Spring 2022 Monument Health Issue 6

M O N U M E N T

H E A L T H

Issue 06

Spring 2022

TOGETHER One Black Hills couple discovered that the journey to better health takes a village — including support from a team of dedicated caregivers.

LIVE YOUR LIFE WITHOUT LIMITS We know the decision to have bariatric surgery is not an easy one. But the years you’ve spent in weight-loss attempts, habit changes and struggling with mental and physical health haven’t been easy either. Improving your health, keeping up with your family and creating a balanced life is easier and safer than you think.

At Monument Health Bariatrics and Weight Management, our team of physicians, nutritionists and mental health professionals work with you to develop a program tailored to your needs.

NOW ACCEPTING NEW PATIENTS Bariatrics and Weight Management Rapid City Clinic | 2805 5th Street | 605-755-5700 Spearfish Clinic | 1445 North Ave. | 605-644-4280

Spearfish Hospital

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W E LC O M E

F R O M

Paulette Davidson

President and Chief Executive Officer, Monument Health

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hanks for picking up the newest edition of Monument Health Magazine. In these pages you will meet some of the people who make Monument Health such an important part of our western South Dakota communities.

Any health system is much more than buildings and equipment.

It’s a group of people – physicians, caregivers, volunteers and donors – who care deeply about their community. That’s especially true at Monument Health.

In this issue, you’ll read about David and Darlene Fickbohm.

Michael Paulson found a unique way to support Children’s Miracle Network: playing video games.

With the help of Surgeon Andrew VanOsdol, M.D., and his bariatric medicine team in Spearfish, they have made significant progress in their struggle to overcome obesity.

You’ll also meet Bobbi Jean Jarvinen, one of Monument Health’s most active volunteers. On top of her full-time role with the Information Technology Division, she logged more than 600 volunteer hours in Fiscal Year 2021.

Rapid City software engineer Michael Paulson raised more than $73,000 for the Children’s Miracle Network through a video game streaming fundraiser, with a $20,000 match from his employer, Netflix.

High-dose-rate (HDR) brachytherapy, a treatment for men with prostate cancer, had seen little use in the past 15 years. However, recent advances in ultrasoundbased planning has made it an effective, three-hour outpatient procedure. Radiation Oncologist Daniel Petereit, M.D., is a leader in HDR brachytherapy.

We hope you enjoy the newest issue of Monument Health Magazine. If you have feedback, story suggestions or questions, send your ideas to magazine@ monument.health.

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C O N T E N T S SPRING 2022

Regulars

In Case You Missed It This is our roundup of all the latest news and happenings throughout Monument Health. page 4

H E A L T H

Managing Editor Melissa Haught Editor Stephany Chalberg Senior Writers Dan Daly Wade Ellett Contributors Karlee Baumann Jennessa Dempsey Dawn Kocina 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 Design Director Chris Valencia Photographer Jesse Brown Nelson Senior Writer Ashley Johnson 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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Awareness Months Highlights of key health issues and medical staff. page 6

Physician Spotlight Meet John Heilmann III, M.D., FACC., a cardiologist, and John Tronnes, M.D., a family medicine physician. page 34

My Space Theresa Ferdinand and Stephanie Iverson have been the face of Monument Health’s LiveWell program for almost three decades. page 9

My Space Kim Bloom greets each day with a smile and spreads cheer with positive notes to caregivers throughout Monument Health. page 37

Ask the Doc James Hellekson, M.D., discusses improving your mental health. page 10

Calendar Upcoming events at Monument Health. page 39

Meet the Volunteers Bobbi Jean Jarvin and Lori Burnham are caregivers who also give back to their communities. page 12

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Introducing Get to know physicians who have recently joined Monument Health. page 33

Prostate Cancer Treatment Daniel Petereit, M.D., and his team are reviving a cancer treatment using new technology and saving lives in the process. page 14 Health by the Decades Routine screenings are an important part of your overall health, but do you know which ones you need, and when? page 20

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Gaming for Charity Local software engineer Michael Paulson has raised thousands of dollars for Children’s Miracle Network by playing video games. page 28

Directory Find a Monument Health provider near you. page 40

Features and Stories

Bariatrics Center of Excellence David and Darlene Fickbohm struggled with obesity for years, but with the help of Andrew VanOsdol, M.D. and his team in Spearfish, they’re on the path to a healthier future. page 16 Donate Life Monument Health is at the forefront of increasing organ, eye and tissue donation throughout western South Dakota. page 24 Clinical Research As the Monument Health Clinical Research department marks 25 years, look back on their impact and see where they’re going next. page 30

NEWS // EXCELLENCE

GO MARSHALS!

Monument Health Orthopedics and Sports Medicine will be the official sports medicine partner of the Rapid City Marshals indoor football team.

Monument Health Orthopedics and Sports Medicine currently partners with 10 area high schools, local expedition league sports teams and NCAA Division II schools — including Black Hills State University, Chadron State College and South Dakota Mines — to provide orthopedic medical coverage, athletic training and strength and conditioning programs. They are also the official sports medicine provider of The Monument.

MONUMENT HEALTH TO BUILD BOX ELDER URGENT CARE Work has started on a new Monument Health urgent care clinic in Box Elder to meet the growing community’s health care needs. The new clinic, which will also provide primary care services, will be built on a 2.15-acre parcel of land that Monument Health recently purchased near the planned Liberty Plaza mixed-use development project.

The new clinic will be Monument Health’s third free-standing urgent care in the Rapid City area. In addition, urgent care services are offered at Monument Health hospitals in Custer, Lead-Deadwood and Sturgis as well as the 10th Street Clinic in Spearfish.

“Box Elder is one of the fastest growing cities in South Dakota, and with the new mission for Ellsworth Air Force Base, that growth is expected to continue, if not accelerate,” said Mark Schulte, Monument Health Vice President of Operations for the Rapid City Market. “The need for convenient health care will continue to grow, and with this urgent care we can meet these needs now and in the future.”

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MAKING A DIFFERENCE

The Kenadi Jean Weis Foundation donated adaptive equipment from Kenadi’s Closet for disabled children to Monument Health Rehabilitation in Spearfish to help the pediatric patients engaged in physical and occupational therapy.

Kenadi’s Closet, named for the late Kenadi Jean Weis, lets families try adaptive equipment prior to making an expensive investment in their child’s adaptive equipment.

For more information on Kenadi’s Closet, please visit www.teamkenadi.com.

SPRING 2022 // HEALTH

PHARMACY LEADER RECOGNIZED Dana Darger, Director of Pharmacy at Rapid City Hospital, was recently included in the 50 Most Influential Leaders in Pharmacy Awards and Recognition Program, launched by the Pharmacy Podcast Network.

Pharmacy professionals were encouraged to nominate peers that made a significant difference in their organizations.

“One of my vendors put my name in for it,” Darger explains.

“I don’t do anything for recognition. It certainly feels wonderful to get it, but it isn’t a driving force for me.”

An example of the innovative thinking that put Darger on this list was his idea of floating work when needed, allowing

pharmacists and techs to take care of patients at any Monument Health location, from anywhere throughout the system.

“We can take care of patients in any of our facilities 24/7,” Darger said. This means staff don’t need to be sent anywhere, which saves at least a couple hours of productivity due to decreased travel.

NEW NATIONAL SURGERY ACCREDITATION Monument Health Spearfish Hospital has been designated a MBSAQIP Accredited Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, a national organization. Read more about Dr. Andrew VanOsdol and the general surgery bariatrics team on page 16.

BIRTH TISSUE DONATION PROGRAM Monument Health and Dakota Lions Sight and Health (DLSH) are introducing a birth tissue donation program at Monument Health Rapid City Hospital.

The program will coordinate the donation and collection of birth tissue including amniotic membranes and umbilical cords.

HEALTH // SPRING 2022

Birth tissue is gathered after a child is born through a planned Cesarean section and poses no risk to the mother or baby. Rapid City Hospital performs approximately 20 planned C-sections a month. A single placenta donation can help 20 to 40 people. Participation is voluntary and costs nothing.

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AWARENESS MONTH // EXCELLENCE

Occupational Therapy Month

Sarah Rathbun

NURSES DAY

Sandra Gruenig

National Nurses Day is May 6. This day is the perfect time to acknowledge the vital role that nurses play in providing high-quality, patient-centered care. Across Monument Health, nurses have been recognized for their contributions to nursing — they have received DAISY Awards, Star Awards and other honors. Monument Health celebrates and honors nurses and all that they do — not only on National Nurses Day, but all year round!

Mental Health Awareness

1 in 5 adults in the U.S. experience a mental health condition during their lifetime.

May is Mental Health Awareness Month, helping to break the stigma of mental illness and encouraging people to get the help they need.

Text 741741 or call 1-800-9506264 for 24/7, free confidential support.

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SKIN CANCER AWARENESS MONTH Skin cancer is the most common cancer in the United States — 1-in-5 Americans will deal with skin cancer during their lifetime. May is Skin Cancer Awareness month. Preventing skin cancer is always preferable to treating it. Wear UV-blocking clothing, properly apply a broadspectrum sunscreen with an SPF of 30 or higher while spending time outside and see your dermatologist for any suspicious spots.

The month of April is Occupational Therapy Month — a month to recognize and thank these clinicians who utilize purposeful, occupationbased and client-centered interventions with each patient. This process is tailored to each patient through a detailed evaluation, and helps them to achieve productive, meaningful, satisfying lives.

National Volunteer Week

National Volunteer Week is April 17-23.

Monument Health is grateful for the many volunteers that help provide comfort and care to patients.

From greeting and helping people find their way, to sewing pillows and cuddling infants, Monument Health’s volunteers are amazing.

For volunteer opportunities with Monument Health, please visit www. monument. health/careers/ volunteer.

Men’s and Women’s Health Month May and June are Women’s and Men’s Health month. This time serves as a reminder to make an appointment with your primary care provider. To learn more about how to manage your health at all stages of your life, see the feature starting on page 20.

SPRING 2022 // HEALTH

HOSPITAL REGISTERED NURSE • Provide high-quality patient care in our hospitals • Openings available in various departments with flexible scheduling

STARTING WAGE $30.40/HR

MEDICAL ASSISTANT • Provide direct patient care in ambulatory clinics • Assist with vitals • Administer medications and immunizations

FINDCARA EER JOB THAT LOVES YOU BACK Monument Health is hiring a number of positions where you can jump-start your career in health care.

STARTING WAGE $18/HR

LICENSED PRACTICAL NURSE • Provide essential direct care to residents at our care centers • Various shifts are available • Degree is required

STARTING WAGE $22.19/HR

CLINICAL ASSISTANT • • • •

Provide direct patient care in clinics Prepare examination rooms Assist with vitals No experience necessary, no nights and weekends

STARTING WAGE $15.50/HR

PHARMACY TECHNICIAN

NURSE AIDE

LAB ASSISTANT

• Assist pharmacists prepare and dispense medications • No experience necessary

• Assist registered nurses in hospital and clinical settings • No experience necessary

• Assists in laboratory by collecting, processing and analyzing samples • No experience necessary

STARTING WAGE $18.50/HR

STARTING WAGE $17/HR

STARTING WAGE $16/HR

For more information, scan this QR code, visit www.monument.health/careers or call 605-755-JOBS.

A leopard can’t change its spots.

That’s not always true for moles.

Finding melanoma at an early stage is crucial.

Look for anything new, changing or unusual on both sun-exposed and sun-protected areas of the body.

Melanomas commonly appear on the legs of women and the torso of men. Keep in mind melanomas can arise anywhere on the skin, even in areas where the sun doesn’t shine.

Monument Health Dermatology provides a complete range of dermatology services, including diagnosis and advanced treatment of skin cancer using techniques such as Mohs micrographic surgery.

When in doubt, have it checked out.

Make an appointment at one of our locations.

Rapid City 4150 5th Street | 605-755-5700

Spearfish 550 East Colorado Blvd. | 605-717-8860

Gillette 620 W Four-J Court | 307-682-1204

monument.health/dermatology

LiveWell addresses every aspect of employee well-being, offering something for everyone — no matter where they’re at on the journey to optimal wellness.

COMMUNITY // MY SPACE

Theresa Ferdinand (left) joined Monument Health 32 years ago and Stephanie Iverson (right) started 29 years ago. Together the two are the face of well-being at Monument Health and it’s rare to see one without the other. The LiveWell team works with approximately 90 LiveWell Champions throughout Monument Health.

They help drive the programming and opportunities offered through our workplaces.

LiveWell focuses on the Five Essential Elements of WellBeing as noted by Gallup research: Career, Social, Financial, Physical and Community Well-Being.

Theresa & Stephanie Health & Well-Being Program

LiveWell by Monument Health is a voluntary well-being initiative offering support, resources and rewards to physicians and caregivers.

HEALTH // SPRING 2022

Our Role Developing and implementing an employee wellness program, LiveWell by Monument Health. This includes healthier food options at work, health challenges, better processes for working mothers that need lactation rooms and mental and emotional wellbeing support resources.

Our Goal To continue to build a culture of health at Monument Health and make this a great place to work, in part due to the LiveWell program.

Our goal is to continue to weave well-being into policies and procedures based on evidencebased practice. We aim to assist in personal and professional well-being, to keep the excellent people we currently have and to attract new talent.

Our Passion Helping those we work and live with to be the best version of themselves. This includes each other as we support one another every day. Spending time with family and friends, being physically active, eating right and being content in life as it presents itself. We try to live as examples for our families, our teams and our community.

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ASK THE DOC // TRUST

What you need to know about mental health Health and wellness aren’t just physical traits — our thoughts and emotions are just as important as our physical well-being. James Hellekson, M.D., explains how we can help improve our mental health, as well as how to help others who may be struggling.

What is mental health, and why is it important?

Mental health is the area of study relating to the mind and emotions. Everyone has mental health, just as they have physical health, and it’s when those two areas come together that we have overall health. Our mental health and our physical health are interconnected, so some physical issues impact the mind and some mental issues impact the body.

To be truly healthy, we need to take care of both.

If I know somebody who is struggling, what should I do?

The old adage, “See something, say something” could not ring more true. If you know someone is struggling or dealing with emotional situations or thoughts of suicide, it is crucial that they get help. A lot of people worry that talking to a loved one about

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their suicidal thoughts may push them toward that outcome, but we know that isn’t true at all.

People with depression or suicidal thoughts often report feeling that they are alone or that their loved ones would be better off without them. Changing that belief is very important and can have a significant impact on lowering the risk of suicide. These individuals likely need to speak with a mental health professional, but there are lots of people who you can reach out to in order to take the first step in getting help. Some examples are police officers and firemen, teachers, nurses such as at school or in the clinics and even parents or a trusted adult. If you are with someone in need of help and you are not sure what to do, you can always go to an urgent care clinic, police station or emergency room where there are trained people who want to help.

When should I or somebody I love seek professional help?

Immediately. If someone tells you that they are thinking of hurting or killing themself or someone else, call for help immediately. Other options would be to go to the emergency department right away.

Anytime someone close to you talks about “ending it all” or gives away prized possession, they need help.

If someone tells you they just want to go to sleep forever; that is a sign they need help. There is never a wrong time to ask for help.

What are the warning signs of somebody struggling with mental health?

In adults, we see difficulty concentrating, an increased need to sleep or not sleeping as much, increased appetite and not enjoying things that were once enjoyable.

Often hobbies will get abandoned, alcohol and drug use may increase and people may lose the desire to go out or see friends. Teens and kids tend to be angrier and begin exhibiting behavior problems.

Generally there are more outbursts with teens. Grades dropping and not performing well in other tasks are common symptoms. Every

SPRING 2022 // HEALTH

To learn more about mental health options at Monument Health, visit monument.health/services/mental-health.

person, regardless of age, handles mental health concerns differently.

It is important to remember that talking is not going to make them worse. Be the person who cares enough to listen.

What role can medication play in helping patients with mental health struggles?

Medication, like any other type of treatment or therapy, can have a significant positive impact. But there is no magic pill that will fix all mental health problems.

Medications will manage the symptoms, but personal reflection and therapy may be needed to deal with the long term effects of depression. Medications can be a great way to treat the chemical imbalances and manage symptoms, but they are not immediate and can take weeks to fully have an effect.

Do you see an impact of the COVID-19 pandemic on mental health?

Loneliness and social isolation are very significant stressors for many right now. Alcohol and drug use are on the rise and people are citing stress-related issues like insomnia and anxiety more and more. In our area, we’re seeing an increasing need for inpatient services, followup care and outpatient alternatives.

“You can always start by texting 741741 or calling 1-800-950-6264 for free, confidential support.”

For additional resources visit monument.health/mentalhealth

If we can look at it that way, the stigma will shift. We don’t tell someone with a broken arm that they should just decide that it isn’t broken, yet people with depression are told, “just decide to be happy,” all the time. We would never tell someone who wears glasses that they are choosing to need them, but many people don’t take antidepressants because they’re encouraged not to. The stigma can be overcome if we as a society work together, communicate openly and accept each other for who and what we are without malice or judgment.

What can we do on a daily basis to promote positive mental health?

Turn off the news and pick up your hobby again. This has been What can the general public tough during the pandemic, but it do to help stop the stigma can be done, and it will absolutely around mental health? make you feel better. Make sure Listen to each other. Be open that you are getting enough sleep, minded and don’t shy away from enough exercise and enough water. loved ones in need of help. Keep Spend 15 minutes per day outside in mind that mental illness is really in the sunlight. Do positive things no different than physical illness. like practicing daily affirmations,

HEALTH // SPRING 2022

doing yoga and enjoying family outings. These all sound simple, but they can have positive effects.

Of course, if you’re struggling with your mental health, the best thing you can do is to reach out for help — you can always start by texting 741741 or calling 1-800-950-6264 for free, confidential support.

James Hellekson, M.D., is a psychiatrist at Monument Health Behavioral Health Center. A South Dakota native, he grew up in Faith, S.D., and went on to complete a bachelor’s degree in Psychology/ Sociology from Black Hills State University. He then earned his medical degree and completed his psychiatry residency, both at the University of South Dakota Sanford School of Medicine. Dr. Hellekson specializes in adult psychiatry, primarily treating patients 18 and older.

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VOLUNTEER PROFILE // COMMUNITY

Bobbi Jean’s drive for volunteering comes from her desire to help children have the resources and opportunities they need to have a happy childhood.

One of Monument Health’s priorities is to dedicate at least 27,000 volunteer hours to our communities during this fiscal year.

What is your role at Monument Health?

I joined Monument Health nearly 25 years ago in Information Technology.

Currently my job is to help our operational areas prepare for IT outages — whether planned or unplanned.

What community organizations are you involved with?

I mostly volunteer with the Black Hills Area Boy Scouts and various groups that support the homeless community in our area. I serve on the Black Hills Regional Homeless Coalition board.

Also, as a member of the former Rapid City Community Conversations group I am working to focus my volunteer time toward trying to heal some of the trauma the region faced that continues to impact the indigenous people today.

What drives you to volunteer?

My hope is to create a safe place for kids in our community. I want to make sure that kids know there are adults who they can trust and count on to be there for them. That there are safe places for those who need it, and opportunities to grow.

How do you think volunteering makes you a better caregiver?

First, you get to know what’s going on in your community and what makes your community special. Second, volunteering to help an underserved population gives you a glimpse into their life and allows you to better understand what it’s like to be in their situation.

Health care doesn’t just mean bandaids and surgery, it means making a difference in our community.

Bobbi Jean Jarvinen Business Continuity Manager, Information Technology

Bobbi Jean is one of Monument Health’s most active volunteers.

On top of her full-time role with Information Technology she also has volunteered more than 260 hours of her time since July 1, and logged more than 600 volunteer hours in Fiscal Year 2021.

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SPRING 2022 // HEALTH

Lori has helped coordinate many new events in her time with Southern Hills United Way, including memorable ones like Kiss the Pig contests and Lip Sync battles.

COMMUNITY // VOLUNTEER PROFILE

Lori Burnham

Patient Access Specialist & Volunteer Coordinator, Custer Hospital

Starting the volunteer program at Monument Health Custer Hospital may have been a lot of work, but to Lori Burnham, it was worth the effort.

What is your role at Monument Health?

I started at Monument Health almost 18 years ago as a transcriptionist, holding multiple roles over the years. Now, I’m a patient access specialist and the volunteer coordinator for our hospital volunteer program, which launched in August 2021.

What organizations do you volunteer with and why?

At Monument Health I started as a volunteer captain for Relay for Life and the American Heart Association Heart Walk.

With Southern Hills United Way, I’ve acted as a hospital representative on the board, run our hospital campaign and I’m currently serving as the cabinet chair. In this role, I am most proud of the strides we’ve made with the Month of Caring and the Lip Sync Battle fundraiser.

One of Lori Burnham’s goals is to complete the Master Health Volunteer certification program through South Dakota State University, allowing her to start additional volunteer programs.

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

As members of a community, I think it is important to give back by volunteering. We have events in our community that just would not happen without people stepping up to volunteer.

How do you think volunteering makes you a better caregiver?

Giving back through volunteering makes me feel good. I may not have much money, but I have time and the desire to help others. I think volunteering makes us better as a community, and I think that carries over into my job as a caregiver.

HEALTH // SPRING 2022

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PATIENT STORY // COMMUNITY

WHAT’S OLD IS NEW AGAIN SOMETIMES BREAKTHROUGHS IN TREATMENT OPTIONS MEAN UPDATING OLD PROCEDURES INSTEAD OF CREATING NEW ONES. Advances in technology have allowed Daniel Petereit, M.D., Radiation Oncologist at Monument Health Cancer Care Institute, and his team to revive a type of prostate cancer treatment that was previously used in Rapid City 15 years ago.

The treatment, called high-doserate (HDR) brachytherapy, involves inserting a single radioactive pellet through multiple catheters into the prostate gland, delivering a highly conformal dose of radiation — which focuses the radiation in the prostate, while minimizing radiation exposure to the surrounding tissue.

With the current ultrasoundbased planning system, the overall process takes about three hours and is performed on an outpatient basis.

Right now, HDR brachytherapy is offered to Monument Health patients with more aggressive prostate cancer who undergo daily radiation for five weeks, followed by a brachytherapy boost to deliver a highly conformal dose.

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“There is now clear evidence from randomized trials that the cure rates are 20 to 30 percent higher when using this approach compared to daily radiation alone for patients with more aggressive prostate cancers,” Dr. Petereit said.

“We are now seeing more aggressive prostate cancers compared to 10 years ago when the U.S. Preventive Task Force recommended against prostate cancer screening in 2012.

Fortunately, this recommendation was then reversed by the same group in 2017.”

Fifteen years ago, Dr. Petereit explained, HDR brachytherapy was performed here, but at that time it required an inpatient hospitalization, and patients were treated three to four times over two days. There is now 10 years of data that show these patients can be safely and effectively treated with a single dose of HDR brachytherapy, which allows for outpatient treatment with less patient discomfort, reduced cost and fewer urinary side effects.

The biggest advancement is the sophisticated ultrasound system that allows the oncology team to plan the accurate placement of the radioactive iridium pellet for precise treatment delivery.

PROSTATE CANCER

In men, the prostate is a walnutsized gland located directly below

SPRING 2022 // HEALTH

Prostate cancer is the second most common cancer among American men. One in eight men can expect to be diagnosed within their lifetime, usually after the age of 65.

the bladder. Prostate cancer is second only to skin cancer in cancer diagnoses for men in the United States. The American Cancer Society estimates that more than 250,000 new cases of prostate cancer will be diagnosed in the U.S. in 2022. One in eight men will be diagnosed with prostate cancer in their lifetime.

Treatment options include active surveillance, surgery, cryotherapy, hormone therapy, chemotherapy and radiation therapy ­– including both daily external beam radiation and brachytherapy.

BRACHYTHERAPY

Dr. Petereit and his team — from left, Cheryl Achbach, Clinical Resourse Nurse; James McKee, Physicist Radiation Safety Officer; and Karen Bender, Nurse Anesthetist — have had great success in modernizing and adapting old procedures to provide precise and effective cancer treatment.

HEALTH // SPRING 2022

Depending on the nature of the patient’s prostate cancer, brachytherapy offers one of the most favorable outcomes in terms of cure rate, patient satisfaction, cost and convenience, according to Dr. Petereit.

Unlike external beam radiation, brachytherapy involves placing the source of radiation inside the body. With lowdose-rate (LDR) brachytherapy, radioactive seeds are implanted in the prostate and left inside.

The radioactivity in the seeds will decay over six months to deliver a safe, but effective dose. This approach is used for patients with less aggressive prostate cancer.

“As many of our patients live two to three hours from the Cancer Care Institute in Rapid City, this is often an ideal

Catheters are used to deliver a precise dose of radiation in an exact place to provide the best possible patient outcomes.

approach, rather than undergoing daily radiation for eight weeks,” Dr. Petereit said.

One advantage of LDR over external beam radiation is that the radiation is delivered specifically within the prostate, sparing most of the adjacent normal tissue from exposure to radiation.

ULTRASOUND PLANNING

With HDR, catheters are placed in the prostate gland to deliver a much stronger dose of radiation. The ultrasound-based planning system generates an immediate placement plan so the oncologist can optimize dose distribution. After the treatment, the catheters are removed and the patient goes home.

“My advice for patients with prostate cancer – know your options,” Dr. Petereit said.

“Patients have very good options, even for high-risk disease. We see cure rates as high as 70 to 90 percent, even for more advanced prostate cancer. So, there are multiple reasons to be optimistic, even if patients present with more aggressive prostate cancer.”

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FEATURE STORY // COMMUNITY

Many people struggle to lose weight and keep it off. That’s why Monument Health caregivers approach weight loss with a wholeperson approach.

HAND IN HAND THE PATH TO BETTER HEALTH CAN BE A CHALLENGING ONE. FOR DAVID AND DARLENE, THE KEY TO SUCCESS WAS TAKING IT TOGETHER.

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SPRING 2022 // HEALTH

Weight-loss surgery isn’t an easy fix, and it’s important to remember it’s only a tool. Success depends on many important factors such as nutrition, exercise and behavior modification.

Support along the way “A lot of people don’t understand the psychological side of eating and this process, but it’s hard on you when you change from eating one way to another. Like on Thanksgiving when everyone is enjoying a lot of stuff, or when you socialize at restaurants and you’re sitting there and not partaking in the same way as the people around you. There’s a big psychological factor there, so having that education from mental health professionals is great, and you can always go back for more sessions if you’re struggling. It’s also important to have that support from others as well, because you can’t do it alone. Darlene and I did this together, which I think has been one reason things have gone so well — we’re our own support group. But there are actual support groups for people who go through this process too,” David said.

David and Darlene Fickbohm have embarked on a journey together. Not to a destination, but rather to a healthier life. Both are Monument Health caregivers: Darlene is a Registered Nurse who works in Utilization Review at Rapid City Hospital, and her husband David works at Sturgis Hospital as a Maintenance Mechanic. And both are patients of General Surgeon Andrew VanOsdol, M.D, at Monument Health Bariatrics and Weight Management in Spearfish.

If you mention bariatrics, many people think about weight loss surgery. That’s only part of the story, though. When you look deeper, you’ll find that the goal of bariatrics isn’t simply to lose weight, but rather to develop a healthier lifestyle. Darlene and David know this from firsthand experience.

STARTING A JOURNEY

Darlene initially met with Dr. VanOsdol and the Bariatrics and Weight Management team in June 2020 to discuss problems with her gastrointestinal tract. She brought with her a long list of health issues including diabetes, but even prior to her appointment she was taking steps to improve her health. A few months prior to her initial appointment

HEALTH // SPRING 2022

with Dr. VanOsdol, Darlene and David had transitioned to a vegan diet to help with her diabetes and digestion problems, and experienced some success with it. “I lost 30 pounds going vegan, and I already felt better,” says Darlene. “But I was still having some GI issues that I really wanted to resolve.”

This began the journey to a healthier lifestyle that Darlene and David would take together, but she hadn’t expected surgery to be part of that journey. The Fickbohms were no strangers to bariatric surgery — about a decade prior, David had a lap band and nissen fundoplication procedure for gastric reflux at another health care facility. He was never fully satisfied with the results, so it’s no surprise that Darlene didn’t necessarily plan on including bariatric surgery on her health journey. Dr. VanOsdol, however, felt that she would be a good candidate for a gastric sleeve.

“During a sleeve gastrectomy, we remove part of the patient’s stomach, creating a new smaller, sleeve-like stomach in the process.

Digestion works exactly as it did before, but there are changes in horemones resulting in feeling less hungry and more satisfaction after eating less food,” explains Dr. VanOsdol. “I’m always cautious about recommending surgery,

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FEATURE STORY // COMMUNITY

but Darlene was a good candidate because of the hard work she and David were already doing to improve their lifestyle.”

SLOW AND STEADY

When she decided that she would get the gastric sleeve, Darlene learned that it would be six months to a year before the procedure would occur. “I had to see a nutritionist, I had to be evaluated by a mental health professional and I needed to see Dr. VanOsdol for so long and a certain number of times to get approved by insurance,” she says. “It’s a long process, not a quick fix.”

Darlene began showing signs of success after receiving her gastric sleeve, so her husband David decided to get one as well.

Like Darlene, he was a good candidate for the procedure — they had made their diet and lifestyle changes as a family, so Dr. VanOsdol felt confident that he would be successful with it as well. After removing his lap band and nissen, Dr. VanOsdol performed the sleeve gastrectomy on David as well. Together, the Fickbohms have continued to lose weight and improve their overall health and lifestyle.

Often people think of bariatrics as just a surgery — and while for many patients a surgical procedure can be incredibly helpful, it’s never just a surgery. There are several caregivers involved with a successful bariatrics program, and they all contribute different skills and experience. “Lots of people tell us, ‘I know enough about nutrition, I just need to eat less,’ but it isn’t just how much you eat, but also what nutrients you’re getting,” said Dr. VanOsdol.

“When there’s any kind of deficiency in our nutrition, that’s when we start craving things and it becomes much harder to control.”

CHANGING PERSPECTIVES

Patients work with the entire team before a procedure is scheduled. Without these building blocks, any kind of bariatric surgery is unlikely to succeed. “It builds a mindset that changes your eating habits and lifestyle.

It’s not just thinking, ‘Oh I’m going to lose the weight and I’ll be done.’ I think that’s where people run into trouble,” says Darlene.

“It’s an entire lifestyle change — it’s not losing the weight or getting to the size you want and then just going back to what you were doing before. Because you’ll end up right back where you were.”

“It’s not something that you can do without support,” adds David. “I think a big part of why we’ve been successful is that we’ve done this together. We’re a team, and we’ve improved our lifestyle together.”

As a family the Fickbohms continue to lead a healthy lifestyle. They’ve each lost about 100 pounds, and their son has come along on the journey as well, losing over 100 pounds through diet and exercise. Darlene no longer has to take medication for her diabetes, and has reduced the amount of medication she has to take for blood pressure. Most importantly, the entire family feels healthier and has more energy.

“That’s what it’s all about,” says Darlene. “Not just weight loss, but having a healthier, and more enjoyable lifestyle.”

Andrew VanOsdol, M.D. “There’s a misconception that weight loss means just eating less and exercising more. There’s more going on as far as metabolic rate and even your own body working against you. Surgery isn’t an easy way out; it requires a significant lifestyle change. The goal isn’t simply to lose weight; the goal is health, so we work on a weight management program that meets all the patient’s needs. That includes the emotional component. Most people know about emotional eating, but research has found links between trauma and obesity. Not everyone struggling with obesity has experienced trauma, but it shows the effect emotions can have on nutrition.”

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SPRING 2022 // HEALTH

Procedures such as gastric sleeves work by changing the anatomy of your gastrointestinal tract or by causing physiological changes in your body that change your energy balance and fat metabolism.

Andrew VanOsdol, M.D. General Surgeon Monument Health Spearfish Clinic A fellowshiptrained bariatric surgeon who focuses on minimally invasive diaphragmatic hernia, anti-reflux and bariatric surgery.

HEALTH // SPRING 2022

Irony C. Sade, M.D. General Surgeon Monument Health Rapid City Clinic A da Vinci robotic-trained general surgeon specializing in a variety of robotic surgeries including bariatric, hernia and anti-reflux, in addition to other open and laparoscopic procedures.

David Fromm, M.D. General Surgeon Monument Health Rapid City Clinic A da Vinci robotic-trained general surgeon who provides a variety of surgeries including hernia repair, bariatric and metabolic surgery.

Award-winning caregivers Monument Health Spearfish Hospital, home to the Bariatrics and Weight Management program, was recently designated a MBSAQIP Accredited Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, a national organization. MBSAQIP is a joint program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS). It affirms that the hospital’s bariatric patients receive multidisciplinary medical care, which improves patient outcomes and long-term success. In addition, accredited centers offer preoperative and postoperative care designed specifically for patients with obesity. Dr. VanOsdol says that this provides the program with additional resources within the ASMBS, and that programs that are accredited have better outcomes than programs that are not accredited. The accreditation process took several years, as all accredited centers are required to treat so many cases each year, as well as to meet specific follow-up requirements. Bariatric surgery is not just about the procedure: it’s also the patient care before and after the surgery.

Dr. VanOsdol adds, “Really, that’s something that our program does really well.

Providing support outside of just the surgical part of the process, from nutrition to support groups. So in many ways, the accreditation process is making sure that we’re providing education for our nurses and that we are taking care of the whole patient rather than just operating.

That has always been our approach, so this accreditation is a tribute to the hard work of the surgical staff and recognition of the great outcomes we’ve been able to achieve.”

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WELLNESS // EXCELLENCE

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TAKING CARE OF YOUR HEALTH IS A LIFELONG PROCESS THAT INCLUDES REGULAR PREVENTATIVE SCREENINGS. IT’S IMPORTANT TO KEEP UP WITH SCREENINGS, BUT IT ALL STARTS WITH UNDERSTANDING YOUR PERSONAL HEALTH RISKS AND THE TESTS RECOMMENDED AT YOUR STAGE IN LIFE. 20

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SPRING 2022 // HEALTH

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Having a primary care provider will help you keep track of routine screenings, and also establish a trusting relationship that makes having difficult conversations about your health easier.

May is Women’s Health Month and June is Men’s Health Month. Both provide an excellent reminder that an annual visit to your physician is an important step in managing your health. It can help keep track of recommended screenings, but more importantly, give you peace of mind that your health is in expert hands.

Lisa Brown, M.D., Family Medicine Provider, Custer Clinic, encourages patients to keep up with their recommended screenings in order to start a foundation their physician can monitor. “Getting those routine yearly screenings, especially when you’re younger and establishing a baseline, makes a difference,” said Dr. Brown. “Then we have a good foundation we can compare later screenings to, not tocomprehensive mention continuity helpscare with the Providing overall sensitivity of the screening. This is true for many for every of life screenings, such asstage mammograms.”

Your physician can recognize slight changes over time, and use that information to help you make informed decisions. If you wait until you’re experiencing discomfort, it may require several tests to pinpoint what’s causing your symptoms. Having a relationship with a provider that includes routine testing can help you catch issues early on. Dr. Brown focuses on the preventative nature of screenings with her patients: “For example, when we do regular colonoscopies, it allows us to catch polyps when they’re small and remove them before they can become cancerous,” she explained.

MEN’S HEALTH

“It’s important to have a consistent relationship with a provider.

You need to have someone you trust that is helping maintain your health,” Dr. Brown said. “If you’re reluctant or unsure about proceeding with YO U R H E A LT H : 5 0 + a screening, already having You may be 50 or over, but you don't have to feel limited. that relationship An increase in screenings begins during this time in your with someone life and having a trusted primary care physician to help youmeans you’re more likely to navigate your health care journey is important. ask questions.”

L IF E STYL E T I P S: • Keep off excess weight to prevent a number of diseases.

• Add in Omega-3

• Find fun ways to stay fit.

• Get enough sleep.

• Love your changing body.

HEALTH // SPRING 2022

YO U R H EALT H : 5 0 +

You may be 50 or over, but you don't have to feel limited.

KNOW YOUR HISTORY

The screenings you need are specific to you and your health journey. Your provider will take many factors into account, including your age, weight, prior health concerns and family history.

Having that relationship is important, but when you’re seeing a new provider, there are a few things you can do to make your initial visit as productive as possible. Before you For more about information, scan history, this QRincluding code go, gather information your family your smartphone or both go tosides. You which health with conditions run on one or www.monument.health/menshealth are more likely to have conditions such as cardiovascular disease, osteoporosis and diabetes if a close relative has them.Providing Before you get concerned, know that familycare history comprehensive doesn’t mean you will have the same health concerns, but for every stage discussing it with your physicianof letslife them order additional tests that can help you come up with a plan. Bring your personal health history, including any allergies, surgeries, chronic issues and medications you routinely take.

If you don’t know your family history or have an incomplete picture, don’t let that stop you from seeing

WOMEN’S HEALTH

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WELLNESS // EXCELLENCE

20 39

HEALTH RISKS: In Your 20s: Melanoma, human papillomavirus (HPV), high cholesterol, high blood pressure, fertility testing and genetic counseling.

In Your 30s Weight gain, changes in your skin, reproductive difficulties, high cholesterol, high blood pressure, stress, type 2 diabetes and testicular cancer.

40 49

SCREENINGS: Annually Blood pressure check Blood test Vision screening STD screening (If sexually active) Vaccinations Every 5 Years: Blood sugar test Cholesterol test If Needed: Skin check Fertility testing Genetic counseling

SCREENINGS: Annually Blood pressure check Blood test Cholesterol testing Prostate exam Eye disease screening Vaccinations Every 5 Years: Blood sugar testing (Annually if overweight or high risk) Colonoscopy if high risk Talk To Your Physician: Heart disease screening (If high risk)

20 39

40 49

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Monument Health offers primary care in Belle Fourche, Buffalo, Custer, Hill City, Hot Springs, Lead-Deadwood, Rapid City, Spearfish and Sturgis.

Visit monument.health/primarycare to find a provider that fits your needs.

50+

SCREENINGS: Annually Blood pressure check, blood test, prostate exam, eye disease screening, coronary screening, screening for type 2 diabetes, skin check and vaccinations Every 2 Years: Bone density testing (DEXA), blood sugar testing, (annually if overweight or high risk), blood sugar testing (annually if overweight or high risk) and colonoscopy if high risk Every 3 Years After Age 65 Heart disease screening (if high risk) Every 3 Years After Age 65 Glucose check Every 5 Years Cholesterol testing Every 10 Years Colonoscopy

50+

SCREENINGS

ANNUALLY SCREENINGS: Yearly physical: Monthly - Blood pressure check Self breast exam - Blood test Annually Clinical breast exam

Prostate exam Blood pressure check Eye Blood disease test screening Vision screening Coronary screening Mammogram Screening for Skin check Type 2 disease Diabetes Eye screening SkinVaccinations check Every 2 Years:

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VERY 3 to YEARS Talk your physician: AFTER AGE 65 Menopause Glucose check symptoms

VERY 5 YEARS Cholesterol testing

a provider. “When someone doesn’t know their family history, we just follow the guidelines for their age, weight and current health, and start there as a baseline,” Dr. Brown said. “If they find out more information from siblings, aunts, uncles or other family members, we can also use that information to move forward.”

AGREE ON A PLAN

Lisa Brown, M.D., is a board-certified Family Medicine physician at the Monument Health Custer Clinic.

She received her HEALTH RISKS: medical degree Stroke from the University Colon cancer of South Dakota Ovarian cancer School of Medicine Heart disease and completed her YOUR 50s: Osteoporosis family medicine Diabetes Osteoporosis isn't just a residency at the Arthritis Sioux Falls Family women's disease. 1 in 5 men Dementia Practice Residency will develop an osteoporosis Depression Program in Sioux related fracture.

Falls.

HEALTH TOPICS

SEXUAL HEALTH IN YOUR 60s: Scientific studies suggest that chronic diseases like diabetes, high blood pressure and heart disease affect a man’s ability to perform sexually. The more severe the disease, the more severe the erectile dysfunction.

Men over 50 who experience sexual problems should talk to their doctor to find out if a medical condition is the cause.

YOUR 70s: In your 70s, nutrition and staying physically and mentally active becomes vital as fall risks and hip injuries may occur.

HEALTH // SPRING 2022

VERY 10 YEARS Colonoscopy

EENINGS

HEALTH RISKS: Stroke Colon cancer Heart disease Osteoporosis Arthritis

HEALTH RISKS HEALTH TOPICS

Beyond your family history, the screenings you require will vary based on factors such as your age, weight and lifestyle habits. Maintaining a healthy weight by eating a balanced diet and exercising regularly is important, as well as reducing risky lifestyle habits like consuming alcohol and smoking. Don’t worry if you’re unsure what steps you can take to improve your health — your provider will discuss your health and recommend lifestyle changes they feel will benefit you.

Guidelines and evidence-based care best practices can change over time, so Monument Health providers work to stay up to date with the latest research and education.

They’ll inform you of the changing recommendations, and work with you to come up with a personalized care plan.

“There’s a stock set of screenings per age, but they can be different for everyone,” explained Dr. Brown. “For example, for a teen who has obesity and diabetes in the family, I might screen them for those things early when we otherwise wouldn’t. There are numerous bodies of specialists that provide recommendations, and they aren’t all aligned, so I’ll have a conversation with patients about the varying guidelines to see what fits their needs and insurance coverage.”

Monument Health providers strive to help their patients maintain excellent health throughout life’s journey. But optimum health comes down to having a primary care provider who knows your entire health picture and how to apply current guidelines to your individual situation. It’s an ongoing relationship that we hope to build and grow with each of our patients.

“As humans, we don’t always like to hear bad news, so a lot of times when I recommend screenings and routine visits, people will say ‘why would I want to go looking for trouble?’” said Dr. Brown. “The way I look at it is, you do routine maintenance for your house by cleaning the gutters, or for your car by getting the oil changed. Why wouldn’t you do the same thing for your own health and body? If you start early, and stick with it, we can deal with a lot of health issues before they even have a chance to become a real problem.”

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FEATURE STORY // COMMUNITY

THE GIFT OF LIFE LEAVING A LEGACY BEHIND IS SOMETHING MANY ASPIRE TO; WHETHER THAT’S THROUGH CHARITABLE GIVING, VOLUNTEERING OR BEING SURROUNDED BY A LOVING FAMILY. ANOTHER INCREDIBLY IMPACTFUL WAY TO LEAVE A LEGACY IS THROUGH EYE, ORGAN AND TISSUE DONATION.

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SPRING 2022 // HEALTH

The United States is an opt-in country; this means that you cannot be an organ donor unless you specifically express the intention of doing so prior to your death.

One person can: Save up to eight lives through organ donation.

Heal more than 75 lives through tissue donation.

Restore sight for up to two people through eye donation; and potentially heal up to 10 individuals through ocular tissue.

Most of us don’t think about becoming an organ donor unless we’re renewing our driver’s license — it’s a topic that plenty of people would rather not think about. However, by agreeing to become a donor, you’re not just checking a box: you’re becoming a guardian angel for others in need.

Monument Health has been at the forefront of organ, eye and tissue donation in the past several years, including raising awareness, working on internal processes to ensure the best possible chance of donation and working to honor and support donors and their families.

Stephanie Battell, MSN, RN, Director of Nursing Operations at Rapid City Hospital, said, “The biggest thing that makes donation possible at Monument Health is our team. From the moment someone comes in the door, to our caregivers identifying potential donors and working with our partner organizations to have them approved.

Everyone has to be on point for this to be successful, and we’re blessed to have a great team.”

To provide the best possible chance for organ, eye and tissue donations, Monument Health

HEALTH // SPRING 2022

partners with two organizations that serve the Upper Midwest: LifeSource and Dakota Lions Sight & Health. Together, they are working to increase the number of donors, streamline the donation process and ultimately improve outcomes for recipients in need.

Emily Larimer, Hospital Partner Liaison for LifeSource, has seen the positive impact of their relationship with Monument Health: “In 2021, Monument Health facilitated care for seven generous individuals and their families who said yes to donation — out of 23 organ donors in South Dakota,” she said. “These selfless donors from Monument Health helped save 15 people, giving them the ultimate gift of life and more time with their loved ones.”

Marcy Dimond, Dakota Lions Sight & Health Chief Executive Officer, echoes Emily’s gratitude: “Monument Health has stayed at the forefront of promoting donation and supporting donors. They’re really at the cutting edge of South Dakota offering every available option,” she said. “One of the best things about working with Monument Health is they are willing to

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FEATURE STORY // COMMUNITY

Donate Life Honor Wall — unveiling in 2022

Every April Monument Health hosts a variety of events in honor of Donate Life Awareness Month. This year, Monument Health will unveil a new project to honor families of organ donors: the Donate Life Honor Wall.

Oftentimes, organ donation is possible through a tragic circumstance such as a car accident. Remembering the passing of a loved one may be difficult for surviving family members, but the Donate Life Honor Wall will be a place where they can reflect on the amazing gift their loved one was able to share with others.

“We really want to support families of donors by giving them a space where they can sit and remember their loved one. We want them to have a space where they can be comfortable while seeing the impact their loved one had,” Stephanie said.

The display will be in the Fifth Street Entrance at Monument Health Rapid City Hospital, and will include a digital display where family members of donors can share stories and photos. The space will be inviting and comfortable, with the goal of giving families a quiet place to spend time in reflection and celebration of their loved one.

look at all opportunities to promote donations and expand that footprint throughout the region.”

UNDERSTANDING THE NEED

South Dakota routinely beats the national average for organ donor registration, but the need is still high: a new name is added to the transplant waiting list every 10 minutes. In South Dakota, kidneys are the number one need, with 306 people on the waiting list as of January 2022. Unfortunately, an average of 17 people die every day while waiting for a life-saving transplant.

A common misconception in organ donation is that you won’t be able to donate because of medical or health concerns. Connie Putnam, Regional Donor Development Manager for Dakota Lions Sight & Health, has seen this firsthand. She said, “There are reasons why someone is disqualified from being a donor — it could be health issues or lifestyle choices, and sometimes when we talk to families they’ll tell us they don’t want their loved one to be a

26

donor because they were sick. But the reality is, so many people can be donors, regardless of the medical conditions, especially for eye and tissue donation.”

With recent medical advances, even those with active HIV, hepatitis, lung cancer or who have recently had COVID-19 can still be eligible for donation in the right circumstances.

Medical advances allow for cornea donation or research tissue to be donated by a variety of individuals. Age doesn’t automatically disqualify someone either: the oldest organ donor to date was 95 years old.

Connie recommends individuals and families consider agreeing to donate and allow the medical professionals to make the final call. “We follow a very strict medical criteria on who we accept donations from,” she said. “But we encourage people not to rule themselves out. If you want to be a donor, the best thing you can do is register and let your wishes be known, and then we can evaluate your medical situation when the time comes.”

April is Donate Life Awareness Month April 1 Honor Wall Unveiling April 22 Blue & Green Day April 24 Annual 5K Run/Walk

SPRING 2022 // HEALTH

South Dakota leads the Upper Midwest region in registered donors — and continues to be ahead of the national average. 62 percent of people in South Dakota are checking the donor box YES when registering at their local DMV .

You can also register to become a donor by going online to www.donatelifesd.org.

THE FUTURE OF DONATION

Moving forward, Monument Health is helping to raise awareness for organ donations in the Black Hills and throughout South Dakota. In 2021, Mike Diedrich, Monument Health Vice President of Governmental Affairs, partnered with LifeSource to make South Dakota online registry information available on the South Dakota Game, Fish & Parks’ hunting and fishing license web page. Efforts like this are expanding virtual awareness and accessibility to register as a donor in new ways.

There are also technological advancements happening behind the scenes that make the donation

HEALTH // SPRING 2022

process easier. Monument Health recently had two caregivers recognized for their collaborative efforts with LifeSource.

“A report to delineate potential donor candidates was requested to grow hospital timeliness and awareness,” Emily explained. “In October 2020, a LifeSource banner was implemented at Monument Health. The banner reads as ‘LifeSource Referral,’ and is visible on the main screen of the patient’s chart when they have been referred to us. It can be turned on and off for an updated donation status and is visible to the health care team.” This new process helps save lives every day by helping caregivers recognize and process donation referrals.

Monument Health’s partnership has also helped Dakota Lions Sight & Health launch a new initiative: their birth tissue donation program. “There are currently only two hospitals in South Dakota that offer the option of donating birth tissue — including the placenta, umbilical cord and amniotic fluid — after a planned cesarean delivery. There’s one in Sioux Falls, and Monument Health,” Marcy said.

Where one organ and tissue donor can usually help up to 75 people, just one birth tissue donation has the potential to give hope to hundreds of people in need of a transplant.

EPIC team recognition In 2021, two Monument Health caregivers were recognized by LifeSource for their contributions to organ procurement efforts.

Fleta (Mandy) Martinez and Tammy Burke, Lead Application Analysts at Monument Health, both received the Hospital Impact Award.

Mandy Martinez worked alongside LifeSource to create a Referral Criteria Report and Referral Notification Banner that has been integral to advancing donation. Emily Larimer, a LifeSource Hospital Partner Liaison for LifeSource shared: “The willingness of Mandy to share her time, heart and IT knowledge is incredibly valuable in saving lives throughout our region. Because of Mandy’s expertise, we can better recognize a donation referral to ultimately honor the ‘yes’ of those who may have the chance to be a donor.”

Tammy Burke led a project that created LifeSource Note Templates, which allowed LifeSource to document family approaches in a more efficient and detailed manner. Emily said, “Tammy’s generosity and innovation was outstanding. In a matter of days, she had created a set of templates in EPIC that provided continuity, efficiency and a resource for use in potential audits.”

These innovations assist hospital teams in recognizing when a patient meets specific triggers for referral, and have been shared with other health care systems in the region, including Regions Hospital in St. Paul, Minn, Avera McKennan, in Sioux Falls, S.D. and Altru Health System, in Fargo, N.D.

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FEATURE STORY // COMMUNITY

IT’S ALL PART OF THE GAME SOFTWARE ENGINEER MICHAEL PAULSON IS AMONG THE THOUSANDS OF GAMERS INVOLVED WITH EXTRA LIFE, RAISING MONEY FOR CHILDREN’S HOSPITALS BY DOING SOMETHING THAT THEY LOVE: PLAYING VIDEO GAMES. Video games, and the gamers that play them, get a bad rap sometimes. Sure, the virtual worlds that they explore may not be real in the physical sense, but amidst the pixels real connections are made, and sometimes gamers aren’t just playing for fun. Sometimes they play to help others.

Michael Paulson has been a software engineer for 15 years. He works remotely for Netflix, lives in Rapid City with his wife and four children and runs a successful YouTube channel devoted to programming and development.

He loves gaming, and even calls it his, “favorite activity in the universe.” That may not seem unusual for someone who makes a living with technology, but Michael is also one of those gamers who has saved lives with his time behind the screen.

This is Michael’s fourth year participating in Extra Life, a program of Children’s Miracle Network powered by Twitch, a video live streaming service for gaming and other entertainment. On Extra Life Game Day, participants play games to raise money for children’s hospitals across the country.

“One of the main components of Extra Life is the ability it gives gamers to individualize their fundraising efforts on behalf of CMN,” says Shawn Powers, CMN Program Manager for Monument Health.

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What can you stream for 36 hours?

Michael didn’t play games for the full 36 hours.

He actually spent the first 11 hours coding live on Twitch, something that he has enjoyed doing for awhile.

“A lot of people when they’re on keyboards doing things in front of people get fat fingers, but it doesn’t bother me at all.” After the first 11 hours he switched to playing Apex for 25 hours. The result? $73,000 for the Children’s Miracle Network at Monument Health, and one exhausted software engineer.

“Participants choose how they play – PC games, console games, tabletop games or even family board games. They also control how they broadcast their efforts, whether it’s through texting and emailing, posting on social media or streaming game play online. Their audience is their coworkers, friends, family or even those that follow them online.”

Starting on Extra Life Game Day, Nov. 10, 2021, Michael streamed for 36 hours, raising $53,000 for the Children’s Miracle Network program at Monument Health — the fifth highest amount raised by an individual streamer. An additional contribution from his employer brought the SPRING 2022 // HEALTH

“Extra Life is a very powerful platform for gamers to make a difference in their community,” Shawn said.

total to $73,000. “So how that works, is that for every dollar that I give, Netflix will match $2 up to $20,000,” Michael explains. “Netflix supports their people giving to charity in a more distributed model, as opposed to making one singular donation. I think that model encourages the giving lifestyle.”

When asked about how he got involved with Extra Life, Michael smiles and says, “I had a friend named Guy, yeah, a guy named Guy, who was doing this four years ago and asked if I wanted to join, and I did. There’s no stars or glitter to this story.” There’s a certain humility to that explanation, but when asked to elaborate about why he continues to participate in Extra Life and raise money for CMN, he offers more. “I think most people would call themselves a good person, I rarely meet someone that says, ‘I’m a bad guy.’ but the greatest litmus test is how you spend your time and your money,” he says. “You have something to give, even HEALTH // SPRING 2022

“Extra Life is highly personal fundraising.

Gamers can connect their own style and values to our mission, and their personal fundraising pages become a way for them to express a story in their own words, as evident from Michael’s efforts.”

Shawn Powers, Program Manager for Monument Health Children’s Miracle Network.

if it’s just a few minutes or one dollar.

Individually it may not be a large amount, but when you have thousands of people giving together, that’s significant.”

The gamers that streamed for donations on Game Day 2021 raised more than $3 million over the course of a weekend, bringing the program’s total to more than $10 million in 2021. Michael is right — everyone has something to give, and these gamers have given countless hours of time to raise more than $100 million dollars for CMN hospitals since Extra Life’s inception in 2008.

Michael intends to keep contributing to CMN, and plans to continue participating in Extra Life. “Giving has always been important to my wife and me,” he says. “It changes your heart, and I think it usually ends up helping the giver as well.”

For more information about Extra Life, go to extra-life.org.

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FEATURE STORY // COMMUNITY

Clinical research, trials and studies are necessary to develop new medicines, treatments, equipment and protocols that can save and drastically improve lives.

But clinical research also benefits the Black Hills community in ways that may not be obvious at first glance.

ADVANCEMENT, ONE TRIAL AT A TIME NEW MEDICATIONS, UPDATED MEDICAL EQUIPMENT AND THE LATEST IN TREATMENT TECHNIQUES DON’T EMERGE OUT OF THE BLUE. IT TAKES CLINICAL RESEARCH TO PERFECT THEM.

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SPRING 2022 // HEALTH

Research studies and clinical trials conducted by Monument Health physicians make the latest treatment options available to our patients, even in the more rural setting. Patients in the region have access to potentially life-changing treatments before they’re widely available, sometimes even in more urban settings.

Roger Deraad Director of Research

Often when we think of the latest medical advancements, we imagine them emanating from metropolitan areas with prominent medical schools. What many fail to consider, is the role that clinical research plays in developing new medicines and treatments.

Most people don’t know that Monument Health has an active clinical research team that partners with physicians to conduct clinical research right here in the Black Hills.

The clinical research conducted at Monument Health focuses on the use of new medications, new uses for existing medications, as well as new devices and therapies. Roger DeRaad, Director of Research, said that sometimes physicians will bring a trial to their attention if there is a new device or medication that they’re interested in working with or that they believe will help one of their patients.

“Other times, research sponsors come to Monument Health to see if there is any interest in the studies, especially if they’ve worked with us in the past,” explained DeRaad.

The research studies are vital to developing new treatments, but they only work when there are participants. “Patients involved in clinical research are always volunteers,” said Crystal Gruetzmacher, Clinical Research Coordinator.

“They give up their time — sometimes a good deal of time — and even though these trials are largely safe, the patients do assume some risk.”

“It’s important to understand that the only way that new medications can become available

HEALTH // SPRING 2022

Crystal Gruetzmacher Clinical Research Coordinator

to everyone is if there are enough volunteers to participate in these studies,” adds DeRaad. “Improvements in treatments and medications depend on clinical research and the patients that participate in them.”

“Whether they realize it or not, the patients who volunteer for these studies are changing and even saving lives,” adds Kelli McIntosh, Manager of Research.

ARE THERE ANY RISKS?

A lot of people may wonder if there’s any risk in participating in a clinical study.

While there is a modicum of risk involved in any clinical trial, safety measures are built into the studies to mitigate any potential problems. “We know we need to be careful so, for example, in early phase studies with a new medication, there will be frequent contact and frequent lab work to identify any unexpected changes,” said DeRaad. “Sometimes during a trial, we’ll learn something new, and it may necessitate changing how often we treat or examine patients. And of course, we always explain the risks as we go along and ask if they wish to continue participating.”

Monument Health Clinical Research is always seeking participants in studies, but it’s important to remember that this isn’t a walk-in clinic. Participants must meet specific requirements for each study, and if you’re already a Monument Health patient,

Kelli Mcintosh Manager of Research

Experience Counts Once the treatments and medications do become widely available, Monument Health physicians are already ahead of the learning curve, since they will have had previous experience with them.

“Sometimes you’ll see physicians shy away from new treatments or medications, simply because they don’t have experience with them yet,” says DeRaad. “That isn’t the case here.

By the time many new medications are approved, our doctors aren’t just learning about them, they’ve already had five or even ten years of experience with them from participating in studies. New treatments are adopted into practice more rapidly and it keeps our physicians on the cutting edge of therapies.”

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FEATURE STORY // COMMUNITY

History of Clinical Research “A lot of people in the community may not be aware of it, but we’ve been doing clinical research here for 25 years,” says Roger DeRaad, Director of Research. “We’ve done somewhere around 400 different trials, and now we carry about 45 to 55 trials at any given time.”

Monument Health Clinical Research got its start in the ‘90s, with the establishment of the IRB Committee and the development of policies and procedures for performing studies and trials. In the early 2000s, the program had a fully established Human Research Protection Program and received Federalwide Assurance of compliance with U.S. federal regulations.

In 2013, the Clinical Research program earned accreditation with the Association for Accreditation of Human Research Protection Programs. AAHRPP accreditation indicates that an organization meets the standards for ethics, quality and protections for human research. “We’ve been doing clinical research in the Black Hills for 25 years now — that’s a lot of people that we’ve helped, directly and indirectly,” says Crystal Gruetzmacher, Clinical Research Coordinator.

“We’re very proud of the work we’ve done, and the length of time that we’ve been able to do it, but I have to mention that the Cancer Care Institute has also been doing research this whole time as well.

In fact, they started before we did,” adds DeRaad. Clinical Research started with focus on cardiac-related studies and trials — and two thirds of their research is still cardiac-centered — but the program has continued to grow, expanding from cardiac-related research to also include endocrinology, rheumatology, pediatric, pediatric endocrinology, infectious disease, nephrology and cancer research.

chances are your provider will let you know if there’s a study that’s right for you.

THE RESULT OF RESEARCH

The long term impact of the studies is incredibly significant. “When we started 25 years ago we didn’t do stents in carotid arteries and we’ve kind of led the way in peripheral arterial stenting here,” DeRaad said. “About 20 years ago we went through numerous antiplatelet studies and now we have multiple effective anti-platelet therapies. We did the same thing with anticoagulation therapy. We went through

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The Institutional Review Board While all clinical research carries some risk, measures are taken to protect participants from any harm. All studies involving new medications, new uses for existing medications or any new devices must be approved by the FDA and all clinical trials and research studies must be reviewed by the Institutional Review Board, or IRB. The IRB is a committee established to review and approve any research involving human subjects to ensure all federal regulations are met, that the studies are ethically sound and that the rights of participants are protected.

The Monument Health IRB is committed to protecting the rights and welfare of the volunteer patients involved in research.

The IRB reviews all plans for any research involving human subjects conducted at any Monument Health facility. The IRB members play an essential role in the research process and bring a variety of backgrounds and experience to the review of research applications.

Jen Hansen served as the IRB Coordinator for three years, a job that can be challenging at times, but that she ultimately found very rewarding. “When we review research applications, we always have the best interest of the volunteers at heart,” she says. “And when we see these studies, and get an understanding of how awesome the benefits of the research could be for people, it’s very exciting.”

10 years of testing multiple anticoagulants and now we’ve got a wonderful array of anticoagulants.” Presently, two thirds of the research is cardiac-related, and there is a big focus on a vast array of anti-cholesterol, lipid lowering drugs.

“We’re always learning new things, and we’re always excited for Monument Health to take part in new research,” said McIntosh.

DeRaad adds, “About once a month we get notified of a new study that’s interesting, intriguing and challenging. There’s always something new — and potentially lifealtering — just around the bend.

SPRING 2022 // HEALTH

Welcome our newest physician PULMONOLOGY and CRITICAL CARE

Lalith Uragoda, . .,

m d provides care in the Intensive Care Unit and inpatient pulmonology services at Monument Health Rapid City Hospital. Dr. Uragoda has worked at the Rapid City Hospital as a locum since 2014 and joined Monument Health on a part-time basis this past fall. Dr. Uragoda received his Doctor of Medicine degree from North Colombo Medical College in Sri Lanka. He then completing his Internal Medicine Residency and Pulmonary Medicine Fellowship at Coney Island Hospital in Brooklyn, NY and his critical care fellowship at Mount Sinai Hospital in New York City. When he is not caring for patients in the ICU, Dr. Uragoda enjoys traveling, photography, cooking, current affairs, arts & theater, history and reading.

IT STARTS WITH HEART. Hundreds of generous community members serve thousands of hours as Monument Health volunteers every year. We are thankful for our volunteers who play a vital role in providing a caring experience for our patients and families every day.

Interested in joining our team as a volunteer?

For available opportunities or to apply, visit: monument.health/volunteer

HEALTH // SPRING 2022

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PHYSICIAN PROFILE // EXCELLENCE

K. John Heilman III, m.d., facc Cardiologist, Heart and Vascular Institute

During the last few years, John Heilmann III, M.D., FACC, has tried to emphasize teaching and mentoring other providers.

He wants to pass on some of the knowledge and experience he has gained to the several excellent new physicians at HVI. Dr. Heilman says his career as a cardiologist is a privilege. He realized in medical school that cardiology would be a rapidly advancing field with lots of tools to help his patients.

Medical advances through the years have allowed him the ability to continue to treat his patients as unique individuals — new technology and medicines are great, but aren’t always best for every patient.

“The knowledge base has grown exponentially since I was trained so newer graduates must focus on an area of cardiology such as noninvasive imaging, heart failure or electrophysiology.

That is the way the field has evolved and, I think, rightly so,” he says.

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My Role I now have the dubious distinction of being the oldest physician in the group and I never thought that day would come. I have been in practice for 35 years and often refer to myself as “the last of a dying breed,” meaning I was broadly trained in cardiology and picked up other skills during my career.

Currently, I am the chair of the Cardiovascular Department at Monument Health Rapid City Hospital. I represent Cardiac Surgery and Cardiology in the larger medical staff structure, assist in assuring safe and high-quality cardiovascular patient care and help colleagues improve behaviors or practice patterns.

My Goal My goal is simple, and has not changed from what I was taught in medical school. Learn something new every day. Deliver the best care to your patients, and place them at the center of any decision made about their care.

Communicate well with patients, their families and with colleagues. Don’t be afraid to admit you were wrong and to change course. Be humble. Take the time to listen.

My Passion In the practice of medicine, it is the joy found in helping people and in medical detective work. By detective work I mean using my knowledge and experience to figure out what is causing a patient’s symptoms and arriving at a diagnosis. In my personal life it is spending time with family and enjoying the great outdoors.

SPRING 2022 // HEALTH

Family physicians get to know your health through all of life’s stages.

Their practice includes pediatric and adolescent health, women’s and men’s health, gynecology, aging issues and office-based surgery.

My Role My role at Monument Health LeadDeadwood Clinic is to provide a full spectrum of care at both our clinic and Critical Access Hospital. I see people of all ages for all their health needs. I offer newborn care, pediatric care, prenatal care, men’s health care, women’s health care and geriatric care. I see patients in the hospital when needed, in the Emergency Department for emergent conditions, and in the clinic for preventative health maintenance as well as chronic disease management. I am new to the clinic and still building my practice, but hope to establish care with many patients in the Lead-Deadwood area.

My Goal My goal has always been to be a partner in my patients’ health.

I hope to improve the health of our community members by working closely alongside my patients. I strongly support patient autonomy and their right to choose what health care options are best for them based on their past medical history and current life situations. I see myself as a teacher of health care and like to provide a patient with options to help them get where they want to be with their health and wellness.

My Passion My passion is family. After my wife and I had our daughter in 2020, we moved to South Dakota to be closer to my sisters who live in Sturgis. This passion is one of the reasons I went into Family Medicine — I want to be involved in an entire family’s life. I find medicine much easier to practice when I can get a sense of the health of all the members of a family. I provide prenatal care because I want to be part of the beginning of the family and be able to provide care from the start of life to the end.

HEALTH // SPRING 2022

John Tronnes, m.d.

Family Medicine Physician at Lead-Deadwood Hospital and Clinic

Dr. Tronnes places a high value on family. That’s what brought him to the Black Hills, and it shines through in his practice, no matter the setting.

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READY TO SUIT UP?

CONSIDER BREAST ENHANCEMENT At Monument Health Plastic Surgery, we make it a priority to translate your desires into a surgical procedure tailored to give

HUNTER MOYER, M.D. Board Certified Plastic Surgeon

you the best possible results. Dr. Hunter Moyer uses breast enhancement procedures that focus on providing you with the breast size you want while improving your breast shape to be as natural and aesthetically appealing as possible.

605-755-6000

www.monument.health/plasticsurgery

Monument Health Plastic Surgery Rapid City Clinic | 2805 5th Street

Delivering high-quality care is one of Monument Health’s priorities.

To fulfill that goal, we rely on passionate and dedicated employees in every facet of our organization.

The laundry department at Monument Health accepts linens from across the system and prepares them for re-entry into the hospitals and clinics that make up Monument Health. This includes sorting, washing, drying, folding and distributing as needed. On a busy day the laundry team can process up to 20,000 pounds of linens.

As blankets and towels wear out and become tattered, they continue to provide comfort and care as they are donated to shelters and those in need throughout the Black Hills.

Kim Bloom Laundry Technician, Rapid City

Kim has seen many changes in her 22 years within the laundry department — from new buildings to updated technology — but the one constant is Kim’s cheerful disposition, as evidenced by the notes she sends with orders.

HEALTH // SPRING 2022

COMMUNITY // MY SPACE

One of Kim’s notes she leaves for fellow caregivers.

My Role As a laundry technician, I fulfill orders for our accounts in the Northern Hills, Southern Hills, central and in-town accounts.

This means ensuring that proper linen counts are sent to the correct places in a timely manner. Some days are busier than others because we’re filling orders for the weekend.

My Goal I really like to keep busy and I push myself to get my work done, and I don’t really like to ask for help. I enjoy doing the work, it really makes the day go by faster. Once I counted my steps and by the end of the day I had walked about five miles.

My Passion I enjoy putting a smile on someone’s face each day. You never know what’s going on in someone’s life — maybe they are having a hard day — and they might just need some words of encouragement. That’s why I like to send notes with each order.

They’re simply meant to give someone a little encouragement when they need it.

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FRIDAY, MAY 13, 2022 6 A.M. - 6 P.M. EVERY DOLLAR STAYS LOCAL, HELPING KIDS EVERY DAY!

Tune in to hear stories about our local Miracle Children treated at Monument Health hospitals.

To make a pledge, call 605-755-9199 or go online at www.monument.health/cmn.

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SPRING 2022 // HEALTH

COMMUNITY // CALENDAR

April 7-9 April 9 April 19

The South Dakota Early Childhood Education Conference COMMUNITY Best Western Ramkota, Rapid City

// CALENDAR

Northern Hills Hospice Ball Holiday Inn, Spearfish

Helpline Center Spirit of Volunteerism Awards Rapid City

May 6

YMCA Healthy Kids Day

May 9

Run for Their Lives — Lach’s Legacy

YMCA of Rapid City

Spearfish

May 13

Children’s Miracle Network Mediathon

June 2

Habitat for Humanity Tees for Keys Golf Tournament

Rapid City

The Club at Red Rock, Rapid City

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

HEALTH // SPRING 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.

Find a location or provider near you HOSPITALS Custer Hospital 1220 Montgomery St. Custer, SD 57730 605.673.9400 Lead-Deadwood Hospital 61 Charles St. Deadwood, SD 57732 605.717.6000 Rapid City Hospital 353 Fairmont Blvd.

Rapid City, SD 57701 605.755.1000 Spearfish Hospital 1440 N. Main St. Spearfish, SD 57783 605.644.4000 Sturgis Hospital 2140 Junction Ave. Sturgis, SD 57785 605.720.2400 MEDICAL CLINICS Belle Fourche Clinic 2200 13th Ave. Belle Fourche, SD 57717 605.723.8970 Buffalo Clinic 209 Ramsland St. Buffalo, SD 57720 605.375.3744 Custer Clinic 1220 Montgomery St. Custer, SD 57730 605.673.9400 Gillette Clinic 620 W. Four-J Ct. Gillette, WY 82716 307.682.1204

Lead-Deadwood Clinic 71 Charles St. Deadwood SD, 57732 605.717.6431 Rapid City Clinic 640 Flormann St. Rapid City, SD 57701 605.755.3300 Rapid City Clinic 2805 5th St. Rapid City, SD 57701 605.755.5700 Spearfish Clinic 1445 North Ave. Spearfish, SD 57783 605.644.4170 Spearfish Clinic 1420 N. 10th St. Spearfish, SD 57783 605.717.8595 Sturgis Clinic 2140 Junction Ave. Sturgis, SD 57785 605.720.2600 Wall Clinic 112 7th Ave. Wall, SD 57790 605.279.2149 Family Medicine Residency Clinic 502 E. Monroe St. Rapid City, SD 57701 605.755.4060 Family Health Education Services 930 N. 10th St. Spearfish, SD 57783 605.642.6337

Hill City Clinic 238 Elm St. Hill City, SD 57745 605.574.4470

URGENT CARE Rapid City Urgent Care 1303 N. Lacrosse St. Rapid City, SD 57701 605.755.2273

Hot Springs Clinic 1100 Highway 71 South, Suite 101 Hot Springs, SD 57747 605.745.8050

Rapid City Urgent Care 2116 Jackson Blvd.

Rapid City, SD 57702 605.755.2273

Lead-Deadwood Urgent Care Services 71 Charles St. Deadwood, SD 57732 605.717.6431 Spearfish Urgent Care 1420 N. 10th St. Spearfish, SD 57783 605.717.8595 Sturgis Urgent Care Services 2140 Junction Ave. Sturgis, SD 57785 605.720.2600 Custer Urgent Care Services 1220 Montgomery St. Custer, SD 57730 605.673.9400 SPECIALTY CLINICS Assisted Living 423 N. 10th St. Custer, SD 57730 605.673.5588 Behavioral Health Center 915 Mountain View Rd. Rapid City, SD 57702 605.755.7200 Sturgis Care Center 949 Harmon St. Sturgis, SD 57785 605.720.2400 Dermatology 550 E. Colorado Blvd.

Spearfish, SD 57783 605.717.8860 Dermatology 4150 5th St. Rapid City, SD 57701 605.755.5340 Dialysis Center 955 E. North St. Rapid City, SD 57701 605.755.6950 Dialysis Center 132 Yankee St. Spearfish, SD 57783 605.722.8110

Heart and Vascular Institute 353 Fairmont Blvd.

Rapid City, SD 57701 605.755.4300

Neurology and Rehabilitation 677 Cathedral Dr. Rapid City, SD 57701 605.755.4150

Home+ Home Health 1440 N. Main St. Spearfish, SD 57783 605.644.4444

Neuropsychology 677 Cathedral Dr., Suite 201 Rapid City, SD 57701 605.755.5276

Home+ Hospice 1440 N. Main St. Spearfish, SD 57783 605.644.4444 Home+ Home Health 224 Elk St. Rapid City, SD 57701 605.755.7710 Home+ Hospice House 224 Elk St. Rapid City, SD 57701 605.755.7710 Home+ Home Medical Equipment 1800 N. Haines Ave. Rapid City, SD 57701 605.755.9000 Home+ Home Medical Equipment 911 E. Colorado Blvd.

Spearfish, SD 57783 605.717.8930

Rehabilitation 2200 13th Ave. Belle Fourche, SD 57717 605.723.8961 Rehabilitation 1220 Montgomery St. Custer, SD 57730 605.673.9470 Rehabilitation 61 Charles St. Deadwood, SD 57732 605.717.6370 Rehabilitation 2449 E. Colorado Blvd.

Spearfish, SD 57783 605.644.4370 Rehabilitation 2140 Junction Ave. Sturgis, SD 57785 605.720.2570

Home+ Home Medical Equipment 2707 Lazelle St. Sturgis, SD 57785 605.720.2676

Rehabilitation Center 1050 Fairmont Blvd., Suite A100 Rapid City, SD 57701 605.755.1230

Home+ Pharmacy 353 Fairmont Blvd.

Rapid City, SD 57701 605.755.8184

Orthopedics and Sports Medicine 2479 E. Colorado Blvd.

Spearfish, SD 57783 605.644.4460

Home+ Pharmacy 1420 N. 10th St., Suite 1 Spearfish, SD 57783 605.717.8741 Home+ Specialty Pharmacy 2006 Mount Rushmore Rd., Suite 2 Rapid City, SD 57701 605.755.3065 Cancer Care Institute 353 Fairmont Blvd.

Rapid City, SD 57701 605.755.2300 Orthopedic & Specialty Hospital 1635 Caregiver Cir. Rapid City, SD 57702 605.755.6100

Sleep Center 2929 5th St. Rapid City, SD 57701 605.755.4000 Sports Performance Institute powered

by EXOS 1635 Caregiver Cir. Rapid City, SD 57702 605.755.6683 Surgery Center 1316 N. 10th St. Spearfish, SD 57783 605.642.3113

1 IN 5 YOUTH WILL EXPERIENCE A MENTAL HEALTH CHALLENGE AT SOME POINT IN THEIR LIFE.

VISIT ONLINE AT www.monument.health/mentalhealth for resources to help your child.

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