Relief from dizziness
!REA CLINIC PROVIDES STATE OF THE ART THERAPY !PRIL
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Table of Contents
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Pumping insulin: Cuyuna Regional Medical Center helps diabetes patients manage blood sugar with short acting pump CUYUNA REGIONAL MEDICAL CENTER Battling high blood pressure: What you need to know to maintain a healthy heart SHEILA HELMBERGER
Life goes on: Living with outdoor allergies means overcoming them JENNY HOLMES
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New wellness campaign taps BINGO fun RIVERWOOD HEALTHCARE CENTER Allergic to the cold: Crosby boy adapts to living with uncommon allergy JODIE TWEED
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Gene mapping for everyone? Study says not so fast ASSOCIATED PRESS
Relief from dizziness: Area clinic provides state-of-the-art therapy SARAH NELSON KATZENBERGER MyHealth moves medical information into technology era JESSI PIERCE
U.S. prescription spending again nearly flat ASSOCIATED PRESS Second annual bike safety day hopes to prevent summer injuries JESSI PIERCE
On the cover Who we are Publisher - Tim Bogenschutz Advertising - Sam Swanson Editor - Sarah Nelson Katzenberger
Relief from dizziness
!REA CLINIC PROVIDES STATE OF THE ART THERAPY !PRIL
Physical therapist Jeff Donatelle (left) and patient Mike Alvarez demonstrate the technology involved in vestibular rehabilitation therapy.
Healthwatch is a quarterly publication of the Brainerd Dispatch. Read Healthwatch online at www. brainerddispatch.com
For advertising opportunities call Sam Swanson at (218) 855-5841. Email your comments to sarah.nelsonkatzenberger@brainerddispatch.com or write to: Sarah Nelson Katzenberger Brainerd Dispatch P.O. Box 974 Brainerd, MN 56401
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Pumping Insulin Cuyuna Regional Medical Center helps diabetes patients manage blood sugar with short acting insulin pump Living with diabetes can be challenging. From diet monitoring to checking glucose levels there is a lot to keep track of, but the help of an insulin pump can change the way many people manage their diabetes. Dr. Christine Athmann and Dr. Laura Rathe, along with the Diabetes Education Team at Cuyuna Regional Medical Center are all skilled in helping people manage their diabetes with the use of an insulin pump. “A lot of people don’t know anything about pumps or that they even exist. We are here to help,” said Dr. Athmann. Basically an insulin pump is just that — a pump that provides short acting insulin around the clock in the dosage the user instructs it to give. The pump is attached to a tiny fluid line connected to a port inserted under the skin
Dr. Christine Athmann
by the pump user. The pump user checks their blood sugar and uses the pump to administer the appropriate amount of insulin. A person could check their blood sugar frequently or wear a continuous glucose monitor, and make adjustments to the pump dosage as needed. Using the pump allows the person with diabetes to time their insulin usage more appropriately and often makes their blood sugar more consistent. Through their specialized training, Dr. Athmann, Dr. Rathe, and the Certified Pump Trainers on the Diabetes Education Team help patients pick an insulin pump that is right for them. They explain things like how to dose the pump and how to make adjustments. The trainers will work with patients and
Dr. Laura Rathe
adjust the pump to avoid ups and downs in glucose levels that can be hard on the body. Insulin pumps are most commonly used in managing type one diabetes, but could work for any diabetes patient who is dependent on insulin. Most insulin pumps are covered by insurance. A lot of times, people who use a pump will see a decrease in their need for insulin. “There is some work for patients to do up front, but in my experience, they are very happy with their insulin pump and on the road to successfully managing their diabetes,” said Dr. Rathe. For more information on insulin pumps and diabetes management, call Cuyuna Regional Medical Center at (218) 546-7000 or visit www.cuyunamed.org.
Novo Nordisk to move ahead with once-weekly diabetes shot Bloomberg News
PARIS - Novo Nordisk is likely to proceed with development of a onceweekly version of its daily diabetes shot Victoza or a medicine from the same class to fend off competition from Amylin Pharmaceuticals’s Bydureon. Chief Executive Officer Lars Soerensen is “starting to open up” to the idea, Mads Krogsgaard Thomsen, chief science officer, said Friday at Novo’s headquarters in Bagsvaerd, outside Copenhagen. A long-acting version of Victoza or the experimental semaglutide, a compound that also mimics the hormone GLP-1 to prompt the pancreas
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to produce insulin, would allow some diabetics to cut back on injections and would challenge Bydureon, the once-weekly version of the older medicine Byetta that Amylin introduced this year. Novo will announce which product it has picked when it releases second-quarter results in August, according to Thomsen. For now it awaits data on the long-acting version of Victoza. “Semaglutide is actually looking quite good but what if once-weekly Victoza looks even better,” he said. “That we still don’t know.” Novo pushed back its deadline last year for picking a compound af-
ter rival products, including Bydureon, suffered setbacks. The company, the world’s largest maker of insulin, also said it doesn’t expect last week’s Food and Drug Administration advisory panel recommendation on weight-loss treatments to delay approval of Victoza as a weapon against obesity. An FDA panel voted 17-6 on Thursday to recommend that companies developing weight-loss therapies for the U.S. market conduct tests to assess heart risks. Novo began selling Victoza in 2009 to expand its offering for blood sugar-lowering medicines. The drug is now in advanced clinical tests for
obesity and the Danish company aims to submit it for approval as a weight-loss treatment by the end of next year, according to Thomsen. “We are not expecting a delay,” Thomsen said. The FDA panel discussions “pertained to new obesity molecules. We already agreed with the FDA that as part of our post-marketing requirements for Victoza we will do a cardiovascular outcome trial.” There are indications that GLP-1 medicines may be beneficial to the heart, Thomsen said. “As it looks now GLP-1s, not only ours, seem to be, if anything, cardioprotective,” he said. Even so, “that’s never been proven statistically.”
Battling High Blood Pressure What you need to know to maintain a healthy heart By SHEILA HELMBERGER Health Watch Correspondent
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he American Heart Association estimates as many as one in three adults in America have high blood pressure.
It’s so important to monitor the readings that a trip to the doctor for almost anything, including minor ailments, will certainly mean a blood pressure check. Without those routine checks the condition often goes unnoticed. “Usually there are no symptoms for high blood pressure alone,” says Rebecca Wirtz, RN, FNP-BC, nurse practitioner at Essentia Health’s Brainerd Lakes Heart and Vascular Center. “That’s why it’s called the silent killer. Some people might get dizzy or light headed or they may experience blurred vision, but that would be a late sign.” Early detection is essential for getting the condition in check. “Most of the time hypertension can be managed through primary care,” says Wirtz.
What it is
The top number, or systolic blood pressure of a reading is the pressure in the arteries as the heart contracts and pumps blood. The bottom number, or diastolic pressure, is the pressure in the arteries between beats as the heart relaxes. The target number for a good blood pressure reading is
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120 over 80. High blood pressure is anything 140/90 or higher. If your readings are between the two you have what is called ‘prehypertension’ which means that you will need to take some important steps to prevent the numbers from rising any higher. The condition can even affect children and teenagers. If your blood pressure is in normal ranges it should still be read about every two years. If it’s in the pre-hypertension stage readings should be done every year or more often if your physician requests. High blood pressure is a dangerous disease because it makes the heart work extra hard to do what should be routine. Unfortunately, if the condition is taken lightly or uncontrolled it will lead to a number of far more serious complications. Lots of other things contribute to blood pressure and thankfully, a number of those factors are in our control.
Causes and Complications
Your doctor can help you find out what might be causing your hypertension. “The most common contributors,” says Wirtz, “are obesity, smoking, inactivity and family history.” Genetics is the only one that we can’t control. The others we may be able to alter with simple lifestyle changes. “It can affect everything from your eyes, kidney and heart. It’s what we call endorgan damage,” said Wirtz, “All of
your vital organs get their blood flow through the arteries and when you cut down your blood flow it hurts all of those organs. So, people can have eye issues. There can be heart failure because the heart is working harder to get blood through those restrictive vessels.” Hypertension raises the chance of heart attack, aneurysm or stroke.
Preventive measures
All of the usual good advice for living a healthy lifestyle can contribute to the management of hypertension as well. Eating a healthy diet that especially targets low sodium intake, eliminating smoking, and daily exercise can help reduce readings. Besides oral contraceptives other prescription medications and over the counter cold remedies such as decongestants can elevate readings too. Ask the pharmacist if it’s okay to take a specific cold remedy if you are already watching your blood pressure. Pay special attention to labels at the grocery store when shopping for food. The sodium levels in some of our everyday grocery purchases can be eye opening. Processed meats, canned foods, potato chips, and many prepackaged foods and prepared frozen dinners all contain shockingly high levels of salt. Dietary Approaches to Stop Hypertension, or the DASH diet, is gaining
popularity as a means to address an elevated blood pressure. Some of the changes are small but the results can be big. The plan calls for an increased intake of whole grains, fruits, vegetables and low-fat dairy products and it limits contributors such as saturated fat and cholesterol. If you are asked to keep an eye on your blood pressure you can stop in the clinic for periodic readings or purchase a blood pressure monitor, or cuff, at a pharmacy to take the readings at home. You’ll be asked to log the daily readings so they can be monitored to tell if they are consistently high. If you’ve already been diagnosed with hypertension Wirtz says it is important to be compliant with your medications. Take them as they have been prescribed but if you’re having side effects or feel that your blood pressure numbers have improved do not quit taking your prescription until you’ve consulted with your physician and are given permission to do so. If you think you may be at risk for high blood pressure make an appointment as soon as possible with your physician. For more information on the DASH diet log on to http://www.nhlbi.nih.gov/health/public/ heart/hbp/dash/new_dash.pdf <http://www. nhlbi.nih.gov/health/public/heart/hbp/dash/ new_dash.pdf> .
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Life goes on Living with outdoor allergies means overcoming them
Steve Kohls/ Brainerd Dispatch
Janet Hennies paddles the waters of Sibley Lake with her dog Dasher. Hennies enjoys the great outdoors despite suffering from severe seasonal allergies. Jenny Holmes Healthwatch Correspondent
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here’s no doubt, the Brainerd lakes area is an outdoor enthusiast’s playground, abundant with nature, scenery, and all it has to offer. Now, imagine if all of those opportunities made you physically sick and forced you indoors each day. Janet Hennies has suffered from allergies since she was a child; however, a move to the Lakes Area nine years ago triggered a physical reaction so severe, doctors finally diagnosed her with environmental seasonal allergies. “I always knew I had allergies and hay fever as a kid,” said Hennies, a mother of two. But Hennies said she was able to cope with the help of over the counter antihistamines. When she moved from Fergus Falls to the Twin Cities for college, her symptoms greatly diminished. “Life was good for an allergy patient there,” she laughed. “Not as much pollen.” In 2003, Hennies and husband, Sam, relocated to the Brainerd area when he accepted
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a position with Lakes Dental in Baxter. Suddenly, Hennies found herself ill on a very regular basis. With symptoms ranging from congestion and sinus pain to headaches and nausea, Hennies didn’t immediately suspect allergies. In fact, recovering from the birth of a child, she wondered if her immune system was low. “It really hit me like a 2 by 4,” she recalls. “I was habitually sick.” But the turning point came when Hennies experienced something similar to an anaphylactic reaction after attending a Christmas party. At that point, she was convinced she needed to find a specialist. “Fortunately, I got in front of the right person at the right time,” Hennies said of her search for an allergist who, after conducting a series of scratch tests, determined Hennies was allergic to trees, ragweed, cats, and a variety of other elements commonly found in the great outdoors. “All kinds of normal things that are quite abundant in the lakes area,” she laughed. “The specialist had recommended I start a
shot therapy program or move to Arizona. My husband fishes and I don’t think there are enough lakes in Arizona, so we decided to start the shots.” Through immunotherapy, Hennies was injected with small dosages of antigens she previously had a negative reaction to. The dosages were given gradually over time to help build up an immunity. Initially, she had the shots twice a week, and then went once every other week. Now, after three years of treatment, Hennies undergoes immunotherapy once every three weeks and is amazed at the difference it has made in her life. “To find this independence, the shots program is pretty incredible. It doesn’t always work for everyone, but for me, I can now go through allergy season and only have to deal with burning eyes. Before I started therapy, I would have been bedridden.” Once environmental seasonal allergies were diagnosed as the culprit, Hennies was able to trace back similar allergies suffered by her own mother, though not as severe. Doctors confirmed these environmental sea-
sonal allergies are genetic. Now a mother herself, Hennies worried about her own children, including five-yearold daughter Brook, who seasonally reacts after being outdoors, with a runny nose and swelling around her eyes. Hennies recently had Brook tested and discovered that she, too, suffers from environmental seasonal allergies. Hennies said they were told Brook is a “rare case,” but her body hasn’t established what it “wants” to be allergic to. During the scratch test, Brook’s body reacted the same amount to everything she was exposed to. “The doctor believes she will have a severe reaction to one particular allergen as she gets older, but they need to wait until she is older before they can determine specific triggers and then begin injections.” The good news is, to this point, son Jack, 9, has not shown indications of having allergies. Weather pattern changes are also known to trigger allergic reactions for both Hennies and her daughter. Those who have been outdoors in the last several months can only imagine the havoc seasonal, or unseasonal, changes can wreak on allergy sufferers. “This year, since everything has come earlier due to the mild winter, normally we
wouldn’t be feeling allergy affects in February. But Brook had a really tough month,” she said, noting at this point, they can only treat her with over the counter antihistamines and a fluticasone nasal spray to alleviate symptoms. While Hennies said she doesn’t look forward to injection treatment for her daughter, as a sufferer she says the end result is so much worth it. “It’s a miraculous way to deal with allergies. I wouldn’t go back to the old days, that’s for sure.” Allergy severity ranges from person to person, and treatment is often based on what an individual is willing to tolerate in terms of symptoms, Hennies agreed. While some natural remedies have been discovered, Hennies said the best advice she can give is to find an allergist who can help you determine what you’re allergic to so you can better pinpoint trigger seasons and how to best avoid high pollen levels and more. With a little help, even allergy sufferers can still offer all the Brainerd lakes area has to offer. “The important thing to remember as an allergy sufferer,” Hennies says, “is that there are options to find a way to manage your symptoms and still live your life to the fullest.”
Steve Kohls/ Brainerd Dispatch
Janet Hennies pulls her kayak out for a spring adventure on the lake.
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New wellness campaign taps BINGO fun
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ith today’s busy lifestyles, pursuing wellness is more challenging — and more important — than ever. The key to good health is prevention and making wellness fun for all ages, according to one local health system. Focusing on small steps individuals can take to improve their health, Riverwood Healthcare Center in Aitkin launched a community-wide wellness campaign called BINGO - Win with Wellness in January. “The campaign’s goal is to improve the health of individuals and our community as a whole,” says Riverwood Nurse Practitioner Janet Larson, a certified mental health practitioner as well as family medicine provider who served on a steering committee to develop the BINGO campaign. “Giving people tools, like our BINGO wellness tips, to stay healthy is as important as helping them when they are sick. The game-board format makes doing healthy behaviors fun for all ages.” The BINGO card offers 24 simple wellness tips that you can do daily, weekly or monthly. Some tips from the first quarter’s card: Eat a new fruit or vegetable. Skip fast food for a month. Go for a walk. Take 30 minutes for yourself. Learn something new. See a new set of tips on the second quarter BINGO card at
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www.riverwoodhealthcare.org/bingo “Our wellness tips cover things to do for mind, body and spirit,” Larson adds. “Managing stress and giving the mind a chance to relax and rejuvenate is just as important as eating a healthy diet. Staying physically active has health payoffs for the mind too. Duke University found that only 30 minutes of exercise three times a week was just as effective as drug therapy in the treatment of some types of depression.” Unhealthy behaviors drive up health costs
Why is wellness and prevention of disease so important now? According to the Centers for Medicare and Medicaid Services, the United States spent a staggering $2.5 trillion on healthcare in 2009, which amounted to 17.6 percent of the U.S. gross domestic product. We spend twice as much per capita on health care as European countries, yet Americans are twice as sick with chronic disease. Unhealthy behaviors and lifestyle choices are key factors that are driving skyrocketing health care costs. Wellness and disease prevention is a growing national imperative, particularly as more American families struggle with the personal and financial implications of chronic illness. According to the Centers for Disease Control, 7 of 10 deaths among
Americans each year are caused by chronic diseases such as heart disease, cancer and diabetes and account for 75 percent of the nation’s health spending. Four health risk behaviors — lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption — are responsible for much of the illness, suffering, and early death related to chronic diseases. “Chronic diseases like heart disease and diabetes are largely preventable and even reversible by changes in nutrition, physical activity and lifestyle,” explains Dr. Mark Heggem, Chief Medical Officer for Riverwood Healthcare Center. “At Riverwood, our practitioners promote wellness as an integral part of patient care. We know that there’s a potential long-term benefit for patients for every minute we spend educating them about how they can take charge of their health and adopt healthier lifestyles.” Schools, employers, community groups participating In the past few months, local schools, businesses and organizations have been getting on the BINGO wellness bandwagon. Riverwood has provided BINGO starter kits with prizes to help groups launch their campaigns. For more information on this, contact Liz Dean, Riverwood Marketing
Wellness tip from Nurse Practitioner Janet Larson of Riverwood Healthcare Center:
Janet Larson
McGregor elementary school children used daubers to track their wellness behaviors on the BINGO cards.
manager, at (218) 927-5555 or ldean@riverwoodhealthcare.org In February, Riverwood began partnering with the Community Education program and Independent School District No. 4 in McGregor to introduce the new BINGO wellness program to elementary school children and fitness classes for adults. To encourage students to use the BINGO wellness tips, the elementary school teachers organized a school-wide wellness competition. With the most completed cards at the end of a month, the sixth graders won BINGO t-shirts.
SLEEP away your stress. One of the most important things you can do to support a stressfree body is to get adequate sleep. Create a bedtime ritual. A warm bath, cup of herbal tea or reading a book. Set a bedtime, then stick to it and lights out.
“The BINGO card is a wonderful visual for everyone,” says Lisa Kruse, Community Education coordinator. “It helps as a general daily reminder that overall wellness is so important in your goal to stay healthy. As part of the BINGO – Win with Wellness program, we send out weekly inspirational messages to staff as well as posting tips on our Facebook page.” Go to www.riverwoodhealthcare.org/ bingo to download a BINGO wellness tips card and to register for random drawings for quarterly prizes. You can also sign up for
Eat a light dinner and then nothing to eat 3 hours prior to sleep. If you worry, try meditation. Focus on pleasant things. Breathe, then deep breathe very slowly, allowing yourself to relax. TIP: Drink milk! What your mother told you is true about warm milk. Supported by scientific evidence, milk contains tryptophan and calcium, both of which increase your serotonin level. Serotonin is released by your body to promote sleep. E-Zzzz…
weekly wellness tips (see sample tip on sleep in this article) from Riverwood practitioners and healthcare professionals. “Take your health into your own hands,” Larson adds. “Own your healthy and unhealthy behaviors. Know that what you do — or do not do — today will affect your health in the future. Aim for healthy choices every day: in how you eat, how you are physically active, and what you do to manage stress. Small steps you take today can make a big difference over time for good health.”
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Allergic to the cold
Crosby boy adapts to living with uncommon allergy Steve Kohls/Brainerd Dispatch
The Turk family settled down on the lawn on Serpent Lake in Crosby recently. They are Colten (left), Carsen, Amy and Cayden.
By JODIE TWEED | HealthWatch Correspondent
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ROSBY – With Serpent Lake right out their back door, Brandon and Amy Turk’s four children naturally spend most summer days in the water. But two years ago, something strange began to happen after swimming in the Crosby lake. One of their twin sons, Cayden, now 10, started coming out of the water with huge itchy welts and red streaks covering his body. Amy Turk said they initially thought it could be swimmer’s itch but no one else, including Cayden’s twin brother, Colten, had welts or itchy skin. She switched laundry detergent, thinking that Cayden may be allergic to the brand she was using, but that didn’t help either. She took him to their doctor, who referred him to an allergist in Brainerd. When Amy described Cayden’s symptoms to the specialist, he immediately knew what was wrong with Cayden. “He put an ice pack on (Cayden’s) arm and it welted up right
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away,” explained Amy. Cayden, the Turks were surprised to learn, has cold urticaria, or an allergy to cold temperatures. According to the Mayo Clinic, it is also called a cold allergy or cold hives. The cause of cold urticaria isn’t known but the cold triggers the release of histamine and other allergic responses in those who suffer from it. Cayden’s skin has so much histamine in it that when he lightly scratches his arms, the marks instantly turn red and swell, an inflammatory response triggered by histamine. Cayden was diagnosed with familial urticaria, since he likely inherited the condition. It can improve on its own within a few years, but Cayden has a more severe form and it isn’t known yet whether his cold allergy will go away or lessen with time, said his mother. After Cayden was diagnosed, the Turks realized that his father, Brandon, also had the condition. If someone would put a cold can of soda against his arm, he would get welts from the cold can. But his
“He put an ice pack on (Cayden’s) arm and it welted up right away.” - Amy Turk on son’s cold allergy condition is less severe than his son’s. Cold air also causes Cayden to break out into hives and become itchy. In the winter he often returns indoors from recess at Cuyuna Range Elementary School with itchy, aggravated skin. The school nurse has Benadryl on hand for him whenever he needs it and he also takes an antihistamine to help control his allergy symptoms. He can break out into hives when he sweats during physical activity. Sweat is utilized by the body to rapidly cool your skin. This also can trigger hives. In rare cases, swimming in cold water could send those who suffer from cold urticaria into anaphylactic shock, a serious allergic reaction. Amy said before her son was diagnosed with a cold allergy, she used to joke that she was allergic to the cold since she loves vacationing in warmer climates. She had no idea such an allergy existed until her son’s diagnosis two years ago. She said moving to a warmer climate wouldn’t help Cayden. People who suffer from cold urticaria See ALLERGY, Page 14A
Steve Kohls/Brainerd Dispatch
Colten Turk (left) defended the basket from his brother Cayden Turk while playing basketball at their home in Crosby recently.
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COLD UTICARIA
Cold urticaria is an allergy to cold temperatures. With cold urticaria, exposure to cold temperatures causes redness, itching, swelling and hives on the skin that has been in contact with the cold. SYMPTOMS Cold urticaria symptoms begin soon after the skin is exposed to a sudden drop in air temperature or to cold water. Although symptoms may begin during the cold exposure, symptoms of cold urticaria are often worse during rewarming of the exposed skin. The majority of cold urticaria reactions occur when skin is exposed to temperatures lower than 40 F (4.4 C), but some people can have reactions to warmer temperatures. Damp and windy conditions may make cold urticaria more likely. Cold urticaria signs and symptoms may include: Reddish, itchy hives (wheals) on the area of skin that was exposed to cold. Wheals generally last for about half an hour. Swelling of hands when holding cold objects. Swelling of lips when eating cold foods. In rare cases, severe swelling of the tongue and throat that can block breathing (pharyngeal edema).
Steve Kohls/Brainerd Dispatch
Cayden Turk (left) tried to defend the basket while his brother Carsen prepared to shoot the ball for a basket at their home in Crosby.
ALLERGY, From Page 13A have more difficulty when they experience extreme temperature changes, such as going from hot outdoor weather to the air-conditioned indoors. Cayden said sometimes people don’t believe him when he says he is allergic to the cold. He said it hasn’t stopped him from doing anything he wants to do but he’s lost some interest in swimming in pools and water parks because he can get so itchy. He is active in football, basketball and baseball, just like his identical twin brother, Colten. Colten is allergic to eggs, but does not suffer from cold urticaria. “I’m fine with it,” Cayden said of his cold allergy, flashing a smile. “It just gets really itchy.” The twins, who are CRES fourth-graders, also have an older sister, Cassandra, 20; and a younger brother, Carsen, 8, who do not suffer from allergies. While Amy, a court reporter and Crosby Just for Kix dance director, doesn’t suffer from allergies, her husband Brandon, a builder, also has asthma and allergies. Amy said they have found it’s important to always have a bottle of Benadryl with them wherever they go, just in case Cayden needs it. They also have an epipen in case he has a severe reaction but so far she said they are fortunate that he has not. JODIE TWEED is a former longtime Brainerd Dispatch reporter and HealthWatch editor. She is now a freelance writer and stay-at-home mom to her two youngest girls, ages 3 and 1.
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Severe reactions For people who have cold urticaria, exposure to cold can be dangerous. In some people, reactions affect the whole body. This is known as a systemic reaction. Signs and symptoms of a severe reaction include: Fainting Chills Fast heartbeat Swelling of limbs or trunk The worst reactions generally occur with full skin exposure, such as swimming in cold water. A massive release of histamine and other immune system chemicals causes a sudden drop in blood pressure that can lead to fainting, shock and, in rare cases, death. In the case of cold-water swimming, drowning can be caused by loss of consciousness. WHEN TO SEE A DOCTOR If you have skin reactions after cold exposure, see a doctor. Even if the reactions are mild, your doctor will want to rule out any underlying conditions that may be causing the problem. Seek emergency care if you have a severe reaction after sudden exposure to cold. Get help right away if you: Feel lightheaded Have difficulty breathing Feel like your throat is swelling Information provided by Mayo Clinic, Rochester, Minnesota, www. mayoclinic.com
Gene mapping for everyone? Study says not so fast WASHINGTON (AP) — Gene scans for everyone? Not so fast. New research suggests that for the average person, decoding your own DNA may not turn out to be a really useful crystal ball for future health. Today, scientists map entire genomes mostly for research, as they study which genetic mutations play a role in different diseases. Or they use it to try to diagnose mystery illnesses that plague families. It’s different from getting a genetic test to see if you carry, say, a particular cancer-causing gene. But as genome mapping gets faster and cheaper, scientists and consumers have wondered about possible broader use: Would finding all the glitches hidden in your DNA predict which diseases you’ll face decades later? Johns Hopkins University developed a model using registries of thousands of identical twins, who despite their shared genes can develop different diseases. They examined 24 ailments, including different types of cancer, heart disease, diabetes and Alzheimer’s. Under best-case scenarios, most people would be told they had a somewhat increased risk of at least one disease, said Dr. Bert Vogelstein, a Hopkins cancer geneticist and the study’s senior author. But a negative test for most of the rest of the diseases doesn’t mean you won’t get them. It just means that you’re at no more risk than the general population. Those are the findings Vogelstein’s team reported Monday in the journal Science Translational Medicine. Why? Cancer, for example, typically doesn’t result from inherited genes but from mutations that can form anytime, Vogelstein explained. Many other common diseases are influenced by lifestyle and environment — so you’d still have to eat well, exercise and take the other usual precautions. The study examined just one possible future use of genome mapping. It doesn’t mean there aren’t other benefits from the effort. Make no mistake: This technology does have huge promise for customizing care for certain people, especially children with otherwise undiagnosed illnesses, said Dr. James Lupski of Baylor College of Medicine, who wasn’t involved in Monday’s study. Last year, Baylor researchers reported one of the first examples of genome mapping directly benefiting a patient. It found a mutation that pointed to the right treatment for a 14-year-old girl’s baffling trouble breathing. But even if finding a genetic explanation doesn’t lead to treatment, knowing whether it was inherited can help parents decide whether to chance having another baby, Lupski added. “There are families where this can be transformative,” said Lupski. He had his own genome mapped to identify the cause of a rare nerve disorder.
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Relief from dizziness
Area clinic provides state-of-the-art-therapy By SARAH NELSON KATZENBERGER | HealthWatch Editor
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or those who suffer from forms of chronic dizziness, the world is spinning — and they want it to stop. A visit to the doctor might provide some temporary relief in the form of medication — usually meclozine. “It’s putting a Band-Aid over the problem,” said physical therapist Jeff Donatelle of Big Stone Therapies, Inc. in Baxter. “It doesn’t solve the problem — it just treats the symptoms.” Donatelle knows. Everyday he treats dizzy patients desperate for a solution. And as it turns out, Donatelle might have just the relief they are looking for. Donatelle said dizziness is one of the most common reasons, second only the back pain, for adults to call their physician. Among adults over the age of 70, dizziness is the number one reason for an appointment with the doctor. Dizziness can result from injury,
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issues with the heart, brain, central nervous system or vestibular system located in the inner ear. “It can be difficult for physicians to try to identify where that dizziness is coming from,” Donatelle said. “That makes it difficult to treat.” For the last year and a half, Donatelle has provided a new therapy, one that he said is so new, many physicians are still unaware of its existence. The treatment, known as vestibular rehabilitation, helps determine if dizziness is a result of a vestibular disorder, and treats the symptoms. “We try to look at the whole person here,” Donatelle said. The vestibular system is a sensory system located in the inner ear that helps the brain process the sensory information that controls balance and eye movement. If the system
is diseased or injured the damage can contribute to a vestibular disorder that causes dizziness. Donatelle said within the vestibular system is a chamber, called the utricle, that contains small crystals known as otoconia. If the otoconia are displaced and lodged on one of the three posterior vestibular canals, the result is often symptomatic dizziness. Dizziness can be mild lasting seconds or it can be severely debilitating. Donatelle said debilitating dizziness can result in imbalance or difficulty with coordination, putting those suffering more at risk for a fall and in elderly patients can result in a life-threatening injury. “If someone breaks a hip as a result of a fall they are 40 percent more likely to die in the next two years,” Donatelle said. ““We want to try to prevent that ahead of time.” Before beginning treatment, Donatelle as-
“You’re basically playing Tetris ... It’s all with how you line it up by gravity.” - Jeff Donatelle, on vestibular rehabilitation therapy sesses the extent of the patient’s dizziness by conducting a series of coordination tests to measure the patient’s ability to track a moving object with their eyes. The assessment also evaluates a patient’s balance and gait. “If I can provide something that can help give them a diagnostic to help determine what is happening that can be a huge savings,” Donatelle said. Once it is determined that vestibular therapy may benefit a patient, Donatelle works with state-of-the-art technology requiring the patient to wear a pair of blacked out goggles equipped with an infrared digital video camera. The goggles are used to track the movement of the patient’s eyes as the therapist moves the patient’s head. “Eye movement shows the problem,” Donatelle said, adding that by watching eye movement, he can determine which ear and which part of the ear canal is affected. Donatelle uses the patient’s eye movement and information acquired to guide displaced otoconia back to the utricle where it
Steve Kohls/ Brainerd Dispatch
Jeff Donatelle shows a model of the inside of a human ear. Donatelle works with patients suffering from various forms of dizziness due to the the displacement of otoconia inside the vestibular system in the inner ear. Vestibular rehabilitation therapy is a state-of-theart treatment used to guide displaced otoconia back to the utricle in the vestibular system thereby ending the resulting dizziness.
See DIZZY, Page 18A
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Steve Kohls/Brainerd Dispatch
Physical therapist, Jeff Donatelle demonstrates the technology used in vestibular rehabilitation therapy with the help of Mike Alvarez, an actual patient who benefited from the treatment. Alvarez says vestibular rehabilitation therapy helped end his struggle with vertigo and allowed him to regain control of his life. “He fixed me,” Alvarez said of Donatelle’s treatement.
DIZZY, From Page 17A belongs, thereby resolving the resulting dizziness. “You’re basically playing Tetris,” joked Donatelle in describing the labyrinth-like therapy process. “It’s all with how you line it up by gravity.” While the exact cause may never be found, vestibular rehabilitation therapy can help treat, and even diminish the symptoms associated with a vestibular disorder. “In a few treatments, this can be life changing for people,” Donatelle said. Mike Alvarez of Baxter is living proof of the positive affects of vestibular rehabilitation therapy. Alvarez, 70, said he visited Big Stone Therapies initially to be treated for severe back pain after traditional treatment didn’t resolve the issue. “It was so bad, they didn’t know if they could help me,” Alvarez said of his initial visit with Big Stone. Determined to overcome his pain, Alvarez said he was vigilant about completing the regimented two-plus hours a day exercises. His ambition resulted in an onset of vertigo — the sensation of motion when, in fact, the body is stationary. The result was dizziness and unsteady balance.
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Alvarez’s symptoms led him to seek help from Donatelle. “The first couple of times, man, it was taken care of,” Alvarez said. Alvarez said he was impressed with the state-of-the-art equipment used in his therapy. “That’s really neat stuff,” he said. Alvarez underwent five treatments over a year’s time and has since had no issues with dizziness. “He fixed me,” Alvarez said, “That was so great.” Alvarez said he has recommended vestibular rehabilitation therapy to friends suffering from vertigo — many of whom have also been treated at Big Stone Therapies for their symptoms. Alvarez said following his treatment he returned to an active lifestyle, golfing and working part time at Madden’s Resort in East Gull Lake. “Now I’m back to my old self,” he said. Donatelle said vestibular rehabilitation may not work for everyone, but the assessment can at least help those suffering from dizziness find a plan of action so they don’t have to live with their symptoms. “If you’re having dizziness that is not being resolved, talk to your physician,” he said. “This (therapy) could be a potential course of treatment.” SARAH NELSON KATZENBERGER may be reached at sarah.nelsonkatzenberger@brainerddispatch.com or 855-5879.
Possible symptoms associated with vestibular issues: Balance issues:
Hearing issues:
• Imbalance
• Hearing loss or dis-
• Stumbling
torted hearing
• Clumsiness • Difficulty with coordination • Tendency to touch
• Sensitivity to loud noises • Sudden loud sounds may increased
or hold onto some-
symptoms of ver-
thing when standing
tigo, dizziness or
• Trouble with
imbalance.
changes in walking surfaces Cognitive issues Vision issues: • Trouble focusing or tracking objects with the eyes • Objects or words on a
• Difficulty concentrating • Confusion or disorientation • Difficulty following
page seem to jump,
speakers in conver-
bounce, or float
staion especially if
• Sensitivity to light
there is background
• Increased night blind-
noise or movement.
ness • Difficulty walking in the dark
MyHealth moves medical information into technology era By JESSI PIERCE Staff Writer
Have you ever had a question for your doctor that didn’t require an appointment? Or need to access your child’s immunization records quickly? Now Essentia Health patients are able to do all that with the click of a mouse. Emulating online banking, a new secure online program called MyHealth offers Essentia Health patients access to portions of their medical records and the ability to electronically keep tabs on their medical information. “It’s part of the health system’s transition into electronic services,” said Miranda Anderson, marketing and community relations at Essentia Health. “Depending on the consumer, we offer all sorts of things. As a mom, I can access immunization for my kids anytime, for seniors who go down south to get health care during the winter months, they always have their health care information with them. “It also lets patients be interactive. You can message your physician if you have a question and we have nurses on hand to either answer it or forward it on to your doctor and that becomes part of your medical record, too.” Anderson said another feature includes the opportunity for patients to request and change appointments. And for people on the go, a free smart phone mobile app allows patients to access the same information as the online site. “I think the main thing is that it’s (MyHealth) putting more of the information back in the patient’s hands,” said Anderson, who added that since the live launch in February, patient feedback has remained positive. “In addition to that, because the patients are more informed, they’re going to be healthy. “It takes away that mystery of ‘what does my chart say’ and on the doctor’s end of things, they love being able to bring back that relationship with patients and help them with our message system.” For more information on MyHealth visit www.essentiamyhealth. org.
JESSI PIERCE may be reached at 855-5859 or jessi.pierce@brainerddispatch.com. Follow her on Twitter at www.twitter.com/jessi_pierce (@jessi_pierce).
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U.S. prescription spending again nearly flat TRENTON, N.J. (AP) — Spending on prescription drugs in the U.S. was nearly flat in 2011 at $320 billion, held down by senior citizens and others reducing use of medicines and other health care and by greater use of cheaper generic pills. Last year, spending on prescription drugs rose just 0.5 percent after adjusting for inflation and population growth, according to data firm IMS Health. Without those adjustments, spending increased 3.7 percent last year. The volume of prescriptions filled fell about 1 percent. That continues a trend of restrained spending that began in 2007, when prescription spending dipped 0.2 percent. Before then, IMS generally reported annual spending increases of several percent. But since the Great Recession started, prescription spending has fallen or risen only slightly each year except for 2009. IMS said Wednesday that it appears patients are still rationing their health care, with visits to doctors down 4.7 percent and hospital admissions down 0.1 percent. However, emergency room visits jumped 7.4 percent, a sign some people aren’t seeking care until they are very sick. “We think we’ve reached a tipping
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point, where people are thinking they’re paying too much and they’re changing their behavior” and getting less treatment, said Michael Kleinrock, head of research development at the IMS Institute for Healthcare Informatics. Fewer visits to doctors and other health care providers results in fewer prescriptions getting filled, which holds down spending in the short term. But that doesn’t bode well for future health care costs, because many of the medicines people are doing without are taken for years to prevent heart attacks and other expensive complications of chronic conditions such as heart disease and diabetes, Kleinrock said. “The ultimate result is that we will have more sick people driving health care costs” down the road, he said. People aged 65 and older cut back on the number of prescriptions filled by 3.1 percent last year, particularly for medicines for high blood pressure. That was despite a 10 percent decline in average prescription copayments under the Medicare Part D program, to $23.31, due to bigger discounts when patients hit the socalled doughnut hole coverage gap. Only one group increased pre-
scription use last year. People aged 19 to 25, now able to stay on their parents’ health insurance plans under a provision of the Patient Protection and Affordable Care Act, boosted their use of prescription medicines by 2 percent. That was led by more use of antidepressants and attention deficit disorder drugs. Kleinrock noted the company’s data indicate both people with and without insurance are having trouble paying for medicines and other health care, and so are limiting or postponing treatments. For instance, insured patients spent $1.8 billion less out of pocket last year, at a total of $49 billion. Meanwhile, use of inexpensive generic medicines continues to climb, hitting 80 percent of all prescriptions filled last year. That growth is fueled both by patients trying to save money and by the start of an avalanche of blockbuster medicines, many for chronic conditions, losing patent protection. Cholesterol fighter Lipitor, the topselling drug in history with a $13 billion-a-year peak, got its first U.S. generic competition on Nov. 30. This year, generic competition arrives for drugs taken by millions of people for
high blood pressure, diabetes, asthma and allergies, depression, schizophrenia and prevention of blood clots that can cause heart attacks and strokes. The institute’s annual report shows patient restraint and increased use of generics are offsetting factors that usually push up spending on prescriptions significantly, particularly use of pricey, newly approved medications. Last year, 34 new prescription medications were launched in the U.S., the most in a decade. They brought significantly better treatments to more than 20 million Americans with life-threatening conditions, including cancer, hepatitis C, heart disease and multiple sclerosis. But the new drugs carry big price tags, with most costing tens of thousands of dollars for a year or a course of treatment. Prescription drug revenue also was boosted by price increases for existing medications and by the newly insured young adults. In an interview, Kleinrock said he doesn’t see the current trends changing anytime soon. Given that, he expects prescription sales to be flat or up 1 percent in 2012, and to decline as much as 2 percent after adjusting for inflation and population growth.
Second annual bike safety day hopes to prevent summer injuries
Associated Press
By JESSI PIERCE Staff Writer
As spring has sprung so have the number of kids anxious to get their bikes out and head down to the local parks with the thoughts of summer looming on their minds. With bike injuries all too common, Essentia Health St. Joseph’s Medical Center is attempting to alleviate some of this year’s injuries, hosting its second annual Bike Challenge from noon until 3 p.m. on Saturday, May 12, at the Brainerd High School lower parking lot. “We see bike related injuries quite a bit,” said Amanda Svir, trauma coordinator at the hospital. “In addition, for myself — as a mom — I want to see my kids wearing helmets and the kids in the neighborhood wearing helmets. “What we want to do is injury prevention, preventing kids from coming to the ER with concussions and other injuries often times related to falling off or crashing on their bikes.” Svir said kids and parents who attend will be walked through stations detailing proper procedures on checking their bike, fitting their helmets and hand signals to be used when biking down the road. “This (Bike Challenge) is an opportunity for us to provide the community with injury prevention,” said Svir who noted that last year’s first Bike Challenge drew roughly 60 kids. “It’s a way to actively engage kids and inform them of some of the things that they can do to prevent injuries while riding a bike.” The Bike Challenge is open to riders of all ages free of charge. Participants are required to bring their own bike and helmet and must be accompanied by an adult. JESSI PIERCE may be reached at 855-5859 or jessi.pierce@brainerddispatch.com. Follow her on Twitter at www.twitter.com/jessi_pierce (@jessi_pierce).
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Health Watch Service Directory • January 2012
Assisted Living
Excelsior Place ÐHFÐÐÁÒ@˘åç}}&ÁÔ˘@ˇå Œä¸•å˘EÁŠT BFÐÏCÁÏFÏÉHÎÎÈ çççÊç•}*&åˇå\}[|å{•Êà}|Ëæä¸•å˘ Good Neighbor Home Health Care BFÐÏCÁÏFÌÉÌFGÏ BÏÏÏCÁFFÐÉIÎÏI çççÊ~{*}|åàä˘åÊà}| Good Samaritan Societies of Brainerd and Pine River BFÐÏCÁÏFÌÉÐHFÌ çççÊ~}}&ɦä|Êà}|
Audiology
Accucare Audiology ÐHFÎIÁØ}\^ÁÓ}c˘¦åÁÛ&ÁÂFFÈÁÁ Œä¸•å˘EÁŠT BFÐÏCÁHIHÉGFÎÎ Preferred Hearing ÐÎFÎHÁÜ•ä•åÁÕç¢ÁGÎÐ Œ˘ä@{å˘&EÁŠTÁIÍHÈÐ ÐÉÏÈÈÉHIÏÉÈÏÌI çççÊ[˘å^å˘˘å&*åä˘@{~ä@&àå{•å˘Êà}|
Construction
Nor-Son ÎÌÈÈÁÕ䦕@{~¦ÁÛ&ÁÁ Œä¸•å˘EÁŠTÁ BFÐÏCÁÏFÏÉÐÎFF BÏÈÈCÁÏIÏÉÐÎFF çççÊ{}˘É¦}{Êà}|
Health Care
Cuyuna Regional Medical Center BFÐÏCÁIHÍÉÎÈÈÈ BÏÏÏCÁHÏÎÉÍHGÎ çççÊàc¢c{ä|å&Ê}˘~ Essentia Health Ü•ÊÁQ}¦å[*æÁÕ}¦[@•ä\ FÐÏÉÏFÌÉFÏÍÐ Œ˘ä@{å˘&ÁÓ\@{@à FÐÏÉÏFÏÉFÏÏÈ Œä¸•å˘ÁÓ\@{@àÁÉÁÓ}|@{~ÁÜ}}{þ çççÊ妦å{•@ä*åä\•*Êà}|
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Lakewood Health System Ü•ä[\å¦ Š}•\å¢ U@\\ä~å˘ Öä~\åÁŒå{& Œ˘}çå˘ˇ@\\å BFÐÏCÁÏÌHÉÐIÐI BÏÈÈCÁIFIÉÐÈGG çççÊ\äbåç}}&*åä•*¦¢¦•å|Êà}|
It’s Here!
Riverwood Healthcare O@•b@{ Ø䢢@¦}{ ŠàØ˘å~}˘ BFÐÏCÁÌFÎÉFÐFÐ BÏÏÏCÁFÎÈÉÐÏÏF çççÊ˘@ˇå˘ç}}&*åä\•*àä˘åÊà}|
MRI
Lakes Imaging Center FÈÐÌÁÜÊÁÍ•*ÁÜ•˘åå• Œ˘ä@{å˘&EÁŠT FÐÏÉÏFFÉÞUÖTÁBÍÎGÍC ÏÎÎÉIFFÉÎFFF çççÊ\äbå¦@|ä~@{~àå{•å˘Êà}|
Opticians
Great Northern Opticians FÈFÈÁÜ}c•*ÁÍ•*ÁÜ•˘åå•ÁÁ Œ˘ä@{å˘&EÁŠT BFÐÏCÁÏFÌÉÐGGI Northern Eye Center Œ˘ä@{å˘& S@••\åÁÒä\\¦ Ü•ä[\å¦ FÐÏÉÏFÌÉFÈFÈ ÐÉÏÈÈÉÏÎFÉÈÈÈI çççÊ{}˘•*å˘{å¢åàå{•å˘Êà}|
Psychiatrists
Northern Psychiatrics ÎÐÐIÁÒ}˘•*c{ÁÛ&ÁÂÁÐÈIÁ Œä¸•å˘EÁŠTÁ BFÐÏCÁHIHÉÈÈÌÈÁ çççÊ{}˘•*å˘{[¦¢à*@䕢@àÊà}|
To have your business listed in future editions of Health Watch, please contact Dave Wentzel at 218-855-5821
The all new Brainerd Dispatch iPad App W@åçÁä˘ à*@ˇå&Áå&@•@}{¦ÁÁÁÁÁ ÜååÁ•*åÁe˘ åä\fiÁ[ä[å˘Á}{Á ¢}c˘Á@Uä&Á ÕäˇåÁ@{¦•ä{•Áäàà妦Á•}Á{åç¦EÁ [@à•c˘ å¦EÁåˇå{Áà\䦦@è Áå&¦þÁ Ü*ä˘åÁ•*åÁ{åç¦Á¦•}˘@å¦Áˇ@äÁ Òäàåæ}}bEÁÙ ç@••å˘Á}˘Áå|ä@\þ Üàä{Á•*@¦ÁÚÛÁ à}&åÁ•}Á&}ç{\}ä&Á •*åÁä[[Á}˘Áˇ@¦@•Á •*åÁ@Ù c{å¦Á O[[ÁÜ•}˘å *free for a limited time
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