEW WEST RIVER HEALTH SCIENCE CENTER Monument Health contributed $2 million to the new West River Area Health Education Center in May. The construction is planned for Black Hills State University’s Rapid City Campus.

The center will cost $15 million and provide space for nursing skill labs, a simulation center and nursing faculty offices. The center will allow the relocation of the SDSU College of Nursing to this site and will increase the region’s capacity to educate and train Registered Nurses.

$80 MILLION IN HEALTH CARE FOR SPEARFISH

In May, Monument Health announced two major construction projects in the Spearfish area. An expansion of the existing Spearfish Hospital campus on Main Street and construction of a multispecialty clinic near the Elkhorn Ridge neighborhood are planned to better support the growing needs of the Northern Hills community. Plans for the hospital include 78,000 square feet of new construction as well as remodeling 13,000 square feet of the existing campus. The new multispecialty clinic will offer improved access to a wide variety of medical specialties.

NEUROVASCULAR SPECIALIST JOINS MONUMENT HEALTH Monument Health welcomed Interventional Neurologist Jae H. Kim, M.D., in April when he joined the Monument Health Neurology and Rehabilitation Clinic in Rapid City as part of a new team of specialists focusing on early intervention and advanced treatment of stroke victims. Dr. Kim is an interventional neurovascular specialist and performs clot retrievals, aneurysm care and many other interventions for blocked and ruptured blood vessels in the brain. Early interventions are critical to help minimize the effects of a stroke and help patients with their recoveries.

The longer the brain goes without blood flow, the more prevalent the loss of brain function afterward.

Dr. Kim completed his Neurology residency at Temple University Hospital in Philadelphia. He also served as Neurology Chief Resident at Temple. He then completed fellowships in Vascular Neurology and Endovascular Surgical Neuroradiology at the University of Minnesota. Dr. Kim is board-certified in Vascular Neurology and Neurology.

HEALTH // FALL 2022

Textbook cardiology In June, Interventional Cardiologist Bhaskar Purushottam, M.D., FACC, FSCAI, FSVMB, of the Monument Health Heart and Vascular Institute, coauthored a chapter in the textbook “Interventional Cardiology: Principles and Practice, Third Edition,” and presented at LINC 2022, the world’s largest endovascular conference, in Leipzig, Germany.

Grants for cancer patients In May, the American Cancer Society awarded $30,000 in grants to the Monument Health Cancer Care Institute in Rapid City to help patients pay carerelated travel and lodging expenses.

Covering these expenses help patients focus on their care and recovery.

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AWARENESS MONTH // EXCELLENCE

National Physical Therapy Month

LUNG CANCER AWARENESS November is Lung Cancer Awareness Month. Lung cancer is responsible for one in four cancer deaths worldwide — more than colon, breast and prostate cancers combined — and is the second most common cancer in men and women. It is most common in people 65 and older.

As with most kinds of cancer, early detection and treatment is vital for improved care outcomes. Monument Health offers lung cancer screenings and comprehensive treatment.

Antibiotics Awareness Week National Antibiotics Awareness Week is November 18 to 24, which seeks to educate people about the risks of antibiotic resistance.

Overuse of antibiotics speeds up bacterial resistance to drugs and reduces their effectiveness.

The best way to slow bacterial resistance is only taking antibiotics as needed.

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Physical therapy can be an important part of improving quality of life for those affected by injuries or chronic pain.

October’s National Physical Therapy Month recognizes the hard work of physical therapists and physical therapist assistants everywhere.

Monument Health’s physical therapy team works to restore and improve function, reduce pain and prevent future injury using the most up-to-date techniques.

November 29 is South Dakota Day of Giving.

Monument Health Foundation is proud to be part of SD Gives.

One hundred percent of every donation to the Monument Health Foundation stays here to benefit our patients through equipment purchases, specialty programs and more.

To give, visit monument. health/donate.

BREAST CANCER AWARENESS Breast cancer makes up 30 percent of all newly diagnosed cancers in women in the U.S. Half of that is found in women younger than 62. In October, we observe Breast Cancer Awareness Month to highlight this major health concern.

Early detection and diagnosis are key to improving treatment outcomes. That’s why screening is crucial.

Monument Health offers 3D mammography in all of its markets.

Diabetes Awareness Diabetes affects more than 37 million Americans.

1.4 million new cases are diagnosed each year.

It is the eighth leading cause of death in the U.S. November’s National Diabetes Month brings

awareness to this growing health concern.

There are many factors to consider when treating diabetes. That’s why Monument Health educators work with patients to find an individualized care plan to maintain quality of life.

National Home Care & Hospice Month In-home and hospice care makes a huge difference for people living with severe, chronic or life-limiting illnesses. In November, we recognize National Home Care & Hospice Month. It’s a time to honor the tremendous impact these caregivers make in the lives of patients, families and communities every day.

FALL 2022 // HEALTH

Everyone 6 months or older should get an annual flu vaccine.

Curious about bringing a flu clinic to your workplace?

Learn more about hosting your own worksite flu vaccination program to ensure all of your employees are protected: visit monument.health/occupational or call 605.755.9166

Getting the flu shot and the COVID-19 vaccine at the same time is safe and won’t affect your immune response to either one.

TAKE ACTION AND

#FIGHT FLU GET VACCINATED Visit any Monument Health Clinic to get your $25 flu shot. www.monument.health

FILL IN THE BLANK

MON MENT H E A LT H

At Monument Health, our vision is to be one team, to listen, to be inclusive and to show we care.

There’s only one thing missing … You. The time is right for you to join a supportive team at the only Level II Trauma Center in the region, with access to Mayo Clinic’s knowledge and expertise — all at a health care organization that prioritizes being a great place to work and delivering high-quality care.

We are Monument Health. Are you?

For more information or to apply visit: monument.health/careers

Monument Health offers diabetes education resources throughout its service area. Diabetes is a lifelong disease, but knowledge is power when it comes to treatment. To find resources and learn more visit: monument.health/diabetes.

COMMUNITY // MY SPACE

My Role I am a Certified Diabetes Care and Education Specialist in the Endocrinology Department.

Diabetes educators provide the knowledge and tools to help patients with diabetes live well and make informed decisions about their health. This includes learning about the disease itself, exploring available treatment options and training patients to use diabetes devices such as blood glucose meters, continuous glucose monitors and insulin pens and pumps. We teach problemsolving strategies and healthy coping skills to help patients live healthy, active lives.

My Goal Each person is unique, and my department’s goal is to individualize care and provide assistance, support and compassion to help patients be successful in self-managing their disease. Diabetes can be a complex and overwhelming disease, and the number of people with diabetes is increasing.

Many people don’t realize all the changes that have taken place, especially over the past 10 years, with medications, technology and the disease itself.

My Passion Making a positive difference with my patients and caregivers is my passion. I work with great teams in Diabetes Education and Endocrinology. They all provide great care and support to patients and providers. Being able to assist them and help with their work is important, as they are amazing people to work with.

HEALTH // FALL 2022

Deb Himrich, rn Diabetes Educator, Rapid City Clinic, Flormann Street

Deb is passionate about teaching people with diabetes how to live a healthy and full life. With improvements in technology and research, diabetes management strategies have never been more customizable and effective for patients.

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ASK THE DOC // TRUST

What you need to know about antibiotic resistance Joy Mueller, M.D., is a board-certified Family Medicine Physician at the Sturgis Clinic and a lifelong South Dakotan.

She graduated from the USD Sanford School of Medicine in 2016 and went on to complete her Family Medicine residency in Rapid City in 2019. She has been practicing family medicine with Monument Health since 2016.

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Antimicrobial resistant infections or antibiotic resistant infections are one of the leading concerns of health care organizations across the world. Methicillin-resistant Staphylococcus aureus (MRSA) is a well known example of an antimicrobial resistant bacteria. MRSA causes staph infections and is carried by one to two people in every hundred.

What is antibiotic resistance?

Antibiotic resistance describes what happens when germs develop the ability to resist the drugs we have developed to kill them. This means that infections can continue to grow and spread and become much harder to treat.

How serious is this problem?

The emergence of antimicrobial infections is a serious and alarming worldwide problem. The World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) list antibiotic resistance as a leading public health concern. More than 2.8 million antimicrobial infections occur in the U.S. each year and they are

responsible for more than 1.2 million deaths worldwide. In some cases, resistant germs may have no other options for treatment, creating an increased threat to public health.

How do germs develop these resistances?

Like all living things, bacteria and other microbes adapt to their environments as part of a natural process. Mutations in their DNA create proteins that determine what resistance mechanisms are present.

Bacteria and fungi specifically can carry a variety of genes for resistance.

As antimicrobial germs spread they can also share these genes with other

FALL 2022 // HEALTH

Antibiotics Awareness Week is November 18-24, which seeks to inform the public about antibiotics. Bacteria can become resistant to antibiotics, so it’s important to only use them when necessary.

www.who.int/drugresistance

Causes of antibiotic resistance CAUSES OF ANTIBIOTIC RESISTANCE

Over-prescribing of antibiotics

Patients not finishing their treatment

Lack of hygiene and poor sanitation

Lack of new antibiotics being developed

germs, even those that have never been exposed around the world and can get into food and to antibiotic medications. water supplies, spread through contact with people and animals through community How does overuse of antibiotic spread or as we travel. Germs from our medication affect this? environment can be ingested when they As germs are exposed to antibiotic treatments transfer from our hands to our food, or more and more often, they face more pressure from improperly stored or prepared foods. to adapt and develop resistant strains. As non- Some infections are spread through sexual resistant strains are killed by antibiotic drugs, or other intimate contact with other people. resistant strains spread and become more Human and animal waste, as well as common. Antibiotics and antifungals can also agricultural and industrial waste, can be a kill off germs that are beneficial to our bodies source of infection if improperly handled or and may impact our immune system’s ability to disposed of. fight off infections.

What can I do?

There are several ways someone can work to reduce their risk of infection with Antibiotics are lifesaving drugs and can be an antimicrobial resistant germs. As with important part of treating an infection, but it’s many things, prevention is often the best important to know when to use them. First, strategy. Proper hygiene can play a major it’s important to talk with your care provider role in preventing illness. Wash your hands and follow their guidance when taking these before eating or after taking part in any drugs. Many of these treatments have a specific activity where you may have come into use. As an example, antibiotics are used to treat contact with germs. Make sure food is bacterial infections, antifungals are used to properly stored and prepared before eating treat fungal infections and so on. Some drugs it, and keep any surfaces or utensils used are focused even further on specific strains of to prepare food properly sanitized. Safe sex bacteria or fungi. practices can prevent the spread of sexually transmitted infections. Make sure waste, or Where are antimicrobial germs spread? other potentially hazardous materials are Germs are part of our everyday lives and can properly handled and disposed of. If you do be found everywhere we can. Not all germs get sick, make sure antibiotic medications are harmful and some even help us. Antibiotic are prescribed appropriately and only taken resistant germs have been found everywhere as instructed by your care provider.

When should I use antibiotic treatments?

HEALTH // FALL 2022

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VOLUNTEER PROFILE // COMMUNITY

Rhonda Schaffer Certified Pharmacy Technician, Lead-Deadwood Hospital

Volunteerism doesn’t just mean supporting one organization directly.

Sometimes it’s finding ways you can independently raise funds or awareness for many local charities.

What is your role at Monument Health?

I am a Certified Pharmacy Technician at Lead-Deadwood Hospital.

Who do you volunteer with, and why?

I help several local charities by organizing and running an annual community rummage sale. It started as a one-off event, but it was so successful we decided to keep running it every year. The proceeds from the rummage sale go to organizations in Lawrence County like City Clothing Center — also known as the “free store” — Lord’s Cupboard and Boys & Girls Club of the Black Hills.

Why do you think it’s important to give back to the community?

Helping charities helps others. Our communities are our homes, and nonprofits are an important part of that. Even by helping in small ways, we can make a big difference in the lives of others. Helping local charitable organizations is paying it forward in our communities.

How do you think volunteering makes you a better caregiver?

Volunteering keeps me grounded and helps keep the compassion real.

Sometimes it’s easy for me to get caught up in the stresses of everyday work and life, but then seeing a big smile on the face of someone I’ve helped — that’s what makes life real.

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FALL 2022 // HEALTH

The Monument Health Veterans Group is open to any physician or caregiver who has served in the U.S. Armed Forces.

What is the Monument Health Veterans Group?

We are a group of 322 veterans who are also physicians and caregivers working at Monument Health. We make up a volunteer group to support our patients and communities. Our main goal is making connections with veterans who are being treated at our inpatient facilities. When registering, veterans can request a visit by one of our volunteers, and we do our best to make it happen.

Why is it so important that this group exists at Monument Health?

There are a significant number of veterans living in the communities we serve, many of them work for Monument Health. Because of that, we go the extra mile to show our veteran patients and communities how much we care about them. Military service provides a unique perspective, and veterans often share an unspoken bond from experiences that are hard to understand if you haven’t lived through them. That shared understanding — knowing you’re not alone — can have a major impact on patient care.

What are some of the goals and projects that the Military Veterans Group has completed?

We provide Hero Walks, which is when a veteran passes away, we line the hallway to pay our respects to them and to their family. We try to provide veteran inpatients with a visit when requested and place a branch-related veteran magnet and an American flag magnet on the frame of their room door. We also present them with a pin and certificate, thanking them for their service. Volunteering is a big part of our group. We’re always looking for opportunities at veteran-related events throughout the Black Hills.

What would you like people to know about the group?

Every one of our members has volunteered in caring for veterans and their families during critical times in their lives. This spirit of service is strengthened by the sisterhood and brotherhood we share as former service members.

HEALTH // FALL 2022

Mark Harder Supervisor Radiation Therapy, Cancer Care Institute Monument Health Military Veterans Group Chair

Military service is a unique experience.

Mark Harder works to make sure every veteran that enters a Monument Health facility is cared for and honored.

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NURSE PROFILE // EXCELLENCE

THE HOME TEAM CAREER PATHS AREN’T ALWAYS STRAIGHT LINES — AND SOMETIMES, TAKING THE LONG WAY AROUND LEADS EXACTLY WHERE YOU’RE MEANT TO BE. Written by Dawn Kocina Photo by Allison Geier-Barlow

When Holly Perli, RN, was in high school, she knew that she wanted to work in health care. Like a lot of teenagers, however, she didn’t know all the paths that were available to her. Knowing that she didn’t want to spend upwards of eight years in college and medical school, Holly chose to pursue another career path — becoming a science teacher.

She had always been drawn to the subject, but once she was in front of a classroom, she discovered that she just wasn’t passionate about teaching high school students. With this lesson learned, Holly made her way back to health care.

Holly was first acquainted with Monument Health — then Regional Health — as a nursing student working part time as a unit assistant in dialysis. From there, she left the area to pursue other opportunities, eventually returning to the Black Hills. At that time, she was working remotely for another employer and, as she said, “I’m a team person and it occurred to me one day, why am I not playing for the home team?” Since returning to the home team, Holly has held positions focused on nursing education within and outside of the walls of Monument Health.

Currently, Holly is part of the Nursing Professional Development (NPD) team whose focus extends beyond education to include onboarding, evidence-based practice, collaborative partnerships and role development.

In addition, she acts as a liaison to nursing schools and students by facilitating continuing education, clinicals and preceptorships. This portion of her role is part of what led Holly to work with the Rapid City Academies Approach (RCAA) at Rapid City Area Schools.

“I feel like I’ve come full circle,” Holly explained.

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“My first degree is in teaching secondary education that I never really used prior to my role with Monument Health and the Rapid City Area Schools Pathways program. I’m able to use this knowledge I’ve gained to help nurses and students find their path.”

RCAA allows students to explore an industry of their choice, including health care, while still maintaining graduation requirements. Holly hopes that participants are able to further explore and learn about job fields that interest them — as well as determine what roles may not be a good fit. With her own experience of pursuing multiple degrees, she feels that this program provides students with a “leg up” in the professional world.

“We hope to show students how meaningful nursing is, and that Monument Health is a great place to work.”

Conventional teaching may not have been the right path for Holly, but her education in the field paired with her nursing knowledge allows her to educate future nurses in her own way.

“Keep your mind open to all aspects of health care.

Get in the door and see things firsthand. Whether or not that ends up being what you do, it’s an experience and a connection that can help you with whatever comes next.”

When asked if she has advice for individuals considering working in health care, or nursing specifically, she laughed and said, “Yes, do it!” More seriously, but with a smile still on her face, she added, “There are hard situations and challenging moments, but each day is so rewarding.

You can never say ‘the work I’m doing isn’t meaningful,’ because it truly is.”

FALL 2022 // HEALTH

Monument Health’s involvement in the Rapid City Academies Approach prepares Rapid City students to succeed in health care as a career — either following high school or after a post-secondary education.

In 2020, Rapid City Area Schools (RCAS) launched an academies approach that provides all students with access to career-connected learning experiences. All ninthgrade students begin their journey in a Freshman Academy course exposing them to various career opportunities to explore during their high school experience.

Rapid City Academies Approach (RCAA) strives to bring career pathways to RCAS, as well as build strong connections to employers, institutions of higher education and community-based organizations.

The Academy model works to equip high school students with the knowledge and skills they need to explore career options while still in school. This approach aims to help students develop a plan that leads graduates to a successful transition beyond high school, including postsecondary education and training, careers and life responsibilities.

Freshman Academy allows students to explore the various Academies and engage with content in digital citizenship, computer applications and workplace skills.

The Rapid City Academies Approach is supported by corporate sponsors and Advisory Councils comprised of community leaders that work to ensure teaching materials are accurate and relevant to the real world.

Due to the unprecedented nationwide teacher shortage, modifications to the initial RCAS Academy have been made. The six academies have been consolidated into three academies: • The Academy of Arts, Humanities, and Social Services • The Academy of STEM • The Academy of Advanced Technologies.

Within each of these academies, students have a variety of pathways to choose, each providing career exploration and work-based learning experiences.

HEALTH // FALL 2022

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FEATURE STORY // EXCELLENCE

CHANGE OF HEART WHEN THE TIME CAME FOR LAURA BRUNMAIER TO MAKE A DECISION ABOUT HER FUTURE, SHE MADE THE BEST POSSIBLE CHOICE — SHE FOLLOWED HER HEART. Written by Wade Ellett Photos by Jesse Brown Nelson

In 2016, Laura Brunmaier decided to make a big change in her life. She left a successful and lucrative career in upper retail management and returned to school to finish her degree. “The standard of living was nice,” she explained with a chuckle. “But there wasn’t a lot of meaning behind it for me. I wanted to do something — more.”

Laura returned to school at SD Mines in Rapid City. Before she even completed her bachelor’s degree in applied biological science, she dove into biological engineering research projects, beginning with nanoengineering. In December 2018, she was introduced to Travis Walker, Ph.D., Associate Professor of Chemical and Biological Engineering, who was looking for a biomedical engineering graduate student to take on a project for making a vascular graft.

“I ended up leaving nano to start in Dr. Walker’s lab about six months before I finished my bachelor’s degree in May 2019. It was a head start on my Ph.D. work,” Laura said. “I knew we were making this vascular graft, a kind of replacement blood vessel, but I had to fill in a lot of details on how.”

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Laura’s research centers around engineering substances found naturally in the human body to create new blood vessels for patients.

Currently, the options for blood vessel grafting are limited to harvesting existing blood vessels from other parts of the body or using synthetic materials to create sections of blood vessels.

Both of these methods have their drawbacks.

Now Laura is a Ph.D. candidate and continues her work developing the vascular graft as a graduate research assistant in biomedical engineering at SD Mines. Her research focuses on creating new blood vessels in a lab that can be used during cardiovascular surgeries to replace damaged tissues. Even more impressive, these grafts will be made out of the biological material that’s already in the human body.

REVOLUTIONIZING CARDIOLOGY

“Our goal for this graft is to have it made out of natural polymers — materials that you would find in the body,” she explained. “A lot of grafts are made from synthetic polymers, and there’s been some success with that, but there are also downsides.”

One example of these drawbacks is with pediatric patients. A child who receives a synthetic graft will need repeated surgeries as they grow to replace the artificial vessel with a better fitting one. That won’t happen with the natural polymers being used by Laura. “It was important to me to use a material capable of being remodeled by the body, which you can

FALL 2022 // HEALTH

Nearly 18.6 million people around the world died of cardiovascular disease in 2019. With so many people suffering from heart disease, Laura’s research has the potential to save millions.

By using collagen, a natural protein found throughout the body, Laura and her team are able to create a replacement blood vessel that can grow and adapt with the human body. Synthetic blood vessel grafts, on the other hand, have to be surgically replaced as the body grows.

do with natural polymers. The cells can actually break down those materials on a micro-level, restructure things and relay proteins as well. That allows the material to be incorporated into the tissue.”

While these grafts have the potential to be used throughout the body, Laura was particularly interested in creating a graft that can be used in the heart — replacements for coronary arteries, to be specific. Heart disease has had a significant impact on her and her family. Her father struggles with high blood pressure, and both of her maternal grandparents as well as her mother passed away from heart attacks.

“Heart disease has affected everyone in my family, and it’s something that I’m very conscious of,” she said. “Our goal is to make a blood vessel, and we have the perspective of how that will make a difference in the fight against cardiovascular disease.”

The challenge with creating a replacement vessel that will be used in the heart is the amount of pressure involved. The heart beats between 60 to 100 times every

HEALTH // FALL 2022

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FEATURE STORY // EXCELLENCE

Physicians from Monument Health like Cardiologist Bhaskar Purushottam, M.D., FACC, FSCAI, FSVMB, and Cardiothoracic and Vascular Surgeon Kalyan Vunnamadala, M.D., have been resources to Laura’s research.

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FALL 2022 // HEALTH

To learn more about cardiology at Monument Health, visit monument.health/heart.

In September 2021, Laura was awarded a National Science Foundation Graduate Research Fellowship to fund her research and to provide her with a stipend while she finishes her Ph.D. The fellowship aims to strengthen and ensure the quality and longevity of the scientific and engineering workforce in the U.S., with an emphasis on diversity and broadening the participation of underrepresented groups.

Since 1952, the National Science Foundation has funded over 60,000 Graduate Research Fellowships, with more than 450 fellows joining the National Academy of Sciences and 42 fellows going on to become Nobel laureates.

minute, moving five to six liters of blood in the process. Many natural polymers don’t have the strength to withstand the constant and consistent pressure generated by the heart.

A REAL WORLD UNDERSTANDING

To better understand the forces that her grafts would need to endure, and to learn about how these materials might be used in the clinical environment, Laura worked with Cardiologist Bhaskar Purushottam, M.D., FACC, FSCAI, FSVMB, and Cardiothoracic and Vascular Surgeon Kalyan Vunnamadala, M.D. These physicians invited Laura to observe related surgical procedures in order for her to have a better understanding of what these grafts will need to withstand in the human body.

“They’re both really great doctors and great people. I’ve worked with Dr. Purushottam longer because he does more of the interventional work putting stents in place,” said Laura.

“I shadowed Dr. Vunnamadala and got to watch him perform open heart surgery and harvest veins from the leg.

Both of them have been very open to any questions and conversations with me. They communicate really well, and even though I know they’re incredibly busy, they’re also very responsive.

They have been really incredible collaborators for me.”

WHERE NO ONE HAS GONE BEFORE

Building a blood vessel is no easy task. It involves creating specialized equipment to even get started. Laura and her team made an in vitro modeling device that allows them to model parts of the human anatomy outside of the body. “What we’re trying

HEALTH // FALL 2022

“Synthetic polymers have their downsides, but natural polymers come with challenges as well. We can do different types of testing in the lab to understand the mechanical strength, but natural polymers and the way that they’ve been processed previously, are just inherently weaker unless we go in and modify certain things.

When you make certain modifications, sometimes you can take away that ability to have the material remodeled by the body.

Our focus is really using certain polymer processing methods to take advantage of alignment of microfibers to enhance the mechanical properties of the graft. Right now, I’m looking at three, possibly four distinctively different layers. I’ve made a three layer graft out of collagen — collagen is really easy to work with just to test some of our processing methods — and now I’m back on the computer researching, trying to figure out different ways that people have processed other materials and what methods we need to use to make it more mechanically sound. Once those projects are done, I’m hoping to have most of my focus on this material’s processing to create the second generation of this graft.” Laura said.

to do is model this small piece of the vascular system. I can put cells in this device to simulate the endothelium, the inner lining of blood vessels, and I can do all kinds of different tests on them,” she explained.

With two years left in her Ph.D. program, Laura is focused on completing her research. “Most of my focus has been the in vitro modeling device that we built and developing the second generation of the grafts. Once we wrap those things up, I’ll probably spend more time trying to figure out what my next steps will be,” she said.

“I haven’t spent a lot of time thinking about my life after school because just trying to finish the design and get the work done is consuming in itself.”

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WELLNESS // EXCELLENCE

HEADED FOR TROUBLE TECHNOLOGY IS VITAL TO THE MEDICAL COMMUNITY. MONUMENT HEALTH’S SPORTS MEDICINE STRIVES TO MAKE SURE ITS ATHLETES ARE PROTECTED USING THE LATEST INNOVATION. Written By Jennessa Dempsey

Concussions are common and can affect people of all ages. Most are mild, and the injury along with any side effects, usually goes away within a few days without lasting effects. However, a severe concussion can cause impaired consciousness for several hours or longer and may cause longer and more serious side effects.

After a concussion, people can lose consciousness for a short time. However, most concussions do not result in a loss of consciousness. Not being able to remember events prior to, or following the injury, for a period of time is another sign of concussion.

Though, some people simply feel dazed or confused.

National surveys estimate that approximately 3 to 18 out of 100 children or adolescents in the general population will have a concussion at some time during their childhoods.

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KNOW THE SIGNS OF A CONCUSSION A concussion is a temporary change in brain function due to a traumatic head injury. It may cause loss of consciousness for a few seconds or even impaired memory of the event.

The symptoms can vary and could include: •H ead pain • Fatigue •T rouble sleeping • Dizziness • Difficulty concentrating • Irritability • Mood changes • Personality changes • Generalized aches and pains • Decreased appetite

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Sway Medical is a cutting-edge technology that allows caregivers to diagnose concussions on the field using a mobile device.

WHO TREATS CONCUSSIONS

When a concussion is sports related, athletic trainers, sports medicine physicians or physical therapists can treat athletes. It is very important to have a concussion identified and treated by qualified health care professionals.

“Athletic trainers are trained in concussion recognition and treatment. They have tools like Sway and SCAT5 to help determine if someone has a concussion,” said Kaleb Birney, Certified Athletic Trainer.

“More importantly, athletic trainers understand the healing process and what the patient needs to do following a concussion so that they can return to sports, activities and school safely.” Athletic trainers also check for any signs of more serious problems and prevent further injury to the patient.

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WELLNESS // EXCELLENCE

MYTHS AND FACTS ABOUT CONCUSSIONS Myth: If they don’t get knocked out it’s “not” a concussion.

Fact: Most concussions occur without a loss of consciousness.

Myth: People suffering from concussions need to wake up every 30 minutes to an hour.

Fact: Unless otherwise directed by a health care provider, people suffering from concussions may sleep as much as needed.

Myth: A mild concussion is not a brain injury.

Fact: There are different levels of concussions – mild, moderate and severe — but even mild concussions are brain injuries.

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To discover more about Monument Health’s comprehensive approach to concussion care, visit monument.health/concussion-management.

Following a concussion, athletic trainers can aid in the treatment with symptom scores, balance testing, Sway testing and VOMS (Vestibular Ocular Motor Screening) rehabilitation. “They can also educate the patient on how to best perform in the classroom if they are a student,” Kaleb said.

CAUSES OF CONCUSSIONS AND POSSIBLE RISK FACTORS

Head traumas are the cause of a concussion and are often associated with sports related injuries. A TBI can cause a concussion with or without an identifiable physical injury.

Concussion is believed to occur due to changes in the chemical activity in the brain that result from trauma. These changes can affect different regions throughout the brain.

Hollan Harper, D.O., most commonly sees concussions in football due to helmet to helmet collisions or from an athlete’s head hitting the ground. He said, “Similarly, with other sports, usually it is the head colliding with another body, part of another person or after falling and hitting their head on the ground, for instance, taking a charge in basketball or getting hit in the head by a volleyball.” He continued, “Outside of athletics we typically see concussions following motor vehicle or bicycle accidents.”

Concussions are generally caused by some type of head impact but can also be caused by non-contact whiplash injuries as well.

Of those contact sports, football, hockey and rugby are the sports with the highest risk of concussions.

SWAY CONCUSSION TESTING

Sway Medical is a new platform of concussion testing that allows Monument Health athletic trainers and providers all-in-one access via a mobile

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WHAT YOU SHOULD DO • Stay off phones and other electronic devices.

• Get as much rest/sleep as possible.

• Perform rehabilitation exercises such as VOMS, walking, jogging as prescribed by your AT, PT or physician.

• Complete an extensive return to play/learn protocol.

• Never return to a game or competition if you suspect a concussion.

• Learn and practice the proper techniques for your sport.

• Talk with the athletic trainer or primary Sport Care Medical practitioner treating you daily about your symptoms.

device to collect data and better care for athletes. Sway has pioneered mobile balance testing with technology that uses nothing more than the mobile sensors built into the device an athletic trainer already has, their cell phone. This allows Monument Health athletic trainers to administer a medical grade balance test in virtually any setting.

“We’re thrilled to be able to use this program. It allows us to establish baseline testing for athletes at a more efficient rate,” Kaleb added. Sway also makes it easier for me to track athlete symptoms and update records in real time. It gives me the opportunity to provide faster feedback to players, their physicians and coaches.”

Kaleb Birney, Certified Athletic Trainer Kaleb Birney, MS, LAT, ATC, CES, PES, has been a certified athletic trainer for 10 years and is the Head Athletic Trainer at South Dakota Mines.

Hollan Harper, D.O. Hollan Harper, D.O., is a Primary Care Sports Medicine Physician at Monument Health’s Orthopedic & Specialty Hospital in Rapid City.

Dr. Harper is one of the team physicians for the South Dakota Mines Hardrockers and several Monument Health sports medicine partner high schools.

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HEATH & WELLNESS // EXCELLENCE

Brandi makes sure that all of her family and friends are vaccinated against two diseases when they’re eligible for the shots: pneumococcal pneumonia and shingles.

“Both of these can have some serious health consequences if you contract them,” she said.

Pneumococcal Vaccine Pneumococcal disease can cause pneumonia, meningitis, sepsis and other potentially deadly infections. Adults 65 years and older as well as some younger adults who are at risk should get a pneumococcal vaccine. Children under 2 also are eligible for a version of the pneumococcal vaccine. In children, the vaccine significantly reduces the risk of early childhood ailments like ear infections. The complications caused by pneumococcal diseases can range from inconvenient to life-threatening.

Aging is complicated enough. If you’re 65 or older, talk to your doctor or pharmacist about the protection that a pneumococcal vaccine can provide.

Shingles Vaccine Shingles is caused by the same virus that causes chickenpox, the varicella-zoster virus. If you were infected with chickenpox as a child, the virus remains dormant in your body. The virus can reemerge years later as shingles.

Although shingles isn’t life-threatening, the infection can result in extremely painful blisters and rashes and may even cause permanent nerve damage and long-term pain. If the shingles rash spreads to the face and eyes, vision loss can occur.

Everyone 50 years or older should get the shingles vaccine. This vaccine is administered in two doses with two to six weeks between doses. The potential pain and complications caused by shingles can be reduced by over 90 percent with two simple shots.

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FALL 2022 // HEALTH

December 6-12 is Influenza Vaccination Week. Flu shots are free with most insurance plans and are just $25 at any Monument Health clinic if not covered by insurance.

VACCINES: A LOVE STORY DIRECTOR OF INFUSION SERVICES, BRANDI TACKETT, PHARMD., IS PASSIONATE ABOUT THE SCIENCE BEHIND VACCINES AND IMMUNIZATION. SHE AND THE REST OF THE PHARMACY TEAM AT MONUMENT HEALTH BRING EXPERTISE TO EVERY PATIENT’S DECISION ABOUT MEDICATION. Written by Stephen Simpson Photo by Jesse Brown Nelson

Brandi Tackett, Director of Infusion Services at Monument Health, learned early in life that the subject of medicine energizes her. When she was growing up, her grandma had diabetes. She points to this as the beginning of her desire to understand how medication can help people.

“I then spent some time working in a rural health clinic in high school,” she said. “I learned there that I really love the study and the science behind medication.” Brandi didn’t miss a beat pursuing her passion. “I started pharmacy school when I was 17,” she explained.

ASSEMBLE YOUR TEAM

GETTING EXCITED FOR VACCINES

3 FACTS ABOUT VACCINES

One particular topic in medication that gets Brandi buzzing with excitement is vaccines and immunization. “If I could tell people one thing about vaccines, it would be that they are the biggest success story in the history of public health,” she shared. By harnessing the natural response of the immune system, vaccines have changed the well-being of humankind in a way that can’t be overstated. “The World Health Organization did a study recently, and they estimated that about 5 million lives each year are saved thanks to vaccines.” Most of the lives being saved by vaccines belong to children from all over the world.

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To ensure that you’re making the best decisions for your health, it’s best to speak with an expert.

“The medication process can be very complex,” Brandi said. “Make sure you’re bringing a team of people around the medications you use. It’s about asking questions to your doctor, your nurse and your pharmacist.” The caregivers at Monument Health are passionate about helping people make informed and complete decisions about their medication and vaccines.

About 200 years ago, Edward Jenner, a British physician, observed that milkmaids who had been infected with cowpox seemed to be immune to the similar but much deadlier smallpox.

Jenner began to experiment with intentionally infecting people with cowpox to protect them from smallpox. Jenner would later name this process vaccination — vacca being Latin for cow.

Children benefit the most from the worldwide spread of vaccines. Every year, vaccines

save the lives of about 3 million children. Since 1988, the number of children paralyzed by polio has shrunk by over 99 percent.

Vaccines have come a long way. One of the latest advancements in vaccinology is mRNA vaccines. Instead of infecting the body with a weakened form of the virus, scientists are able to create a protein that instructs cells how to fight off specific diseases.

This technology has been in development for decades.

The first commercially distributed mRNA vaccine was the vaccine for SARS-CoV-2.

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PATIENT STORY // COMMUNITY

THE BEAT GOES ON WHITNEY DRISCOLL AND HIS SON, RYAN, HAVE MORE IN COMMON THAN JUST THEIR LAST NAME. THE FATHER AND SON FIND THEMSELVES GRATEFUL TO A COMPREHENSIVE TEAM OF MONUMENT HEALTH CAREGIVERS. Written by Stephen Simpson Photo by Jesse Brown Nelson

WHITNEY’S EXPERIENCE

Whitney Driscoll started biking with an ulterior motive. “I really, really like to ski,” he said. “So, I started mountain biking to stay in shape for skiing.” But as he explored in and around his hometown of Spearfish on the seat of his bike, he started to enjoy the sport for its own charms.

To give himself a goal, Whitney started to enter bike races — including the Dakota Five-O, an annual 50-mile mountain bike race.

In December 2020, something started to change for Whitney. “I know the exact spot where I first noticed it. I call it ‘heart attack hill,’” he said.

Whitney was riding a gravel trail in the Black Hills when he noticed a strange feeling to the left of his sternum. “It kept happening into January. So, I called my friend who’s a vascular surgeon. He told me I needed to go in and start ruling some very serious things out.” Whitney made an appointment to see his doctor, Jay Bogard, M.D., in Spearfish.

Whitney went through a stress test, but it didn’t show any abnormalities.

“After that, my wife and I went down to Arizona,” Whitney said. “We were doing some rides down there that I had done easily before, but it left me feeling wiped out. I finally told my wife that I needed to see the doctor again. So I called Dr. Bogard from Arizona and made an appointment.”

Dr. Bogard was determined to pinpoint what was causing Whitney’s chest discomfort and fatigue.

“I think the phrase he used was ‘full-court press,’” Whitney said. Dr. Bogard discovered that Whitney’s troponin levels were elevated. Troponin is a protein that appears in blood when the heart is damaged.

Dr. Bogard then ordered an echocardiogram. The mood changed when Dr. Bogard was able to see Whitney’s heart.

Whitney was then rushed by ambulance to Rapid City for surgery. “I realized how serious it was when the cardiologist, Dr. Heilman, met me at the door of the ER in Rapid City,” Whitney said. Whitney had major blockages in his heart and received a stent.

Following recovery, Whitney found that his support from Monument Health didn’t end. “After I went home, Dr. Bogard and Dr. Heilman took the time to call me — it wasn’t me calling them; they called me,” Whitney explained. “They really helped to find the right balance of medication that worked with my active lifestyle.”

Following his surgery, Whitney returned to mountain biking and skiing. He attributed his speedy return to his exercise routine to the tailored attention he received from his caregivers at Monument Health. “Dr. Bogard has been awesome. He’s super available, whether it’s sending him a quick message on MyChart or giving him a call. The individualized care has been incredible.”

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Primary care physicians, like Dr. Bogard, help their patients navigate day-to-day health needs by establishing a baseline of well-being and tracking your health needs over time. They also provide education for disease prevention and help coordinate with specialists, such as Dr. Heilman.

RYAN’S EXPERIENCE

Taking It Seriously John Heilman, M.D., FACC, Chairman of the Cardiovascular Department at Monument Health and Whitney Driscoll’s cardiologist, points out how his patient’s actions made for a successful experience during his cardiac event.

“Whitney was persistent and advocated for himself,” Dr. Heilman shared. “It’s very important for patients to pay attention to any new or unusual symptoms.” Whitney’s decisive actions contributed to his ultimate recovery. “Some people recognize the seriousness of these symptoms immediately,” Dr. Heilman said.

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“Others will have symptoms for months and then seek medical attention. The third group may deny the seriousness of their symptoms and chalk it up to indigestion or a cold.”

Dr. Heilman reminds people not to ignore these and other symptoms: • Shortness of breath • Tightness or squeezing sensation in the chest • Sweating • Feeling ill at ease • Nausea • Pain radiating from the chest to the back, arm or jaw

A little over a year later, Whitney’s 27-yearold son, Ryan, began experiencing chest discomfort. “I was diagnosed with AVNRT back in eighth grade,” Ryan explained.

Atrioventricular nodal reentrant tachycardia causes the heart to beat much faster than normal. To manage the symptoms, people afflicted with AVNRT use different breathing techniques to reduce their heart rate during trachyocartic episodes.

One day, his ability to manage his AVNRT changed. “All of a sudden my breathing techniques weren’t working as well. I couldn’t get my heart to slow down very much,” Ryan said. “I was talking to my dad about it, and he suggested I go see Dr. Bogard. So, I made an appointment.”

When Ryan went to Dr. Bogard’s office in Spearfish, his heart was beating around 200 beats per minute. “I was in Dr. Bogard’s office for about 20 minutes before they sent me to the ER to get my heart rate down,” Ryan said.

Once caregivers at the Spearfish ER were able to slow Ryan’s heart rate, he was taken by ambulance to Rapid City Hospital for surgery. “I remember being really impressed with the new Heart and Vascular Institute.

It’s really cool to have access to a facility like that in South Dakota,” Ryan said.

“The other thing that really blew me away was how well each team worked and communicated together.”

Ryan’s surgery worked to normalize his heartbeat. “My surgery lasted for three hours.

I recovered for a few hours, and I was able to go home around 8 p.m.,” he said.

Both father and son faced unique challenges and in the end were able to walk away from their experiences with new perspectives and grateful attitudes. Whitney has this advice: “If you feel your heart and it’s not feeling quite right, be humble enough to go get yourself checked out.”

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FEATURE STORY // COMMUNITY

PLAYING A PART IN DIGNITY AND GRACE HOME HEALTH, HOSPICE AND PALLIATIVE CARE ARE NOT TAKEN LIGHTLY AT MONUMENT HEALTH. END-OF-LIFE CAREGIVERS ARE MESSENGERS TO THE COMMUNITY THAT EACH LIFE IS PROFOUND AND IS WORTHY OF EXCELLENT CARE. Written by Stephen Simpson Photo by Jesse Brown Nelson

As the Hippocratic Oath states, “There is art to medicine as well as science.” This oath sworn by many physicians goes on to state that, “Warmth, sympathy and understanding may outweigh the surgeon’s knife or the chemist’s drug.” No other group of caregivers may understand this balance more than the team behind end-of-life care.

A SPECIAL BOND

Caregivers who choose to enter a career in end-of-life care are accepting a special assignment. “We really get to help patients and their families at a really scary time in life,” said Michelle Sieveke, Director of Home Health, Hospice and Palliative Care at Monument Health.

Medical strategies in end-of-life care work to treat the whole person through physical, mental and spiritual care.

One of the most important aspects of the hospice philosophy goes beyond the patients themselves. “We’re not only there for the patient; we’re there for the family, as well,” Michelle said. “Families and caregivers get to create a special bond.” Following the passing of a loved one, family members are eligible for up to 12 months of grief support from Monument Health caregivers.

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AN EXTRA DRIVE

Crystal Philpot, the Nurse Manager for Monument Health Home Health and Hospice, shared what it takes to be a caregiver who specializes in end-of-life care. “They have to have an extra drive to connect on a one-on-one basis with patients.” Caregivers who work in hospice, palliative and home care include doctors, nurses, social workers and other specialists who are able to focus on specific aspects of end-of-life care.

“Everyone who starts in this field of health care comes in with an idea of what they think it is,” Crystal said.

“They get to see the part they play in a patient passing with dignity and grace. Then they connect the dots of how important and fulfilling what they’re doing is.”

MEMORIES

“People will always ask me, ‘How can you work in that setting? Isn’t it depressing?’” Crystal said. “To that, I’ll always explain the importance of what we do. When you look back on those really important days in your life, you may not remember the exact details of the moment, but you definitely remember how you felt.

And that stays with you forever. My goal is to teach our

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“The Rapid City Hospice House facility was 100 percent funded by the community,” Michelle Sieveke said. “We’re really proud of that. We come in with the attitude that we’re giving something back to the community.”

Michelle Sieveke, Director of Monument Health Home Care and Hospice believes that each of us has the desire for comfort, care and support.

When someone we love has a terminal illness, these desires become critical needs.

When this happens, what we want most for our loved one is compassionate support and care that allows them to live their last days with dignity and without pain. These are the types of services that can be found in Monument Health’s Hospice House.

Hospice and Palliative Care These common terms associated with end-of-life care may seem interchangeable, but each word refers to a unique facet of this field of health care.

Hospice is a philosophy of care that centers around a person who has received a prognosis from their doctor that they have six months or less to live.

Hospice care can happen in that person’s home, an assisted living facility or a specialized hospice facility.

Curative treatments cease and caregivers focus on comfort and quality of life.

caregivers that’s what will happen for the loved ones of our patients. You need to provide that experience and that environment so that when the patient’s loved ones look back, it’s a good memory.”

Michelle added, “Our caregivers would say that this is extremely rewarding and fulfilling work.”

We are honored to bring a little light to a family’s darkest days and are truly living out a calling to serve our communities.

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Palliative care is the field of health care that centers on easing the pain and suffering of patients. Palliative care may be included as part of hospice care, but it can also be part of a prognosis that includes curative measures.

Caregivers can use palliative medicine and treatments to help their patients, for example, find relief from chronic pain or nausea.

Hospice caregivers are committed to making a lasting difference in the lives of patients diagnosed with a lifelimiting illness by enabling them and their loved ones to live each day as fully and as comfortably as possible.

Most Hospice patients live in their own home, but Home+ Hospice Care is available for people no matter where they call “home” — a private home, assisted living, nursing home, or the Hospice House. To learn more about the Hospice Care or the Hospice House visit: monument. health/services/hospice.

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FEATURE STORY // COMMUNITY

GIVING SORROW WORDS

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FALL 2022 // HEALTH

To learn more about Bri’s new book or to order your copy, visit www.athousandpoundsbook.com.

BRIANNE EDWARDS COMPARED THE EXPERIENCE OF LOSING HER SON, LACHLAN, TO A THOUSAND POUNDS BEING DROPPED ON HER CHEST. EXPERIENCING JOY AGAIN SEEMED IMPOSSIBLE, BUT SHE FOUND A WAY FOR HER AND HER SON TO ALWAYS BE TOGETHER. Written by Stephen Simpson Photos by Jesse Brown Nelson

“Death is very difficult to talk about. I recognized that very early in my grief,” said Bri Edwards, a Physician Assistant in General Surgery at Monument Health. “People don’t know what to do or to say.”

Her son, Lachlan, was born in 2007. “His smile would light up a room,” she said. In 2008, at 10 and a half months, Lachlan didn’t wake up from his nap. He had died from SIDS. Bri was a mom who wanted answers. What she found was a sacred duty to tell her story and to walk alongside other moms and dads who are experiencing the darkest nights of parenthood.

‘LIKE A THOUSAND POUNDS ON YOUR CHEST’

“SIDS is a diagnosis of exclusion,” Bri explained. That means when all other causes of death are ruled out, examiners label the baby’s death certificate with sudden infant death syndrome, or SIDS. This label leaves around 3,500 families in the U.S. each year with few answers following an unimaginable tragedy.

The grieving process surrounding the unexpected loss of a baby is unique to each parent, but there are elements to that season of loss that are consistent. “The illustration that I use a lot when I’m walking grieving parents

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through this is that it feels like a thousand pounds being dropped on your chest,” Bri said. “You can’t breathe, you can’t think. It seems like you’ll never be able to experience joy ever again.”

The numbness, the rage and the despair that families experience in the wake of SIDS can seem endless. “But being able to see another family experience joy after a loss can be the start of rebuilding hope,” she said.

THE KNOWNS AND UNKNOWNS OF SIDS

“I’m naturally a scientifically minded person,” Bri said. “I wanted answers.” The science behind SIDS isn’t totally understood because the phenomenon is difficult to study. SIDS cannot be totally prevented, but the research is clear on how to lower the risks of unexpected infant loss.

Babies should sleep on their backs on a firm mattress with tight fitting sheets.

Parents/caregivers shouldn’t allow blankets, stuffed animals or other loose items in the crib. In spite of the unknown cause of sudden infant loss, safe sleep guidance and other practices are proven to reduce the risk of SIDS.

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FEATURE STORY // COMMUNITY

For resources and more information about Lach’s Legacy, visit www.lachslegacy.org.

Lach’s Legacy is a nonprofit organization dedicated to the fight against SIDS and other sleep-related infant deaths in South Dakota.

The organization offers connections, comfort and hope for those grieving the loss of an infant.

Brianne Edwards started Lach’s Legacy to help families who are experiencing the unexpected loss of a baby.

The newest facet of Lach’s Legacy is available now in the form of a book on coping with grief, A Thousand Pounds: Finding the Strength to Live and Love under the Weight of Unbearable Loss. Bri wrote this book to help grieving parents discover their own journey by guiding them through hers.

Sudden Infant Death Syndrome The exact cause of SIDS remains unknown to researchers, but effective ways to reduce the risk of unexpected infant death are clear. One of the most important practices parents/caregivers can observe is safe sleep. Safe sleep practices were established and promoted starting in the 1990s.

Research shows this push for safe sleep has led to a decline of SIDS deaths from 130.3 deaths per 100,000 live births in 1990 to 38.4 deaths per 100,000 live births in 2020.

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Here are five things parents need to know about safe sleep: • Place babies on their backs for naps and bedtime.

• Use a firm mattress with tight fitting sheets in a safetyapproved crib or bassinet for baby’s sleep.

• Keep loose items out of the baby’s crib — no crib bumpers, stuffed animals, blankets or other loose items.

• New babies should share a bedroom with their parents, but not the bed itself.

• Look for signs of the baby overheating like sweating or being hot to the touch.

A LEGACY OF HOPE

At the time of Lachlan’s death, Bri and her husband were reeling and found themselves in a desperate search for help and resources.

“We couldn’t find anything in South Dakota,” she said. So, Bri decided to start her own way to support parents experiencing grief from the unexpected loss of a child.

Lach’s Legacy was born. Bri’s organization offers connection, comfort and hope to families in South Dakota experiencing the loss of a child. “We’ve been able to send over 100 care packages to families in their early days of grief,” Bri said.

In addition to helping families navigate the death of a daughter or son, Lach’s Legacy has been able to contribute to the fight against SIDS by raising over $40,000 for research.

Bri and her team are also helping to spread the word on best practices for parents to reduce the risk of SIDS. “We, first, work to prevent families from ever having to experience this tragedy. Second, to provide a warm embrace of comfort in the wake of the unimaginable.”

Lachlan was only in his parents’ arms for 10-and-a-half-months, but he’ll always be with his mom and dad. Every time Lach’s family comforts another family following the unexpected loss of a baby, Lach — in a way — is offering that hug or that listening ear, too.

Learn more about Infant Safe Sleep Guidelines at monument.health/safesleep.

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EXCELLENCE // PHYSICIAN

Welcome our newest physicians HOSPITAL MEDICINE

Anish Patel, m.d.,

is a Hospitalist at Monument Health Rapid City Hospital. He completed his Doctor of Medicine degree at Ross University School of Medicine in Portsmouth, Dominica, West Indies and his residency in Internal Medicine at the University of South Dakota Sanford School of Medicine. Prior to joining Monument Health in May 2022, Dr. Patel worked as a Hospitalist at the Sanford USD Medical Center in Sioux Falls where he served on numerous hospital committees to improve patient care.

CRITICAL CARE MEDICINE

Jared Sutton, m.d.,

is a Critical Care physician working in the Intensive Care Unit at Monument Health Rapid City Hospital. He completed his Doctor of Medicine degree at the University of South Dakota Sanford School of Medicine, his residency in Critical Care Emergency Medicine at the University of Washington’s Madigan Army Medical Center and his fellowship at the Hennepin County Medical Center in Minneapolis. In addition, Dr. Sutton is a decorated soldier in the US Army Airborne, earning numerous military awards including the Bronze Star Medal, the Army Commendation Medal five times and the Army Achievement Medal twice to name just a few. His military service includes serving as an Army Critical Care Emergency Medicine Physician, a Staff Physician at the Dwight D. Eisenhower Army Medical Center at Fort Gordon, Ga. and a Battalion Surgeon at Fort Bragg, N.C. He has conducted and published research articles on various emergency medicine topics, with his most recent appearing in the latest edition of Tintialli’s Emergency Medicine, the premiere textbook in the field of Emergency Medicine.

IT TAKES A TEAM In its first year participating in the American Heart Association’s Get With The Guidelines®-AFib Registry, the Heart and Vascular Institute achieved the Silver Award, the highest possible first-year award.

For the 11th straight year, the American College of Cardiology presented the NCDR Chest Pain–MI Registry Platinum Performance Achievement Award to Monument Health, which is one of only 240 hospitals nationwide to receive the honor this year.

The Cardiovascular Surgery Program achieved a rating of 2 out of 3 stars from The Society of Thoracic Surgeons. The Society of Thoracic Surgeons is a national leader in health care transparency and accountability. Participation in the STS National Database is a crucial investment for quality improvement.

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Congratulations to the Heart and Vascular Institute

353 Fairmont Blvd. | Rapid City, SD monument.health/heart

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PHYSICIAN PROFILE // EXCELLENCE

At Monument Health, you’ll receive high-quality care by a board-certified orthopedic surgeon and a comprehensive team of trained orthopedic specialists. With our years of experience, we are proud to offer a fast track of comprehensive care with services such as same-day total joint replacement focused on getting you back home again.

My Role I am a general orthopedic surgeon, so I evaluate and diagnose complaints involving the musculoskeletal system, come up with a treatment plan and help patients move and feel better through surgery and collaboration with other orthopedic specialists. I focus largely on pediatric orthopedics, trauma, hand, and hip and knee replacement.

My Goal I provide a caring experience to adults and kids requiring orthopedic services in the Black Hills. I’m also excited to provide outreach orthopedic services to Monument Health Custer and Hot Springs clinics.

I always aim to provide the highest-quality care possible, so that my patients have less pain and can return to active lifestyles doing things that they enjoy.

Rachel Michael, m.d.

Orthopedic Surgeon

Dr. Michael specializes in general orthopedics and is passionate about helping people live their lives to the fullest. Whether it’s treating trauma cases or performing joint replacement surgery, Dr. Michael wants to ensure her patients have the best possible orthopedic care.

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My Passion I enjoy serving my community. I am passionate about serving my patients and I want them to know that I am willing to do the work to get them back to living their full lives. Being able to work with a variety of patients in our area is such an incredible opportunity. Outside of work, I love spending time traveling, reading, hiking and practicing yoga.

FALL 2022 // HEALTH

The daVinci Ion is a robotic-assisted platform for minimally invasive biopsy in the lung.

Rorak Hooten, m.d.

Pulmonologist and Medical Director for Respiratory Therapy

Although he plays many roles at Monument Health, one thing is constant for Dr. Hooten — his desire to help his patients breath easier.

My Role I have a variety of roles at Monument Health. The first is in the Intensive Care Unit where I care for some of our sickest patients. The ICU tends to be fast paced and usually requires cooperative care with multiple other specialties.

When I’m not in the ICU, I can usually be found either in the clinic or the hospital taking care of pulmonary patients.

Pulmonary medicine has a different flavor of care, often with patients with more chronic and complex diseases like COPD and pulmonary fibrosis.

Lastly, I’m the Medical Director for Respiratory Therapy. Our respiratory therapists are crucial for taking care of all of our patients with respiratory disease.

My Goal My goal is always to help patients and families navigate through their illnesses.

Sometimes that’s accomplished directly through my care of the patient; other times it may be as part of the team, or making sure the patient gets connected to the right services.

Part of that goal has been to expand our pulmonary services

HEALTH // FALL 2022

in order to ensure the Black Hills continues having access to high-quality pulmonary care. In the last few years, that has included developing our EBUS program, and more recently an addition of robotic navigational bronchoscopy with the ION system. Both of these help with our pulmonary diagnostics, particularly in the area of lung cancer.

My Passion My passion, as it relates to being a physician, is making a difference. That may be as simple as prescribing a medicine for a patient so they can breathe easier or listening to a patient’s stresses in an effort to alleviate them. It may be more complex, like helping to launch an ION program so that patients with lung cancer can get their diagnosis and staging more efficiently and get to treatment faster.

As a physician, I feel I have a responsibility to try to make life better for my patients, my coworkers and my community. Ultimately making an impact, great or small, in people’s lives gives me great joy.

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Tune into your health with Monument Health.

A weekly podcast featuring Monument Health physicians discussing the latest topics in health care.

Listen wherever you get your podcasts or at monument.health/podcast.

A Guest Services Specialist is available at the Guest Service desk in the main lobby of Monument Health Rapid City Hospital daily from 7 a.m. to 8 p.m.

Monument Health Guest Services provides a welcoming atmosphere and promotes a patient- and familycentered approach to care. These caregivers offer a variety of vital, nonclinical services that include helping guests find their way around the hospital and providing patients and their guests with important information, support resources and programs.

The services offered range from welcoming people as they enter the hospital to parking guest vehicles.

Sarah Wolfe

Guest Services Specialist, Monument Health Rapid City Hospital

Guest Services delivers high-quality, nonclinical patient care in Monument Health’s hospitals so providers can focus on offering exceptional clinical care.

HEALTH // FALL 2022

COMMUNITY // MY SPACE

My Role I see to the nonclinical needs of our patients and their loved ones while they are waiting to see a doctor in the emergency room. I guide a patient’s support person to the right rooms, help guests find their way around, provide comfort or distraction items or simply offer a listening ear when it’s needed. I also help people find services outside the hospital, such as contact information for taxis, hotels and pharmacies, among many other things.

My Goal My goal is to provide an informative and caring environment for our hospital’s guests and make them as comfortable as I can while they wait.

I want to provide comfort to our guests, even if it is just for a few moments.

A personal goal of mine is to expand my knowledge base and further my education.

My Passion I strive to help our patients and guests emotionally who may be in a state of panic, pain or anxiety. We come in and give that little extra love and attention to the patients and their guests to make them more comfortable. I find that rewarding.

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MONUMENT HEALTH FOUNDATION

IS PROUD TO BE PART OF SD GIVES!

ON GIVING TUESDAY, NOVEMBER 29, 2022, people just like you who love South Dakota have an opportunity to ignite a movement of giving all across the state.

HOW TO GIVE On November 29, visit www.monument.health/donate.

You will be directed to our giving form. You may choose to give to our Greatest Need fund or another fund that’s close to your heart. Donate specifically to Children’s Miracle Network, Hospice Services, Cancer Care Institute or our hospitals in Custer, Lead-Deadwood, Spearfish, Sturgis and Rapid City.

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SPRING 2022 // HEALTH

COMMUNITY // CALENDAR

Nov 18

Western Legacy Foundation NFR Send Off and Calcutta Sturgis

Nov 26

Festival of Lights

Nov 29

South Dakota Day of Giving

Dec 14-17

Rapid City

Monument.health/donate

Lakota Nation Invitational Rapid City

A Holiday Collection benefiting One Heart

Dec 16-17 Black Hills Stock Jan 27- Show & Rodeo Rapid City Feb 4 Rapid City

Rapid City

*All events are subject to change due to COVID-19 concerns. Schedules were correct at time of publication.

HEALTH // FALL 2022

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DIRECTORY // COMMUNITY

Please call your local clinic to schedule an appointment.

Monument Health is also offering extended services through video and telephone visits with your provider.

We’re near you HOSPITALS Custer Hospital 1220 Montgomery Street Custer, SD 57730 605-673-9400

Hot Springs Clinic 1100 Highway 71 South, Suite 101 Hot Springs, SD 57747 605-745-8050

Spearfish Urgent Care Services 1420 North 10th Street Spearfish, SD 57783 605-717-8595

Lead-Deadwood Hospital 61 Charles Street Deadwood, SD 57732 605-717-6000

Lead-Deadwood Clinic 71 Charles Street Deadwood, SD 57732 605-717-6431

Sturgis Urgent Care Services 2140 Junction Avenue Sturgis, SD 57785 605-720-2600

Rapid City Hospital 353 Fairmont Boulevard Rapid City, SD 57701 605-755-1000 Spearfish Hospital 1440 N. Main Street Spearfish, SD 57783 605-644-4000 Sturgis Hospital 2140 Junction Avenue Sturgis, SD 57785 605-720-2600 CLINICS Belle Fourche Clinic 2200 13th Avenue Belle Fourche, SD 57717 605-723-8970 Buffalo Clinic 209 Ramsland Street Buffalo, SD 57720 605-375-3744 Custer Clinic 1220 Montgomery Street Custer, SD 57730 605-673-9400 Family Medicine Residency Clinic 502 East Monroe Street Rapid City, SD 57701 605-755-4060 Family Health Education Services 930 N. 10th St Spearfish, SD 57783 605-642-6337 Gillette Clinic 20 W Four-J Court Gillette, WY 82716 307-682-1204 Hill City Clinic 238 Elm Street Hill City, SD 57745 605-574-4470

Rapid City Clinic Flormann St. 640 Flormann Street Rapid City, SD 57701 605-755-3300 Rapid City Clinic 5th St. 2805 5th Street Rapid City, SD 57701 605-755-5700 Spearfish Clinic North Ave. 1445 North Avenue Spearfish, SD 57783 605-644-4170 Spearfish Clinic North 10th St. 1420 North 10th Street Spearfish, SD 57783 605-717-8595

SPECIALTY & SURGICAL CENTERS Assisted Living 432 North 10th Street Custer, SD 57730 605-673-5588 Behavioral Health Center 915 Mountain View Road Rapid City, SD 57702 605-755-7200 Care Center 949 Harmon Street Sturgis SD 57785 605-720-2400 Cancer Care Institute 353 Fairmont Boulevard Rapid City SD, 57701 605-755-2300

Sturgis Clinic 2140 Junction Avenue Sturgis, SD 57785 605-720-2400

Dermatology 4150 5th Street Rapid City, SD 57701 605-755-5340

Wall Clinic 112 7th Avenue Wall, SD 57790 605-279-2149

Dermatology 550 East Colorado Boulevard Spearfish, SD 57783 605-717-8860

URGENT CARE Custer Urgent Care Services 1220 Montgomery Street Custer, SD 57730 605-673-9400 Lead-Deadwood Urgent Care Services 71 Charles Street Deadwood, SD 57732 605-717-6431 Rapid City Urgent Care Jackson Blvd.

2116 Jackson Boulevard Rapid City, SD 57702 605-755-2273 Rapid City Urgent Care Lacrosse St. 1303 N. Lacrosse Street Rapid City, SD 57701 605-755-2273

Dialysis Center 955 East North Street Rapid City, SD 57701 605-755-6950 Dialysis Center 132 Yankee Street Spearfish SD 57783 605-722-8110 Heart and Vascular Institute 353 Fairmont Boulevard Rapid City, SD 57701 605-755-4300 Home+ Home Health and Hospice 931 E Colorado Boulevard Spearfish, SD 57783 605-644-4444

Home+ Home Health 224 Elk Street Rapid City, SD 57701 605-755-7710

Rehabilitation 2200 13th Avenue Belle Fourche, SD 57717 605-723-8961

Home+ Home Medical Equipment 1800 N. Haines Avenue Rapid City, SD 57701 605-755-9000

Rehabilitation 220 Montgomery Street Custer, SD 605-673-9400

Home+ Home Medical Equipment 1635 Caregiver Circle, Rapid City, SD 57702 605-755-6150 Home+ Home Medical Equipment 911 East Colorado Boulevard Spearfish, SD 57783 605-717-8930 Home+ Home Medical Equipment 2707 Lazelle Street Sturgis, SD 57785 605-720-2676

Rehabilitation 61 Charles Street Deadwood, SD 605-717-6000 Rehabilitation 2479 East Colorado Boulevard Spearfish, SD 57783 605-644-4370 Rehabilitation 2140 Junction Avenue Sturgis, SD 605-720-2400 Rehabilitation Center 1050 Fairmont Boulevard Rapid City, SD 605-755-1230

Home+ Hospice House 224 Elk Street Rapid City, SD 57701 605-755-7710

Sleep Center 2929 5th Street Rapid City, SD 57701 605-755-4000

Home+ Infusion 224 Elk Street, Suite 100 Rapid City, SD 57701 605-755-1155

Sports Performance Institute powered

by EXOS 1635 Caregiver Circle Rapid City, SD 57702 605-755-6683

Home+ Pharmacy 353 Fairmont Boulevard Rapid City, SD 57701 605-755-8184 Home+ Pharmacy 1420 North 10th Street, Suite 1 Spearfish, SD 57783 605-717-8741 Home+ Specialty Pharmacy 2006 Mount Rushmore Rd., Suite 2 Rapid City, SD 57701 605-755-3065 Neurosciences Center 677 Cathedral Drive, Rapid City, SD 57701 605-755-5276 Orthopedic & Specialty Hospital 1635 Caregiver Circle Rapid City, SD 57702 605-755-6100 Orthopedics and Sports Medicine 2449 East Colorado Boulevard Spearfish, SD 57783 605-644-4460

Surgery Center 1316 North 10th Street Spearfish, SD 57783 605-642-3113

SAVE THE DATE

GAME DAY

11.5.22

Join us for our annual Game Day where thousands of Extra Life community members like you execute their fundraising activities.

Whether you’re streaming, playing board games, making art or just plain asking your friends and family to donate, Game Day is whatever you want it to be! November 5 is the day we’re setting aside this year — but your Game Day can be any date that works best for you!

SUBSCRIBE At magazine.monument.health

CONTACT General information 605-755-1000 MyChart For assistance with MyChart, please call the MyChart patient portal hotline at 605-755-9890 or email mycharthelp@ monument.health