Fall 2021 Monument Health Issue 4

M O N U M E N T

H E A L T H

issue 04

Fall 2021

PERSEVERE This Rapid City woman turned tragedy into opportunity with the help of Monument Health’s caregivers — and a wicked sense of humor.

RIGHT CARE. RIGHT PLACE. RIGHT TIME.

WHEN TO GO TO

PRIMARY CARE

Call your primary care provider’s office when you need routine care or treatment for a current health issue. Your primary care provider knows you and your health history, can provide preventive and routine care, manage your medications and refer you to a specialist if necessary.

• Routine checkups • Immunizations • Preventive services • Care to manage your general health • Common infections – strep throat, bladder, sinus • Minor skin conditions – poison ivy • Vaccinations – tetanus shots, flu shots • Pregnancy tests • Minor injuries – cuts, burns, bruises • Earaches • Nausea/vomiting • Respiratory infections – pneumonia, bronchitis

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WHEN TO GO TO

$$

WHEN TO GO TO THE

URGENT CARE OR ORTHOEXPRESS

EMERGENCY ROOM

Visit Ugent Care for common things that need to be treated soon, but your primary care doctor is not available. Urgent Care is on a walk-in basis.

Visit the Emergency Room (ER) for serious life or limb threatening conditions.

Visit OrthoExpress for walk-in orthopedic care that needs to be treated soon but isn’t life-threatening.

Urgent Care

OrthoExpress

• Heavy bleeding

• Lacerations/

• Fractures –

• Large open wounds

wounds

casting/splinting

• Sudden change in vision

• Stitches

• Sprains

• Chest pain

• Labs

• Strains

• Sudden weakness or trouble talking

• X-rays

• Swollen joints

• Major burns

• Minor burns

• Injuries to the hands,

• Spinal injuries

• Common infections – strep throat, bladder, sinus • Nausea/vomiting • Respiratory

wrists or shoulders

• Severe head injury

• Back pain

• Difficulty breathing

• Muscle and tendon

• Major broken bones

strains • Torn bicep, tricep or

infections –

quadricep tendon

pneumonia,

• Hamstring injuries

bronchitis

• Lower extremity injury

• Loss of consciousness • Eye injuries

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W E LC O M E

F R O M

Paulette Davidson

President and Chief Executive Officer, Monument Health

S When Leah’s accident left her paralyzed, it changed her life in unexpected ways.

She can no longer walk, but she finally has time to truly pursue her passion.

tarting a quarterly magazine wasn’t an easy task, but we’re glad we took the plunge.

It’s given us a chance to share exciting things happening around Monument Health, but it’s also let us show off the greatest part of our organization: the people.

“Health” magazine has introduced our physicians, let patients share their health care journeys and highlighted littleknown areas of our organization.

It has breathed life into our vision statement to be one team, to listen, to be inclusive and to show we care.

As we round out the year, we’re excited to introduce you to volunteers like Sue Plooster, who helps cancer patients feel like themselves again. You’ll also meet Joyce Klein and the Christian Motorcycle Association who volunteer with us during the Sturgis Motorcycle Rally.

We’re also excited to introduce Leah Nixon. She turned a tragedy into opportunity with incredible caregivers from Monument Health by her side every step of the way. Her story is one of courage, perseverance and hope that we know will inspire you.

We took the opportunity to focus on one specific condition in this issue: diabetes. The disease is common — 1 in 10 adults have it — but many of us don’t know a lot about it. In this issue you’ll hear from our experts about diabetes risk factors and treatment options; learn how to make healthy changes to your diet; and read a first-hand experience from one of our patients about his treatment journey.

As 2021 comes to a close, we are thankful for each and every one of you, and thank you for trusting us with your health. We look forward to what 2022 will bring!

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C O N T E N T S FALL 2021

Regulars

H E A L T H Managing Editor Melissa Haught Editor Stephany Chalberg Senior Writers Dan Daly Wade Ellett Contributors Karlee Baumann Jennessa Dempsey 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 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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In Case You Missed It This is our round up of all the latest news and happenings throughout Monument Health. page 4

My Space Patrick Sabrowski has filled important roles at Monument Health for 11 years thanks to a partnership with Black Hills Works. page 37

Awareness Months Highlights of key health issues and medical staff. page 6

Calendar Upcoming events at Monument Health. page 39

My Space Meet Brian Blenner, the Security Services Director who ensures Monument Health is safe for all. page 9

Directory Find a Monument Health provider near you. page 40

Meet the Volunteers Sue Plooster and the Christian Motorcycle Association help in unexpected ways. page 10 Ask The Doc Sonali Khachikian, M.D., discusses risk factors and stateof-the-art treatment options for diabetes. page 12 Patient Stories Gordy Pratt is no stranger to the spotlight, and he wasn’t about to let diabetes put him on the sideline. page 28

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Bob Lantis is the epitome of an American cowboy. When back pain got in the way of his daily life, Monument Health got him back in the saddle. page 30 Introducing Get to know physicians who have recently joined Monument Health. page 33 Physician Spotlight Meet Chad Storch, D.O., MPH, a board-certified physician in Aerospace and Occupational Medicine and Kyle Schmidt, M.D., a neurosurgeon. page 34

Features and Stories

Mindfulness A practice we can take anywhere, and it has incredible benefits in stress management and our health. page 14 The Science of Sweetness Much of our understanding of sugar in our diet is incorrect or misinformed. Monument Health dietitians explain how to make healthy changes to your diet and lifestyle. page 18 Perseverance A tragic accident meant Leah Nixon could no longer work as a builder for Habitat for Humanity, but it allowed her to focus on her true love: art. page 22 Thoracic World Cardiothoracic surgery is complex, and the stakes are high. Luckily, Monument Health has two surgeons that are experts in the field. page 26

NEWS // EXCELLENCE

One of the fifthfloor patient care areas has been converted to six Intensive Care Unit rooms to accommodate more seriously ill patients.

SIX ICU ROOMS ADDED TO RAPID CITY HOSPITAL In June 2021, Monument Health expanded its Intensive Care Unit capacity, completing construction of six new ICU rooms at Rapid City Hospital. The new rooms are a response to expanding demand for medical and surgical services, especially cardiothoracic surgery, at Monument Health.

“Monument Health cardiovascular specialists, cardiothoracic surgeons, intensivists and other specialists are providing increasingly complex care to patients at Rapid City Hospital, which increases the need for ICU rooms,” said George Sazama, RN, Director of Intensive Care at Rapid City Hospital.

The rooms are on the fifth floor of Rapid City Hospital in a newly remodeled and refitted patient care area. The new rooms represent a $2.3 million investment by Monument Health.

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COVID-19 EFFORTS CONTINUE

Monument Health shares weekly statistics of patients with COVID-19, which show that hospitalized patients are overwhelmingly unvaccinated. Almost 90 percent in the ICU or on a mechanical ventilator are unvaccinated.

To stop the spread of COVID-19 everyone who is able to receive the vaccine should do so. To schedule your vaccine go to monument.health/ covidvaccine.

RAPID CITY DIALYSIS CLINIC EXPANDING

The clinic is located in Dakota Market Square — formerly the Kmart plaza — at East North and Cambell streets in Rapid City.

The new 16,000square-foot clinic will have 36 dialysis stations and is all on ground level, so patients in wheelchairs won’t have to navigate elevators.

The clinic begins seeing patients in November.

Monument Health also offers dialysis care at Rapid City Hospital and in Spearfish.

FALL 2021 // HEALTH

Whether it’s offering more care options or expanding our existing facilities, Monument Health’s priority is to deliver high-quality care that impacts the communities we call home.

NEW JOINT VENTURE SPECIALTY HOSPITAL COMING TO RAPID CITY Monument Health joined in a partnership to build a new specialty hospital in Rapid City to serve the acute medical rehabilitation and long-term acute care needs of patients throughout the region.

The new hospital will be operated by a joint venture partnership between Monument Health and Vibra Healthcare, an industry leader that operates 29 longterm acute care and rehabilitation hospitals nationwide.

The Rehabilitation and Critical Care Hospital of the Black Hills will have 36 rehabilitation beds, as well as 18 longterm acute care beds. It will be built near the northwest corner of the Catron Boulevard and U.S. Highway 16 intersection.

HEALTH // FALL 2021

GILLETTE CLINIC OPENS Monument Health opened a clinic in Gillette to help Northeast Wyoming patients meet their dermatology, bariatrics, general surgery, orthopedics and sports medicine needs. The new Monument Health Gillette Clinic is at 620 W. Four-J Court.

A member of the Mayo Clinic Care Network, Monument Health is excited to expand services into Wyoming.

Monument Health is accepting new patients. For more information, call (307) 682-1204 or visit monument.health.

CANCER CARE INSTITUTE BREAKS GROUND On April 29, 2021 Monument Health broke ground for the two-story, 70,000-square-foot Cancer Care Institute expansion at Rapid City Hospital. Work is underway and is expected to be completed in the summer of 2023.

The Monument Health Foundation also announced it surpassed its $8.5 million fundraising goal. The foundation committed $6.5 million in January, with the remaining $2 million coming from community donations.

They surpassed that goal with help from 1,100 donors. The two largest donors were Dakota Charitable Foundation and the Monument Health Rapid City Hospital Auxiliary.

CUSTER HOSPITAL EARNS NATIONAL RECOGNITION The National Rural Health Association recently announced that Monument Health Custer Hospital is among the nation’s top 20 Critical Access Hospitals for patient satisfaction.

The association bases its top 20 Critical Access Hospital lists on a quality index, a patient perspective index and an overall hospital strength index. Custer Hospital was named to the list of Top 20 hospitals based on its patient perspective index.

CARDIOLOGY GROUP HONORS MONUMENT HEALTH For the 10th straight year, Rapid City Hospital and the Heart and Vascular Institute have received the American College of Cardiology’s NCDR Chest Pain­—MI Registry Platinum Performance Achievement Award. Monument Health is one of only 212 hospitals nationwide recognized this year, and one of just 57 honored for 10 years.

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NEWS // EXCELLENCE

BREAST CANCER AWARENESS

Did you know that about one in every 8 women in the U.S. will develop invasive breast cancer in her lifetime? Or that breast cancer is the most commonly diagnosed cancer among American women? In order to increase awareness of the disease, October is Breast Cancer Awareness Month.

Because it’s so prevalent, Monument Health Cancer Care Institute helps women in the region get the cancer care they need close to home.

DIABETES AWARENESS November is National Diabetes Month, an annual campaign that shines a light on diabetes and diabetes education.

More than 10 percent of Americans have diabetes, and approximately 1 in 3 have prediabetes — and in 2017, diabetes was the seventh leading cause of

death in the U.S. Treating diabetes takes a multi-faceted approach, which is why Monument Health has diabetes educators that help patients find the right treatment options and develop an individualized care plan.

Lung Cancer Month

Lung cancer is the leading cause of cancer deaths worldwide; including approximately 131,880 Americans every year. November is National Lung Cancer Awareness month to aid in early detection.

Smoking is the primary risk factor for lung cancer, contributing to 80 percent of deaths.

Monument Health provides lung cancer screenings and treatment at the Cancer Care Institute.

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Respiratory Care Week Respiratory Care Week, October 24-30, recognizes and celebrates the important contributions of respiratory therapy professionals.

Respiratory therapists help patients with lung diseases or disorders, including asthma, COPD, chest trauma, lung cancer and more. With the continued threat of COVID-19, now more than ever, respiratory therapists play a crucial role in patient care.

National Home Care & Hospice Month Monument Health’s Home Health caregivers provide valuable care within a patient’s home, and Hospice caregivers enable patients diagnosed with life-limiting illness to live each day as fully and comfortably as possible. Every November, Home Care & Hospice Month, we honor the incredible contributions they make in the lives of patients, families and the community.

Physical Therapy Month

October is National Physical Therapy Month, a time to thank and celebrate physical therapists and physical therapist assistants for all they do.

Whether patients are recovering from an injury, or dealing with chronic pain, Monument Health’s physical therapy team uses targeted therapy and advanced technology to help decrease their pain, restore mobility, improve function and prevent future injury.

ANTIBIOTICS AWARENESS Antibiotics are incredibly important when it comes to treating infections, and since their introduction in the early twentieth century they have saved countless lives. Antibiotic resistance, however, is one of the biggest public health challenges of our time.

Antibiotic Awareness Week, November 19-24, exists to educate people on the risks of antibiotic resistance. Antibiotic resistance occurs when bacteria and germs are no longer killed by antibiotics — this happens naturally, but misuse and overuse of antibiotics speeds up the process. The best way to protect yourself and your family from antibiotic resistance is to only take antibiotics as needed and as prescribed.

FALL 2021 // HEALTH

www.monument.health/weneedyou

SHE IS MY

MONEIK Breast Cancer Survivor

STRENGTH 1 IN 8 WOMEN WILL DEVELOP BREAST CANCER IN HER LIFETIME. Mammograms are the best weapon we have against breast cancer.

To the women in our lives, we need your strength. Don’t delay your mammogram because of Covid-19.

All Monument Health locations are taking precautionary measures to keep you safe.

Talk to your doctor today about scheduling your mammogram and ask about Genius 3D Mammography.

Monument Monument Monument Monument Monument

Health Health Health Health Health

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 Clinic, Flormann Street 640 Flormann St., Rapid City, SD 57701 | 605-755-3300 Spearfish Clinic, North 10th Street 1420 North 10th St., Spearfish, SD 57783 | 605-717-8595 Sturgis Hospital 2140 Junction Ave., Sturgis, SD 57785 | 605-720-2400

OUR PRIMARY FOCUS IS YOU. No matter your age, a Primary Care provider at Monument Health is an important part of your health journey. They get to know YOU. With over 100+ Primary Care providers system wide, our providers have a wide variety of backgrounds just like our patients. Regular primary care visits help prevent diesease progression, catch problems earlier, and help you stay on track to better health. Avoid a medical emergency and choose a provider that is right for you.

Find a provider close to you: monument.health/primarycare

We believe you deserve world-class care that is respectful, considerate and free from all forms of abuse or harassment. Our mission is to provide a safe environment where you can focus on your health.

COMMUNITY // MY SPACE

Brian Blenner Safety Services Director, Rapid City

Monument Health’s Safety Services team is working hard to ensure our caregivers and our patients are safe. This includes Life Safety as well as addressing Workplace Violence.

Monument Health has had a Workplace Violence Committee in place since 2017.

This committee uses data to develop strategies to keep caregivers safe. Health care is unique because when workplace violence occurs there is a tendency to accept it as part of the job.

People get into this business to care for others and if they decide to take action, the belief is they are hurting that person and not helping.

We want all caregivers, current and future, to understand and feel comfortable in not accepting violent behavior as a norm.

HEALTH // FALL 2021

My Role As the Safety Services Director I wear many hats. I oversee policy, procedures and caregivers covering Life Safety, Emergency Management and Workplace Violence. My job is to support the safety of all caregivers and patients to promote a safe work environment.

Safety Services is made up of two divisions. The first division, security, is composed of 28 security officers, four dispatchers, a supervisor and a manager.

The second division, Emergency Management, focuses on Monument Health’s preparedness, response, mitigation and recovery in emergency situations.

My Goal Is to create a work environment where our caregivers and physicians feel safe while doing their jobs.

My Passion Is to serve our caregivers and community through compassion, innovation and trust to make every day better than the last. I served the Rapid City community for nearly 24 years as a police officer and school board representative, and now being able to serve the caregivers, physicians and patients at Monument Health is an honor.

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VOLUNTEER PROFILE // COMMUNITY

The Wig Room at Monument Health’s Cancer Care Institute is just one way to support survivors as they adjust to the side effects of their cancer journey.

Sue Plooster

Volunteer, Rapid City Home+ Home Health and Hospice House

Between caring for others at Hospice House, serving on the Volunteer Auxiliary Board and helping the Cancer Care Institute create a wig room for patients, Sue Plooster loves to give back.

When her mother developed cancer, Monument Health Hospice helped Sue’s entire family. One year later, she decided to give back, volunteering to help others in Hospice. She didn’t realize it at the time, but she was only getting started.

Why do you volunteer?

It began with Hospice. I wanted to pay them back for helping my family and pay it forward to help others. What keeps me going is the people that I meet. All the other volunteers are amazing, and the people that we help are wonderful.

Sue Plooster credits the success of the wig room to the amazing help she gets from other volunteers, like her friend Sandy Stanton, who she refers to as her “right-hand person.” Sue says, “Sandy and the other volunteers make sure that what needs to happen gets done. They amaze me all the time.”

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What have you done as a volunteer?

Hospice is where my heart is at and I still volunteer at Hospice House. But I have also served as chair of the Volunteer Auxiliary Board, because there was nobody from Hospice on the board.

Since then I’ve served on the board in many different positions. The wig room at the Cancer Care Institute is another big one I support.

I owned a beauty shop in town, and so I just kind of fell into that, which is a wonderful thing.

Why would you recommend volunteering to others?

It makes you feel good at the end of the day to put a smile on somebody’s face.

You know that they’re going through a really tough time, but when they’re able to talk about it, it makes it not quite as bad. My favorite thing is helping these patients and working with the other incredible volunteers.

FALL 2021 // HEALTH

Since 1999, the Christian Motorcyclists Association has had members across the country who come to volunteer during the Sturgis Motorcycle Rally.

COMMUNITY // VOLUNTEER PROFILE

The Christian Motorcyclists Association and Monument Health both believe that caring for others starts with heart.

CMA’s mission is religious, but they’re here to help anyone who needs them, regardless of denomination or religious affiliation. CMA member Joyce Klein has been volunteering at the Rally since 2000, and this year coordinated efforts at Rapid City Hospital. “We would love to minister to anyone who is open to it. Plenty of people request it and we love sharing that, but we’re not just coming and preaching to people. We’re asking how we can help, what we can do for you,” she says.

Why do you volunteer?

The only thing I think explains why any of us come and do this work — because we put in long hours and it’s emotionally draining — is we’re called by the Lord to be here, and it’s incredibly fulfilling to answer that call.

Christian Motorcyclists Association (CMA) Volunteers, Monument Health Hospitals

CMA has volunteered with Monument Health during the Sturgis Motorcycle Rally since 1999, and 2021 was no different. The organization had more than 200 volunteers in the Black Hills and a presence at Monument Health’s hospitals in Custer, Deadwood, Rapid City, Spearfish and Sturgis.

HEALTH // FALL 2021

What is your role as a volunteer with CMA? One of the big things that we do is when there is an accident, we get all the information about where the accident happened and coordinate with dispatchers in different counties and either recover that bike or get the saddle bags or personal papers off the bike.

For these bikers that’s incredibly important. Not knowing where your bike is can be like not knowing where your child is. But we also have stuff for kids if they’re waiting in the emergency room, and we will visit with patients and caregivers and develop a relationship with them as well.

Why do CMA volunteers return year after year?

We love what we do. It’s hard work, but it’s fun too.

And boy is it fulfilling! Everybody’s got the heart for Jesus, they’ve got the heart to be a servant, they’ve got the heart to share and to get that many people in one group is an exciting thing!

What’s your favorite part about what you do?

I love being able to help people who are scared and don’t know what to do next. I just love being here and helping people whatever their needs are. And the camaraderie within the team is amazing.

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ASK THE DOC // TRUST

What You Need to Know About Diabetes

average of your blood sugar levels over the past three months.

Risk factors include insulin resistance — which means your body produces insulin but is resistant to it — obesity and polycystic ovary syndrome.

What are the health conditions associated with diabetes?

Having diabetes means you’re also at risk for heart disease, peripheral artery disease, cardiovascular disease and eye, kidney or nerve damage.

Diabetes affects 1 in 10 Americans, but it’s still largely Treating diabetes is all about misunderstood by the general public. Sonalika Khachikian, keeping your blood sugar levels M.D., explains the different types, factors that put you at under control, but that’s really just a means to an end. The whole risk and treatment options once you’re diagnosed. reason we’re doing that is to prevent further complications or impacts What are the types of diabetes? on your health.

There are two main types; 1 and 2.

Type 1 diabetes is an autoimmune Can lifestyle choices increase our risk of developing diabetes? disorder, which means your body Some people are genetically is attacking the cells that produce predisposed to having or developing insulin until your body can no diabetes, so sometimes there isn’t a longer produce it at all. Type 2 diabetes is when your body makes lot we can do. Generally speaking, Sonalika however, watching your diet, insulin but not enough, or your Khachikian, limiting simple carbohydrates and body isn’t using it correctly.

M.D., is a board-certified There are also lesser known forms exercising regularly can decrease endocrinologist your risk. The more you exercise, of diabetes. One has to do with skilled in the the more sensitive your body is to chronic pancreatic issues or can diagnosis and insulin, which means your body can happen if you have your pancreas treatment of type 1 and type use it more efficiently. You should removed. Another is gestational 2 diabetes. She aim to get at least 30 minutes of diabetes, which happens during enjoys teaching moderate exercise per day, or 150 pregnancy and affects a small her patients minutes per week. percentage of women. how to care for themselves on a daily basis to improve their overall health and staying current on new technologies such as insulin pumps and sensors.

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What does it mean to be prediabetic? What are the risk factors?

The American Diabetes Association defines prediabetic as having a blood glucose level between 100126, or an A1C of over 5.7 but less than 6.5 percent. Your A1C is an

What role do genetics play in risk for diabetes?

There are certain genetics that mean you’re more likely to have or develop diabetes. Men are more likely to have type 1 diabetes than women, for example. While you can inherit risk factors for type 1

FALL 2021 // HEALTH

To learn more about diabetes education and treatment options at Monument Health, visit www.monument.health/services/diabetes.

or type 2, we see type 2 diabetes run in the same family more often than type 1. Ethnicity can also be a factor; African Americans, Native Americans, Pacific Islanders and Asian Americans are at a higher risk than other groups.

What do you think is the biggest misconception about diabetes?

One of the biggest misconceptions I hear from people who don’t have diabetes is they think treatment is a one-size-fits-all approach, or that changing just one thing will fix it.

Everyone is different, and the way their body responds will determine the course of treatment we pursue.

I also have many people who think that having diabetes means you can never have certain things again, like a chocolate cupcake. You can still have a cupcake once in a while, or to celebrate a special occasion.

It’s about balance, and knowing how your body responds.

For my patients, a misconception I see a lot is that having to go on insulin means they’ve failed, which is entirely inaccurate. Diabetes is a progressive disease, so even if you do everything right, you may still need to go on insulin. You have done nothing wrong, and it isn’t the end of the world; we just have to adjust your treatment.

needs, such as using a long-acting insulin that will last for 36 hours, or a fast-acting one that will take immediate effect after you’ve eaten.

Another incredible change has been continuous blood glucose monitors. Not only do they relieve the need for pricking your fingers, they give us so much more insight and data about diabetes and help us find new ways of managing it.

How do diet and exercise factor into treating diabetes?

Exercise is important, and for some people it can make a tremendous difference. However, diet is more important than exercise overall.

Eating healthy meals and snacks throughout the day that keep your blood sugar levels in control, and knowing what foods will spike your blood sugar, is very important.

LeAnn Nelson, RN, is a Diabetes Educator who specializes in pediatrics. She explains how to manage diabetes in a way that even the youngest patients can understand.

How is diabetes treated? How do diet and exercise factor in?

The world of diabetes treatment has opened up so much in the past five years. For example, the options we now have for getting people the insulin they need have changed drastically. We have much more flexibility now to put you on a system that matches your specific

HEALTH // FALL 2021

Learning how to manage diabetes is an ongoing conversation between a patient and their caregiver.

Whether you have type 1 or type 2 diabetes, every person is different.

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MIND FUL NESS

Good or bad need not apply: mindfulness is about being grounded in the moment and accepting the world around us with a non-judgmental stance.

THE ABILITY TO BE FULLY PRESENT IN THE MOMENT, WHILE NOT BEING OVERLY REACTIVE OR OVERWHELMED BY WHAT’S HAPPENING AROUND US In practical terms, mindfulness is paying attention to what’s going on and responding in a measured way. It’s often tied to activities like yoga and meditation, but these exercises are simply a means to an end. Mindfulness is a state we can find and cultivate, regardless of location or activity.

Mary Kurniawan, CSWPIP, is an Outpatient Social Worker at Monument Health’s Family Medicine Residency Clinic. She says, “Mindfulness consists of two concepts: focusing on the here and now versus the past or future, and then paying attention to the here and now with a non-judgmental stance.

Mindful thinking doesn’t immediately judge what’s going on around us but accepts it as it is. Then we assess the information as useful or not useful, and respond appropriately.”

There are several easy ways to include mindfulness in our day, including breathing exercises and increased self-awareness, which can ultimately reduce stress and improve our overall health.

HEALTH // FALL 2021

INSTILL CALM WITH BREATHING

A powerful yet simple way to include mindfulness in our daily lives is to focus on something we already do: breathing. Mindful breathing is a simple stress-reduction practice that anyone can do, and it can help reduce physical, mental, emotional, behavioral and relationship stressors.

When we’re anxious or upset, we take in fast, shallow breaths. This speeds up heart rate and increases our overall feeling of stress. Our body enters a fight-or-flight state, which makes it hard to react to stressors in an appropriate or measured way. By taking a few deep breaths from our diaphragm, we allow our body a chance to slow down. This creates space to respond to whatever is causing stress rather than simply reacting.

Mary says, “Breathing can be helpful in a number of ways. It can be a short 2-3 breaths that give your mind time to calm down and remember the skills or strengths that you have to deal with a situation.”

When we’re relaxed, we naturally breathe through our nose in a slow, even way. By purposely taking deep, controlled breaths, we can mimic this state and signal to our nervous system that it’s okay to relax.

Mary says, “If mindful breathing is done on a more lengthy basis, like 5-10 minutes, it can provide a reset for your mind and body and allow for a full decompression of stress. It signals the brain that you’re safe, and that it can relax and stop signaling that you’re in

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MINDFULNESS // EXCELLENCE

WHEN WE TRULY FOCUS ON WHAT’S AROUND US, RATHER THAN RUSHING FROM A TO B, IT OFFERS A RARE OPPORTUNITY TO TAKE A STEP BACK FROM OUR CONSTANTLY WHIRRING INTERNAL MONOLOGUE AND NOT BE BEHOLDEN TO REACTIVE THOUGHTS AND FEELINGS.

5 easy steps to get you started with mindful walking • Start walking at a natural pace; not too fast, but also not much slower than a casual gait.

•P ay attention to the movement of your body. Notice how your feet lift from the ground and come back down, and how your body moves in sync with your legs.

• I f your mind wanders to other things, gently come back to focus on the sensation of walking. If you’re having trouble, you can count your steps up to 10 and back down to zero, taking deep breaths that last 2-3 steps each.

•A fter a few minutes, expand your attention to what you experience around you. Focus on your breathing and what you smell, then listen to the sounds around you, and so on. Continue through all five senses: what do you smell, see, hear, feel and even taste. Savor each sensation and enjoy the world around you.

•A s your walk ends, refocus your attention on your body. Feel how your feet and legs work together, and how your body moves. At the end of your walk, stand still and take a few deep breaths to end your practice.

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danger.” Our body will respond by lowering heart rate, balancing oxygen and carbon dioxide levels, increasing levels of well-being and decreasing stress. This is called the relaxation response, and it’s the physical reaction we encourage in our body by breathing deeply.

GO ONE STEP FURTHER

Breathing helps us calm our mind and body to a state that prepares us for the next key to mindfulness: self-awareness.

Self-awareness is the part of mindfulness that helps us differentiate between what is actually happening and what our mind is experiencing based on our own personal narrative. When faced with a stressful situation, many of us push our emotions down while reacting to the stress in an unproductive manner. Being aware of our feelings and emotions in the moment helps us respond to our stress in a measured way.

Being self-aware, like being mindful, takes practice. Selfawareness is something we can work on in small pieces throughout the day, and gradually build into a more routine practice.

Mary says, “going for a walk is a great way to increase mindfulness and awareness in your day. Head outside and be aware of what’s around you, engage your senses and be present in the moment.”

MINDFULNESS-BASED THERAPY

Beyond a personal practice, there are ways that mindfulness can be used in a more intensive way. Mindfulness-based therapy is a form of cognitive therapy that uses tools, such as breathing and self-awareness, to help patients break negative thought patterns.

“I teach these skills with almost every patient, but for people struggling with anxiety or chronic stress, mindfulness is one of the first things we talk about,” Mary says. “Part of mindfulness that I discuss with patients is being able to analyze your thoughts with a nonjudgmental stance and ask yourself: Is this helpful? Is this useful? Is this true? Once you’ve done that, you get into the habit of being mindful and examining your thoughts before reacting.”

Originally conceived to help people with recurrent depression or anxiety disorders, mindfulness-

FALL 2021 // HEALTH

It can be hard to fully engage in any mindfulness practice or meditation at first. If your mind wanders, that’s okay. Recenter your thoughts by coming back to the movement of your body and start again. The more you practice, the easier you’ll be able to ignore distractions around you and focus on grounding yourself in the moment.

based therapy has grown to treat a variety of conditions. While research is ongoing, its use has shown promise as an alternative to maintenance antidepressants in patients with recurrent depression. It has also been used to help relieve conditions such as chronic pain and post-traumatic stress.

THE EFFECT ON STRESS MANAGEMENT

Stress is a normal part of life and is even necessary in some situations. When it becomes a chronic condition or not well managed, stress can be problematic.

Fortunately, mindfulness is a great tool to help relieve unnecessary stress by helping us focus on what we can control and what we need to let go.

“Mindfulness helps us manage stress in so many ways,” Mary says. “It helps us relax instead of worrying about the future.

It helps us recognize where we have power, where we don’t, and how to use resources wisely as far as where we spend time and energy.”

By managing our own stress, we have more energy for things that bring us happiness or provide meaning, rather than worrying about things out of our control.

Reducing unnecessary stressors can also improve our physical health by lowering blood pressure, increasing sleep quality and improving our overall mood. We also contribute to the relief of stress throughout society: research shows mindfulness can help cope with stress and improve health, which makes us better able to serve others in need.

Mary says what’s most important about mindfulness is understanding it gets better with practice.

“Mindfulness will improve and get easier the more you do it, just like any other skill. It’s also attainable for anyone; it’s not something you have to have a certain level of focus or concentration to do effectively.”

HEALTH // FALL 2021

How to make meditating easy We’re taught to always think ahead or consider what’s coming next, which means many of us have trouble quieting our mind. We’re so used to staying busy we can’t simply sit in silence and let go of the world around us to meditate.

“People feel like meditation means you have to have an empty mind, which isn’t necessarily true,” Mary says. “It’s not about making your mind empty, it’s choosing to focus on something like your breath, and if it wanders, re-centering your mind to what you’re focusing on.”

Here are three short meditations to help start a new practice: • Morning M orning check in: take one minute to slow down and get into a good frame of mind for the day using positive affirmations. This can be in the shower, while you drink your coffee or before starting a workout.

• Body B ody scan: with eyes closed, start at the top of your head and slowly scan your body. Notice how each part feels; are you

tense or relaxed? Comfortable or uncomfortable? Continue to your toes and finish by checking in with your body overall.

• End E nd of day review: relax in a quiet place and take five minutes to reflect on your day. Think about how you felt throughout the day and how to approach tomorrow.

Crisis Care Unit Rapid City’s Care Campus is a nationally recognized program focused on substance abuse in our community. It's the collaborative effort of nearly 40 organizations, including Monument Health. Care Campus includes a Crisis Care Unit that focuses on mental health issues related to substance abuse. The unit teaches tools to cope with trauma, stress and other triggers that interfere with living a full and healthy life.

In 2021, over $4 million in funding was approved for a new 13,000 square foot building to house the current Crisis Care Unit and a new Stabilization Unit. The expanded facility will reduce health care costs and expand mental health services. Most importantly, it will provide world-class care in Rapid City, so those in need no longer have to travel across the state to receive help.

The Crisis Care Unit hosts classes such as Moral Reconation Therapy and Cognitive Behavioral Interventions for Substance Abuse. These classes help those struggling with addiction or substance abuse learn how to address problematic thoughts and beliefs, make conscious decisions rather than react to triggers and become aware of how their internal feelings affect their actions.

Many principles used at Care Campus and the Crisis Care Unit are similar to strategies for practicing mindfulness. Understanding the link between our thoughts, emotions and behaviors helps us be better able to respond in a measured and productive manner. Selfawareness and mindfulness are tools that can help with overcoming addiction, substance abuse, post-traumatic stress, trauma and more.

By focusing on the person as a whole and assisting in long-term recovery, the Crisis Care Unit is helping people in our community improve their quality of life based on their individual needs.

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WELLNESS // EXCELLENCE

Too much sugar in our diet can lead to a host of health problems, including obesity, diabetes, heart disease and certain cancers.

The key to sugar intake is knowing what amount is healthy, and making smart choices about diet and exercise.

THE SCIENCE OF SWEETNESS 18

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Healthy alternatives to sweet treats include no-bake energy bites, frozen yogurt with dark chocolate chips, frozen bananas dipped in chocolate, or dates stuffed with peanut butter and dipped in chocolate.

Reducing your sugar intake seems simple, but there are several factors at play that can make it difficult to cut back. From the multitude of names for sugarbased ingredients to recent trends insisting only natural sugars are okay to eat. Not to mention, our bodies sometimes seem to crave sugar when in fact they’re low on minerals, or simply need more sleep. It’s hard to know what you should or shouldn’t consume.

NOT ALL SUGARS ARE THE SAME

Sugar is used in many ways consumers don’t expect.

Its obvious use is as a sweetener, but it's also used as a bulking agent, as a preservative, to add or improve food texture or to add viscosity or thickness to drinks and semi-liquid foods. Because of this, reducing sugar in your diet isn’t as straightforward as it seems. It’s helpful to understand that sugar can be broken down into three categories: natural sugar, artificial sugar and sugar alcohols.

Natural sugars occur naturally in foods and are not added in by the manufacturer. Examples include fruits, vegetables and dairy products. Whole fruits may have high amounts of sugar, but also vitamins, minerals and fiber which are all part of a healthy diet.

Artificial sugars can be defined as nutritive or nonnutritive. Nutritive sweeteners have calories associated with them, like honey or high-fructose corn syrup.

Non-nutritive sweeteners are either calorie free or very low calorie, including aspartame, stevia and sucralose.

NATURAL SUGARS fruits vegetables cheese milk

Your daily sugar intake

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ARTIFICIAL SUGARS high fructose corn syrup sucralose aspartame stevia

SUGARS ALCOHOLS xylitol erythritol sorbitol maltitol

10 energy boosting foods Sugar cravings may actually be signalling that your body isn’t getting enough of certain nutrients, such as magnesium, chromium or calcium. Most of us grab whatever is available to satisfy a craving, but we aren’t actually giving our body what it needs.

Sugars and refined carbs can give your body a quick dose of energy, but can also cause you to crash shortly after. Foods that are high in fiber, antioxidants and nutrients keep your body fueled without spiking your blood sugar.

Trade out your breakfast or afternoon snack for one of these foods to squash sugar cravings and boost your energy.

•B erries like blueberries, strawberries, blackberries and raspberries • Fruit like apples, bananas and oranges • Nuts, especially pistachios, almonds and cashews • Sweet potatoes and yams • Seeds, such as pumpkin, chia and flax

•D ark chocolate with at least 70 percent cacao • Non-flavored yogurt, especially Greek varieties • Dark leafy greens like kale and spinach • Whole-grain oatmeal • Peanut butter

Divide up several individual portions and keep them handy so you can grab a healthy snack as soon as a craving strikes.

Sugar alcohols are neither sugar nor alcohol, but are instead a form of carbohydrate that has a chemical structure similar to sugar. Those can also be found in many sugar free products, and common names for them include xylitol, erythritol, sorbitol and maltitol.

DON’T BE FOOLED BY MARKETING

While current trends would have us believe artificial sweeteners are bad, that’s not necessarily true.

Helen Nichols, Registered Dietitian at Monument Health Lead-Deadwood Clinic, says, “I don't like to label foods as good or bad; that can create a negative relationship with food, and oftentimes restricting our diet makes us want that item even more.

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WELLNESS // EXCELLENCE

Three Registered Dietitians, Kayla Wede, Helen Nichols and Mason Wellskopf, from Monument Health share their favorite smoothie recipes. From increasing energy to cutting sugar cravings, they’re a great way to boost your day without sacrificing a healthy diet.

PINK SUNRISE

KAYLA'S BRAIN BOOSTER

Serves 4 1 cup frozen strawberries 1 cup raspberries 1/2 cup pineapple 1/2 cup frozen cauliflower 1 cup plain Greek yogurt 1-2 cups liquid of choice (water, dairy milk, plant-based milk, etc.)

1 small beet peeled and quartered 1 tbsp chia or ground flax seeds

KALE ICE CREAM

HELEN'S IMMUNITY PUNCH

Serves 2 1/2 cup liquid of choice 1/2 tsp probiotic powder (open a capsule and tap the powder into the blender) 1/2 cup raw unsalted cashews, soaked (place cashews in a jar or bowl, cover with water and let them soak overnight.

Pour off excess water in the morning.)

1 cup curly green kale leaves with stalks removed, ripped into small pieces 2 ripe bananas, fresh or frozen 1/4 cup pitted dates, soaked or 1 Tbsp pure maple syrup 1/2 tsp vanilla extract 2 cups ice cubes 1 piece of fresh ginger (about the size of half your thumb)

BERRY BASH

MASON'S ENERGY KICK

Serves 2 1 cup unsweetened almond, coconut, hemp or oat milk 1/2 frozen banana 1/2 cup low/no added sugar Greek yogurt (a flavored variety such as raspberry is best in smoothies) 1/4 tsp vanilla extract 1/2 cup frozen berries (raspberries are my favorite) 1/2 tsp cinnamon 2 tsp chia seeds 1 tbsp ground flax seed 1 tsp honey (optional for sweetness)

Add all ingredients to a blender and blend until smooth. You may need to add more liquid depending on your personal preference for consistency.

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Helen’s favorite sugary snack alternatives for fall include homemade muffins low in sugar and full of satisfying chopped nuts, or trail mix with almonds, walnuts, unsweetened coconut, pumpkin seeds, dried apples and raisins.

Right now, most artificial sweeteners have GRAS certification from the FDA, which means they are generally recognized as safe.”

Before you reach for a sports drink or sugar-free soda, know these are marketed as a better choice, but often aren’t actually a healthier option. These drinks have less added sugar but don’t provide nutritional benefits, which means you’re filling up on empty calories. Our bodies also tend to be less satiated by liquids, so it’s easy to overconsume.

“In some cases, I have had patients drinking over 1,000 calories per day from soda and other sugar sweetened beverages without even realizing it,” Helen says. A great way to prevent drinking more sugary beverages than you should is to make sure you’re getting enough water. Staying hydrated can reduce cravings for sodas while also supporting your body’s functions.

The daily recommended water intake for adults is half of your body weight in ounces of water. For example, a 200 pound person would need 100 ounces of water a day.

REDUCE, DON’T ELIMINATE

Reducing sugar intake is easier when you know what to look for.

Ingredients ending in “ose,” such as maltose or sucrose; natural sugars such as honey or raw sugar; additives like high fructose corn syrup or fruit juice concentrates are all types of added sugar.

Donna Riley, RD, is a Diabetes Educator at Monument Health’s Rapid City Clinic. She says, “Long ingredient lists often mean more processing, with added vitamins and minerals instead of the level as it came from nature.”

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A healthy diet can reduce disease Did you know that diet and lifestyle can increase your risk for type 2 diabetes? Your body needs carbohydrates — including sugar — to function, but the type and amount you eat matters.

Donna says, “A significant cause of insulin resistance is excess body weight. When we have excess body weight — especially in the abdominal area — this causes insulin resistance. In short, carrying excess weight increases the risk of type 2 diabetes.”

Luckily for the majority of people at risk for type 2 diabetes, there’s strong evidence that shows you can prevent or delay the condition with a 5-10 percent weight loss. A consistent workout routine of at least 150 minutes of moderate exercise a week and a healthy eating pattern can help you get there.

A healthy eating pattern recommended by the Academy of Nutrition and Dietetics includes: •V egetables •F ruits — especially whole fruits • Grains, at least half of which are whole grains • Protein, including seafood, lean meats, eggs and legumes

•F at-free or low-fat dairy products • Healthy oils • Limited saturated and trans fats, added sugars and sodium

Monument Health offers the National Diabetes Prevention Program (NDPP). The NDPP is a year-long lifestyle change program that helps people prevent type 2 diabetes by losing weight with improved eating and physical activity.

36g is the recommended* daily maximum amount of added sugar for a man

A single can of Mountain Dew has 46g of added sugar

A 16oz Sweet Tea has 42g of added sugar

*American Heart Association

While this seems like a good thing, fiber isn’t required to be added back in afterwards, and is often replaced with other nonnutritive or unsatiating ingredients.

To help consumers make more informed decisions about their sugar intake, the FDA recently adjusted food labels to highlight added sugars. The American Heart Association recommends the average adult male eats only 36 grams of added sugar per day and adult women only 25 grams.

If you have questions about your diet and your health, Donna recommends seeing a dietitian or diabetes educator about your specific situation. “Despite information on the internet or from family and friends, it does not take into account an individual’s personal situation or personal medical history. The internet often has too much information and it is hard to know how to apply it.”

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PATIENT STORY // COMMUNITY

After a forklift fell on her and severed her spine, Leah had a long road to recovery.

Fortunately, her sister, Grace, her mother, Glenda, and her dog, Lucy, were there to support her every step of the way.

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From cracking jokes to hosting dance parties, Leah has found ways to stay optimistic. It’s an outlook that has served her well in her recovery, but also in cards and illustrations she does for the business she shares with her sister.

TURNING TRAGEDY INTO OPPORTUNITY

SOMETIMES A LIFE-ALTERING EVENT HAS UNEXPECTED RESULTS. FOR LEAH NIXON, TRAGEDY WAS THE MUSE THAT INSPIRED HER TO TAKE HER ART SERIOUSLY. Leah Nixon has an edgy sense of humor, which comes in handy when writing and designing a line of greeting cards. But humor was an absolute necessity during her long, painful recovery from an accident that left her paralyzed below the armpits and required doctors amputate one of her legs.

An example of Leah’s humor: while describing how she felt about being transferred to Craig Hospital in Denver, one of the world’s best spinal cord injury rehabilitation centers, Leah said, “It sounded so magical to go from being a slug in a bed to, like, being able to do laundry and drive again.”

Did she really feel like a slug in a bed?

“Actually, I told my family I felt like a rotisserie chicken on a bed of ice,” she deadpans.

A year before her accident, Leah and her sister, Grace Nixon Peterson, became partners in Tiny and Snail, a company that designs and prints greeting cards, postcards, stickers and other products. Grace had started the company, at the time selling hand-painted cards. The work was hard on her wrists, so Leah began helping out.

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“I told her ‘I think we should go into business together. I can be your hands, and you can be my brain,’” Leah recalled.

The sisters, 32 months apart in age, were already close. But collaborating on cards and running the business brought them even closer together, even though Leah lives in Rapid City and Grace lives in Milwaukee.

THE ACCIDENT

In 2018, Tiny and Snail wasn’t paying the bills, so Leah kept her day job working construction in Rapid City. On August 14, 2018, a forklift tipped over at a job site, crushing her and severing her spine.

Grace remembers the terrible phone call from her mother about the accident. “I remember wailing on the couch that night with my husband, and he just held me and I said, ‘God, you have to let her live and you have to let her still use her hands.’ It was definitely the worst day of all of our lives, and it was difficult flying to see Leah, just hanging by an absolute thread.”

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PATIENT STORY // COMMUNITY

TINY & SNAIL Grace Nixon Peterson and Leah Nixon have built Tiny and Snail into a successful business, marketing directly to customers online at tinyandsnail.com.

Their Instagram account, @tiny_ and_snail, has been well received.

Both Leah and Grace draw the images and write the text for their products.

Sometimes they collaborate.

Sometimes they work separately.

However all of their cards, stamps, stickers and other designs share the same smart, simply worded and brightly illustrated style.

More recently, Grace and Leah have been focusing on the wholesale side of their business, selling through retailers and gift shops.

Gifts With Heart, the gift shop in the lobby at Monument Health Rapid City Hospital, is a Tiny and Snail outlet.

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Before her accident, Leah worked as a builder for Habitat for Humanity. She found purpose and joy helping families in need build a place they can proudly call home.

Leah was in the intensive care unit at Rapid City Hospital for 29 days. With a breathing tube in her throat and under anesthetic, Leah was unable to speak. She communicated by tracing letters on Grace’s palm.

Her first question: “Can I still draw?”

ICU DANCE PARTY

Leah later graduated to writing on paper with a Sharpie. She started telling jokes to put the family at ease. “It was really funny because we’re just kind of waiting on pins and needles, and then I say something totally unexpected and the tension just goes away.” Leah recalled.

Grace added, “It was like the joy was amplified because the pain was amplified.”

Even though Leah was very weak, the neurosurgeon urged her to keep using her arms at least once every hour to stop the paralysis from advancing.

“My family was kind of militant about it, but I said, ‘This would be a lot easier if we turn on some music.’ So then we started having dance parties in the ICU. The nurses would join in sometimes,” Leah said.

After recovering enough to travel, Leah was flown to Craig Hospital in Denver where she began her long recovery and extensive rehabilitation.

LIFE TODAY

Leah lives in Rapid City with her husband, Kelsey Fitzgerald, and her dogs, Lucy and Ryder. In June of 2021, Leah gave birth to a baby girl named Ellie Grace Nixon Fitzgerald.

Family remains very important to Leah.

She lives a couple miles from her parents and talks often with her siblings. Every year on August 14, the whole family gathers to celebrate — not mourn — the anniversary of Leah’s accident. “From the get-go, we decided to reclaim that day and make it a celebration,” Grace said. “We call it ‘Leah Lived Day.’” Despite her strength, humor and family ties, Leah said it’s hard to accept she still lives

HEALTH // FALL 2021

every day in extreme pain. People assume if someone is paralyzed they have no feeling.

The reality, at least for Leah, is that she spends every waking moment feeling like she’s receiving electric shock or sitting in ice water.

“When I go to the doctor, they always ask me to describe my pain on a scale of 1 to 10… You would need letters to describe my pain; you can’t put it on a scale of 1 to 10,” she said.

In spite of her pain, Leah and Grace feel the accident has transformed their art and their lives. Leah loved art before, but wasn’t sure what she wanted to do with her life. The accident let her truly focus on what she loves.

Grace believes Leah’s accident brought new depth and compassion to their creations at Tiny and Snail.

“There’s something about being thrown into this crazy life situation and traveling to the depths of tragedy,” she said. “I think it’s just given us such an empathy for being human and enduring the hard things that can happen. That’s helped us create art that gives others the words to support each other.”

THE PERFECT BOOK DEBUT In addition to Tiny & Snail’s greeting cards, Leah recently illustrated a children’s book.

“Best Day Ever” was written by award-winning author Marilyn Singer. It’s about a boy’s adventures with his energetic dog, and how they go from a bad day to making it the best day ever.

The young boy happens to be in a wheelchair, and the book’s publisher wanted an artist in a wheelchair to illustrate it. Leah thinks it was the perfect story to be her first book.

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FEATURE STORY // EXCELLENCE

THORACIC WORLD Rapid City surgeons provide a full spectrum of care and leading-edge procedures close to home The Monument Health Heart and Vascular Institute began as Cardiology Associates PC, Heart Doctors in 1993. It started with five cardiologists who wanted to develop a comprehensive cardiology practice to better meet the needs of their patients.

At the time, major procedures meant patients had to travel as far as Denver to receive care. It meant staying in hotels and being away from home, not to mention the stress of a five- or six-hour car ride can be incredibly difficult for patients.

Today, the Heart and Vascular Institute has 20 physicians, 22 advanced practice providers and two electrophysiologists. The physician team includes two cardiothoracic surgeons: Kalyan Vunnamadala, M.D., and Charan Mungara, M.D. Their specialty includes procedures such as coronary artery bypass surgery, lung cancer resection and other procedures inside the chest cavity.

More importantly, they are a critical link in the overall program at the Heart and Vascular Institute.

Jacob Staley, Director of Ambulatory Operations at the Heart and Vascular Institute, said, “Without a strong vascular and cardiothoracic surgeon team, all other aspects of the Heart and Vascular Institute are impacted. The surgeons allow the full spectrum of care to be provided

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Charan Mungara, M.D., received his medical degree from the University of Mysore in Karnataka, India. He completed his residency in General Surgery and his fellowship in Cardiothoracic Surgery at the University of Wisconsin Hospital & Clinics in Madison, Wisconsin.

Kalyan Vunnamadala, M.D., received his medical degree at St. George’s University School of Medicine in Grenada, West Indies. He completed his residency in general surgery at Easton Hospital in Easton, Pa., where he was also Chief Surgical Resident.

He completed his residency in cardiothoracic surgery at the Texas Heart Institute/Baylor College of Medicine in Houston, Texas.

close to home – which means that patients get treatment earlier on in disease processes – and achieve better outcomes.”

SMALL BUT SPECIALIZED

Most cardiac hospitals or centers with a similar number of staff as the Heart and Vascular Institute serve a larger population than the roughly 250,000 residents of the western South Dakota region. The small population doesn’t sway Dr. Vunnamadala.

“One of the nice things about working here is you can do a little bit of everything and still be good at what you’re doing,” he said.

Dr. Vunnamadala and his colleague Dr. Mungara performed about 500 surgical procedures in the past year. As the only two cardiothoracic surgeons serving western South Dakota, they perfect their skills in a variety of procedures to ensure patients at Monument Health receive world-class care close to home.

The Heart and Vascular Institute has received many awards and recognitions over the years. In 2017, the Heart and Vascular Institute received the distinguished three-star rating from The Society of Thoracic Surgeons for patient care and outcomes in coronary artery bypass grafting procedures. This rating places Monument Health among the most elite for heart bypass surgery in the United States and Canada.

FALL 2021 // HEALTH

In human anatomy, the thoracic cavity is the region above the abdomen, below the collar bone and beneath the rib cage. Special skills are required to gain surgical access to the heart, lungs and other organs.

Dr. Mungara and Dr. Vunnamadala are some of the best in their field, and they choose to practice in Rapid City. Rather than selecting one specialty within thoracic surgery, they enjoy performing a variety of operations so they can keep their skills sharp.

CUTTING EDGE HEALTH CARE

Dr. Mungara and his electrophysiology colleagues at the Heart and Vascular Institute are performing a relatively new procedure for persistent atrial fibrillation, or AFib. The two stage procedure is called convergent ablation, and there aren’t many medical teams in the country performing it.

In the first procedure, Dr. Mungara makes a small incision beneath the breastbone. With a scope to guide his work, Mungara reaches to the back wall of the left atrium and burns scars on the unneeded short-circuiting heart tissue.

In the second stage, several weeks later, the electrophysiologist threads a catheter from the groin to the inside of the heart and ablates any tissue not ablated from the outside.

“We’re working from the outside to the inside of the heart, and they’re working from the inside to the outside of the heart, so we meet in the middle,” Dr. Mungara said. The combined procedure has a cure rate in the range of 70 to 80 percent, compared with 40 to 50 percent with other ablation techniques.

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A patient’s perspective Sergeant Thomas Keller works at the Rosebud Adult Correctional Facility near Mission, South Dakota. One day at work he was lifting weights on the bench press when a weight slipped and landed on his chest. His coworkers called an ambulance who transported him to the Indian Health Service’s Rosebud Unit Emergency Room. He had fractured his sternum and punctured his heart — a condition that would need specialized care.

Thomas was transported by Apollo MedFlight to Monument Health Rapid City Hospital. He was rushed into surgery with Dr. Vunnamadala.

“I thought it was just a cracked rib,” he said. “I didn’t realize it was that serious.

When I got to Monument Health they got straight to business.”

After his surgery, Thomas spent four days at Monument Health recovering before going home. “My care was top of the line, and everyone catered to my recovery and comfort while I was there,” he said. “I know without a doubt that Dr. Vunnamadala saved my life. If he hadn’t acted so quickly things could have been very different.”

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PATIENT STORY // COMMUNITY

Gordy Pratt is no stranger to being in the spotlight. The singersongwriter was inducted into the South Dakota Country Music Hall of Fame in 2017. He brings his own brand of musical comedy to venues like the High Plains Western Heritage Center and Palmer Gulch Chuckwagon, where he provides comic relief in a western setting.

Perhaps because he’s familiar with holding an audience’s attention, he’s also very open about his own health.

Gordy has managed his diabetes for 21 years, on top of being diagnosed bipolar in 1987 and during a recent bout with tonsil cancer.

HELP FROM THE EXPERTS

“If I had sage advice for anyone, it would be that it always works best if I do what the smart people tell me to,” Gordy says with a laugh. “Of course, it’s not always easy. I take pills for bipolar disorder, I’ve got a CGM pump for my diabetes and I had to manage those while I got chemo and radiation for cancer.”

The CGM pump that Gordy refers to is a Constant Glucose Monitor and insulin pump, which uses a sensor underneath the skin to take glucose readings and then delivers precisely measured doses of insulin to match the user’s needs.

This advancement can replace traditional testing and multiple daily injections for many diabetics.

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KEEP ’EM LAUGHING Diabetes is a serious condition, but when you’re in the business of musical comedy, you tend to face these things with a smile.

FALL 2021 // HEALTH

Diabetes is a lifelong disease, but knowledge is power when it comes to treatment. The diabetes education team helps patients find the best treatment plan for their individual health needs.

“Technology has drastically improved.

The insulin pumps are a great example of rapid change,” says Deb Winter, RN, CDE, CFCN, a Diabetes Educator at Monument Health.

“CGM wasn’t available 20 years ago, and now there are units that can do remote monitoring. The medications have improved as well. It’s unreal now, compared to even 15 years ago.”

Gordy is grateful for the innovation, but he can’t help but laugh as he says, “I’m amazed when I see people my age operating these things, because it’s an extremely sophisticated piece of gear. Poking a needle based on numbers was easier, but it wasn’t nearly as good.”

Keeping up with that changing technology is only part of what Deb does. She also educates patients with diabetes about the treatment and management options that are right for them, including the latest innovations.

Deb says, “I trained Gordy when he went on his insulin pump, and it helped him with his management over the years. The education has really shifted from presenting a curriculum to developing an individualized approach where we sit down with the patients and teach them, but also provide support and encourage them to be more involved in the education process. People understand diabetes now, and the education and management is more of a team approach.”

HEALTH // FALL 2021

Teamwork is the Key to Success “Diabetes education isn’t me or another educator telling a patient what they need to do. It’s sitting down and saying, ‘let me help you understand your options for managing your diabetes.’ It wasn’t always like that. Now we say, ‘here are the options available to you. Do you want to try these medications? We feel like this treatment will be effective for you, what do you think?’ Then we work with them and the provider and keep the patient involved and making decisions in their treatment plan. That’s what we encourage, because we know that’s when patients stick with it.”

Deb Winter, RN, CDE, CFCN

THE FUTURE IS BRIGHT

Gordy visits his primary care physician every three months to monitor his diabetes and other medical conditions, and over the years, he has noticed a change in the public perception of diabetes.

“I think there’s a better understanding among the general public of what diabetes is and how it works. Everybody knows somebody who has it, and I think there’s much less of a stigma about it than there was when I was first diagnosed,” Gordy says.

The technology and treatment options may have changed, but one thing hasn’t: diabetes education isn’t just about curriculum, it’s about building relationships.

“Gordy was one of my first patients when he was diagnosed,” Deb says. “We’ve known each other since that time, developed a good friendship and had a lot of fun. He’s a true delight to work with — he’s got a good sense of humor and he’s always looking at everything with a positive view.

The glass is always half full, not half empty.”

When Gordy was receiving chemotherapy and radiation to treat his tonsil cancer, there was a day where he became severely dehydrated, which negatively affected his state of mind.

He wasn’t able to change his pump, and relied on his wife, Patty Roadifer, to contact Deb Winter who walked her through the process.

“My better two thirds was having to deal with me in that state of mind, and bless her heart she needed help,” explains Gordy. “So we called Deb and for the next four hours, Patty and Deb were on and off the phone on a Saturday night. I know Deb’s done that kind of stuff before. The woman is a saint.”

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PATIENT STORY // COMMUNITY

SADDLE UP Cowboys are tough enough to withstand harsh conditions, and Bob Lantis is no exception. But when his health started to limit his cowboy way of life, Bob turned to Monument Health for help getting back in the saddle.

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Monument Health’s Sports Performance Institute Powered by EXOS leverages proven methodology with award-winning facilities to revolutionize your life and transform how you perform, look and feel each day.

MONUMENT HEALTH’S SPORTS PERFORMANCE INSTITUTE POWERED BY EXOS HELPED THIS COWBOY KEEP RIDING

The cowboy is an American icon, a legendary figure woven into the history and culture of South Dakota. If you’re looking to find one, Bob Lantis looks and sounds the part. To be clear, this isn’t an act, and Bob isn’t playing a role — the man is a cowboy. A former bronc rider, nowadays he spends his time outfitting trips with his 15 pack horses, loading hay in the barn for winter and helping to herd bison at the Annual Custer State Park Buffalo Roundup.

At 86 years old, Bob’s been at this awhile. He’s no stranger to the challenges that come with his lifestyle. But last year, pain in his low back made things much harder.

In the course of his training, Bob convinced Kyle to join him on horseback.

“It was great to go out there and enjoy that experience, but it also gave me an opportunity to get a glimpse of what he’s putting himself through when he’s not in the gym,” Kyle says.

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“When I would get on a horse it was a struggle. I could barely pull myself into the damn saddle, and it just got to the point where I was so mad at myself,” he says.

Before he started experiencing the pain, Bob could mount and dismount his horse without a problem, as well as load his pack horses for trips. “I was lifting 70 pound panniers up and hooking them on the horse, and doing it by myself,” he explains. “Then I had to cut it down to 50 pounds. Then 40, and I was having a hell of a time.”

Struggling to get into the saddle, and with his strength to load pack horses dwindling, this cowboy knew he had to do something in order to keep doing the things he loves. That’s when he decided to give Monument Health Sports Performance Institute a try, with a little encouragement from his loved ones. “I gave it a shot because of my daughters and my wife,” Bob says with a slight chuckle. “I tell you, I had been moaning and groaning around here since the Fourth of July last year, and they knew I’d tried everything else. I’ve had shots, I’ve had physical therapy and none of it worked for any length of time.”

At first glance, Monument Health Sports Performance Institute Powered by EXOS may not seem like the kind of place where you’d expect to find a cowboy. With the main room ringed with colorful weights, specialized exercise equipment and medicine balls,

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PATIENT STORY // COMMUNITY

and treadmills overlooking the room through plate glass windows, you could imagine professional athletes and Olympians training here.

While that perception isn’t wrong, there’s a lot more to it.

“SPI is a place where experienced, competitive athletes can come to improve and be their best,” says Scott Guidotti, General Manager of Monument Health Sports Performance Institute. “But we don’t just cater to professional athletes.

We feel that performance is defined by the individual, and our goal is to help everyone who walks through the door meet those performance goals, whatever they might be.”

Kyle Taylor, a Performance Enhancement Coach, works with Bob to address the source of his problem. “He had some nagging pain in his lower back and in his hips, that was affecting the quality of his life,” says Kyle. “We see that kind of problem from time to time, but in Bob’s case, it was more of a limiting factor in his lifestyle.”

Working together, Kyle and Bob started with exercises to stretch the lower back, hips and glutes to release tension and relieve some of the pain. Then they moved on to strengthening exercises to prevent it from coming back.

Like a lot of athletes who train at SPI, Bob has a specific metric he uses to measure success, and it’s pretty unique. “I have a strange way of judging whether I’m gaining or not — how I get on a horse! And when I first went in there I could barely pull myself up on the damn

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horse!” he exclaims. “Then as I worked with Kyle, I started to notice I was getting better and better and better. As far as I’m concerned, it’s the real deal.”

Since he started training with Kyle in March 2021, Bob has seen continuous improvement — that means a reduction in pain, increased strength and, of course, greater ease getting into the saddle. “One of the biggest factors was Bob’s consistency,” adds Kyle. “He came here with intent and purpose, and showed up every day ready to train.

I think that’s one of the biggest reasons we had success as quickly as we did.”

After dealing with the discomfort for so long, Bob is grateful to be able to continue doing what he loves without pain. “I can get on a horse now, with relative ease,” he explains, pausing before continuing with a laugh. “Not like I could years ago, but a hell of a lot better than I could when I first came in there.”

Buffalo Roundup For nearly 50 years, Bob Lantis has herded bison in the Custer State Park Buffalo Roundup.

Every year, cowboys and cowgirls round up over 1,300 bison, or buffalo, as part of the park’s management plan for maintaining balance between the number of animals and the amount of grassland available to forage. The Buffalo Roundup provides an opportunity to sort out excess animals to be sold at auction, vaccinate new herd members and check for pregnancies. It’s also one of Bob’s favorite times of year.

“It’s an adrenalinekicking son-of-a-gun to be chasing those buffalo, I’ll tell you,” he explains.

“It’s amazing the whole roundup takes about an hour and a half, but you anticipate for a whole year. It’s like Christmas morning.”

FALL 2021 // HEALTH

Monument Health’s priority is to deliver high-quality care to every patient we care for. Our team of over 5,000 physicians and caregivers help us do just that.

EXCELLENCE // NEW PHYSICIANS

Please welcome our newest physicians Primary Care

Rheumatology:

is a family medicine physician at Monument Health Lead-Deadwood Clinic.

He received his medical degree from The University of North Dakota School of Medicine and developed a passion for family medicine during rural clinical rotations. Dr. Tronnes then completed his residency at The University of Minnesota Family Med Residency: St. Cloud Hospital in St. Cloud, Minn. Dr. Tronnes continues his passion for rural family medicine, taking a comprehensive family medicine approach including services such as prenatal care, vasectomies, IUDs, Nexplanon and Suboxone for opiate use disorder. He and his wife, Emily, are excited to join the LeadDeadwood community and raise their daughter in the Black Hills, close to family.

is a rheumatologist at the Monument Health Rapid City Clinic on Flormann Street. She received her medical degree from the University of North Dakota School of Medicine in Grand Forks, N.D. Dr. Argenziano completed her internal medicine residency at the University of South Dakota Internal Medicine Residency in Sioux Falls, followed by a rheumatology fellowship at the Division of Rheumatology and Pediatric Rheumatology, Saint Louis University in St. Louis, Mo. Before attending college, Dr. Argenziano served in the United State Air Force as a Ground and Air Refueling Specialist. She was awarded the US Air Force Achievement Medal in 1994 and the US Air Force Commendation Medal in 1997.

John Tronnes, m.d.,

Esperanza Argenziano, m.d.,

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.

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

HEALTH // FALL 2021

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PHYSICIAN PROFILE // EXCELLENCE

Occupational medicine is focused on treating workrelated illnesses or injuries. Our caregivers will help you return to work quickly — but more importantly — safely.

My Role I am board-certified in both Aerospace Medicine and Occupational Medicine. I primarily provide a variety of physical exams, including pre-employment and post-offer physical exams, Department of Transportation Medical Certification exams, Federal Aviation Administration Medical Certification exams and Workers’ Compensation evaluations.

My Goal Is safety through medical excellence, commitment and teamwork. I am dedicated to working hand-in-hand with my patients and going the extra mile to keep workers working, drivers driving and flyers flying.

My Passion I am passionate about my profession, but I’m also happy on the golf course, at the shooting range, on the bike trail or in the air.

I truly enjoy the healthy work-life balance I’ve been afforded here in Rapid City at Monument Health.

When companies and employees need specific services like Department of Transportation physicals, return to work evaluations and other medical services, it’s important to have a health care provider with flexible hours and expert staff to meet your needs with as little disruption as possible.

Chad Storch, d.o., mph Aerospace and Occupational Medicine Physician, Rapid City

With 21 years of experience in the United States Navy, and over 25 years of experience in hospital and clinic settings, Dr. Storch is exactly who you need to make sure your employees can meet the physical demands of the job.

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FALL 2021 // HEALTH

Monument Health’s neurosurgery team combine the latest proven techniques with state-of-the-art equipment, infrastructure, staffing and training to restore quality of life.

EXCELLENCE // PHYSICIAN PROFILE

Kyle Schmidt, m.d.

Neurosurgeon, Rapid City

Sometimes tough decisions really do require “brain surgery.” Luckily, Dr. Schmidt has that covered.

My Role Is to provide surgical options for brain, spine and peripheral nerve conditions in both elective and emergency situations.

Because nervous system disorders are so complex, I am part of a team that works with nervous system tumors, traumatic brain or spine injuries, degenerative spine disease, movement disorders, hemorrhagic stroke and pain disorders.

My Goal Is to discuss all options with patients being evaluated for a neurosurgical condition and have an honest conversation about their treatment goals.

Brain and spine surgery is not without risk and developing a treatment plan tailored to each patient’s individual scenario and their goals of care is of the utmost importance.

Originally from northwest Nebraska, Dr. Schmidt chose to practice in the Black Hills and provide services to the people in the surrounding communities.

When he’s not with patients or working you can find Dr. Schmidt back home in Nebraska helping out on the farm.

My Passion I am most passionate about working with traumatic brain and spine injury patients. These are life-changing events for patients and their families.

Obviously no one wakes up planning to have an emergency consultation with a neurosurgeon. We work with our patients and their families so that they understand the options available to them. It is important for patients and their families to understand that even a successful surgery may not always result in the quality of life a patient desires. We strive to ensure families are comfortable with their decision to proceed or not proceed with aggressive care in these lifechanging situations.

HEALTH // FALL 2021

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Kipp Gould, D.O.

Joseph Humpherys, D.O.

Ray Jensen, D.O.

Richard Little, M.D.

KEEP GOING WITH MONUMENT HEALTH ORTHOPEDICS

Daniel Lochmann, M.D.

Steve Maser, M.D.

David Maxfield, M.D.

At Monument Health, you’ll receive top-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.

Rachel Michael, M.D.

Darshan Patel, M.D.

OUR SERVICES + Arthroscopic shoulder, knee and ankle surgery + Carpal tunnel release + Fracture care + Hand surgery + Hip replacement + Joint injections + Knee replacements + Minimally-invasive orthopedic procedures + Orthopedic surgery + Regenerative medicine + ROSA Robotic Knee System

www.monument.health/orthopedics

Monument Health is the largest private employer that partners with Black Hills Works, and was presented with a “Proud Employer of People with DisABILITIES” seal in April.

COMMUNITY // MY SPACE

Black Hills Works is a person-centered agency that helps individuals with disabilities set goals and provides education, experience and support as they work hard to achieve them.

Monument Health is proud to partner with Black Hills Works.

Because of this partnership, 30 individuals have fulfilling jobs, and the health care system has valuable caregivers. This relationship is a win-win-win — it’s good for the community, good for the individuals employed and great for Monument Health.

Patrick Sabrowski Distribution Attendant, Rapid City

29-year-old Patrick Sabrowski was diagnosed with autism before he turned 3. Despite his communication challenges, Monument Health’s partnership with Black Hills Works means Patrick has an important role to fill.

HEALTH // FALL 2021

My Role In the 11 years Patrick has worked at Monument Health, he has tackled many different tasks — from folding towels that will be used for sanitation to prepackaging medical supplies or filling new patient packets. Completing these jobs saves Environmental Services workers, nursing support and other caregivers valuable time, allowing them to focus on patients.

My Goal Although Patrick communicates differently than others, it’s clear that he enjoys his job, finds it fulfilling and strives to accomplish as much as possible each day. Joe Sabrowski, Patrick’s father, says, “He wants to come to work, he wants to accomplish his tasks for the day. He really struggled when COVID-19 hit and he couldn’t come for a while.”

My Passion Like many people, work is more than just a job to Patrick. “He has a sense of purpose,” says Toni Sabrowski, Patrick’s mother.

“On days that he works, you can tell that he’s excited.”

Joe adds, “Work is also a way for him to establish some independence and achieve something that’s his.” Patrick may not speak much, but when asked if he likes working at Monument Health, he smiles and says, “Yes! Thank you!”

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ON GIVING TUESDAY, NOVEMBER 30, 2021, people just like you who love South Dakota have an opportunity to ignite a movement of giving all across the state.

GENEROSITY. GOOD. 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.

HOW TO GIVE

On November 30, scan the QR code below or visit www.monument.health/donate.

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 2020 // HEALTH

When it comes to making a difference, nothing matters more than taking action. At Monument Health we strive to put actions behind our Mission Statement: Make a Difference. Every Day.

Oct 28 Nov 4-6 Nov 6 Nov 6 Nov 30 Dec 15-18

COMMUNITY // CALENDAR

Children’s Miracle Network Miracle Treat Day

Participating local Dairy Queen locations

SD Local Foods Conference

Sturgis Community Center, Sturgis

Children’s Miracle Network Extra Life Game Day www.extra-life.org

Black Hills Works Gala The Monument, Rapid City

National Day of Giving #GivingTuesday

Lakota Nation Invitational The Monument, Rapid City

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

HEALTH // FALL 2021

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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

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 Hospital 61 Charles St. Deadwood, SD 57732 605.717.6000

Lead-Deadwood Clinic 71 Charles St. Deadwood SD, 57732 605.717.6431

Lead-Deadwood Urgent Care Services 71 Charles St. Deadwood, SD 57732 605.717.6431

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 Orthopedic & Specialty Hospital 1635 Caregiver Cir. Rapid City, SD 57702 605.755.6100 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 Hill City Clinic 238 Elm St. Hill City, SD 57745 605.574.4470

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

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 432 N. 10th St. Custer, SD 57730 605.673.5588 Behavioral Health Center 915 Mountain View Rd. Rapid City, SD 57702 605.755.7200 Custer Care Center 1065 Montgomery St. Custer, SD 57730 605.673.2237 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 57783 605.755.5340 Dialysis Center 640 Flormann 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 Home+ Home Health 1440 N. Main St. Spearfish, SD 57783 605.644.4444 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 Infusion Services 224 Elk St., Suite 100 Rapid City, SD 57701 605.755.1155 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 Home+ Home Medical Equipment 2707 Lazelle St. Sturgis, SD 57785 605.720.2676 Home+ Pharmacy 353 Fairmont Blvd.

Rapid City, SD 57701 605.755.8184 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 and Specialty Hospital 1635 Caregiver Cir. Rapid City, SD 57702 605.755.6100 Neurology and Rehabilitation 677 Cathedral Dr. Rapid City, SD 57701 605.755.4150 Neuropsychology 677 Cathedral Dr., Suite 201 Rapid City, SD 57701 605.755.5276 Rehabilitation 2200 13th Ave. Belle Fourche, SD 57717 605.723.8961 Rehabilitation 2449 E. Colorado Blvd.

Spearfish, SD 57783 605.644.4370 Rehabilitation Center 1050 Fairmont Blvd., Suite A100 Rapid City, SD 57701 605.755.1230 Orthopedics and Sports Medicine 2479 E. Colorado Blvd.

Spearfish, SD 57783 605.644.4460 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

Monument Health is proud to welcome

OUR NEWEST CARDIOLOGISTS Fawzi Ameer, M.D. Cardiovascular Medicine

Luis Hernandez, M.D. Cardiovascular Medicine

Jeff Wilson, M.D. Cardiovascular Medicine

HEART AND VASCULAR INSTITUTE PROVIDERS

Anurag Bajaj, M.D., FACP

Saverio Barbera, M.D., FACC, FHRS

Michael D’Urso, M.D., FACC

Samuel Durr, M.D., FACC

John Hatanelas, D.O.

John Heilman III, M.D., FACC

Ethan Levine, D.O., FHRS

Charan Mungara, M.D.

Cardiovascular Medicine

Electrophysiology

Cardiovascular Medicine, Interventional Cardiology

Cardiovascular Medicine, Interventional Cardiology

Cardiovascular Medicine

Cardiovascular Medicine

Electrophysiology

Cardiothoracic Surgery, Vascular Surgery

Rajesh Pradhan, M.D. FACC

Drew Purdy, M.D., FACC

Cardiovascular Medicine

Cardiovascular Medicine, Interventional Cardiology

Bhaskar Purushottam, M.D., FACC, FSCAI, FSVMB Cardiovascular Medicine, Interventional Cardiology

353 Fairmont Blvd. | Rapid City, SD 57701 605-755-4300 | monument.health/heart

Alexander Schabauer, M.D., FSVMB, FACC Cardiovascular Medicine

Stephen Joseph Tuma, Kalyan M.D. FACC, FSCAI Vunnamadala, M.D. Wasemiller, M.D. Cardiovascular Medicine, Interventional Cardiology

Cardiothoracic Surgery, Vascular Surgery

Cardiology

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