By SARAH NELSON KATZENBERGER Editor
My Chart
CUYUNA REGIONAL MEDICAL CENTER GIVES PATIENTS BETTER ACCESS TO RECORDS CROSBY — There are few greater frustra frustrations in life than not being able to reach your healthcare provider. Whether it’s a prescription that needs refilling, tracking down medical records or test result information or even just asking a simple health-related question, reaching out to health care providers often feels overwhelming and unrequited. Cuyuna Regional Medical Center is out to change that. Last May, CRMC switched their medical record management software to Epic, a system allowing controlled patient access to the same medical records their doctor uses. Epic works with MyChart, a browser and mobile application giving patients round the clock access to their own secured medical records. Patients create their own secured-login to access their MyChart account. Then they can view and cancel upcoming appointments, access test results, medical records, request prescription
refills, view a child’s records, manage care for elderly parents, view visit summaries and even email their own health care providers directly. Patients can also view their statements, billing information and account balance with CRMC and make payments through MyChart. They also have access to a downloadable record to be shared with another provider as needed. MyChart is available on both browser and app for Apple and Android, providing access from anywhere. Soon users will be able to request a new appointment through MyChart. “It has been really well received by our patients,” said Julie Iten, registration and scheduling supervisor at CRMC. “They’ve really embraced it.” Iten said natural concerns about the security of records have drawn some hesitancy, but Iten compared the security of MyChart to online banking. Patient confidentiality is the No. 1 concern at CRMC, Iten said, “We take that very seriously.” On the provider side, Iten said CRMC doctors and nurses have embraced the use of MyChart. “It’s a nice
way to interact with patients in real time,” she said. Doctors can follow up with patients after appointments to provide test results, further explanation on medication prescribed or to make sure a patient clearly understands their treatment plan. “It’s that extra level of contact,” Iten explained. Iten also noted that the nursing staff has access to their providers’ charts providing an extra set of eyes on everything. Iten said MyChart and Epic have come with a learning curve for all involved including a great deal of education for providers, but CRMC is committed to bettering the way it interacts with its patient population “It’s a great service,” she said. “That is widely recognized.” Iten noted that CRMC anticipated a greater patient response from younger patients who tend to be more comfortable with electronic communication, but all patient demographic groups have embraced the new system. “We want our patients to feel connected and in control of their own health,” she said. “That’s the biggest goal.”
...Falling ...medication errors ...depression ...nutrition ...housekeeping ...companionship
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Table of
Publisher • Pete Mohs Advertising • Susie Alters and Phil Seibel Editor • Sarah Nelson Katzenberger Art Direction/Design • Jan Finger
Contents My Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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CRMC gives patients better access to records . . . . . . .By Sarah Nelson Katzenberger Contributing Writers Sheila Helmberger • Jodie Tweed • Joshua Kempf, DO • Sarah Nelson Katzenberger • Jenny Holmes
Essentia Health Family Birthplace. . . . . . . . . . . . . . . . . . .
Recognized as ‘Baby-Friendly’ . . . . . . . By Essentia Health-St. Joseph’s Medical Center
Health Watch is a quarterly publication of the Brainerd Dispatch.
Teen Depression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Read Health Watch online at www.brainerddispatch.com
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Watch for the warning signs . . . . . . . . . . . . . . . . . . . . . . . . By Jodie Tweed
For advertising opportunities call Susie Alters at 218-855-5836.
So fresh and clean . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Email your comments to newstips@brainerddispatch.com or write to: Brainerd Dispatch P.O. Box 974 Brainerd, MN 56401
CentraCare Kidney Program at Essentia Health . . . . . . . . .
Cover illustration by Jan Finger
International Medicine . . . . . . . . . . . . . . . . . . . . . . . .
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Woman’s mission provides healthy makeup line for women . . . . . . . By Jenny Holmes
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Provides lifeline for dialysis patients . . . . . . . . . . . . . . . . By Sheila Helmberger
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CRMC OB nurse changes lives in Haiti . . . . . . . . . . By Sarah Nelson Katzenberger
‘It just hurt really bad’ . . . . . . . . . . . . . . . . . . . . . . . .
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Appendicitis sidelines hockey player. . . . . . . . . . . . By Sarah Nelson Katzenberger
Osteopathic Medicine . . . . . . . . . . . . . . . . . . . . . . . .
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A Healthy Touch of Medicine . . . . . . . . . . . . . . . . . . . By Joshua Kempf, DO
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By ESSENTIA HEALTH-ST. JOSEPH’S MEDICAL CENTER
Essentia Health Family Birthplace RECOGNIZED
AS
Alissa Lindner has learned no two births are alike and that experienced nurses are a laboring mother’s best friend. When her son was born two years ago, Alissa labored for nearly 12 hours. She labored a little over two hours with her daughter, who was born just 13 minutes after Alissa arrived in the Family Birthplace at Essentia Health-St. Joseph’s Medical Center on Oct. 14. Alissa’s surprise at such a fast labor dissolved after Lily was born and she held her daughter skin-to-skin, sharing the experience with her husband, Dan. “When they laid Lily on me, that was the coolest part,” she recalls. “She was there. It was painful but she made it all OK. I just felt really content.” One of Alissa’s memories will be the first night she spent with her daughter. “I felt better and more comfortable with her on me — it was the most comfortable feeling ever,” she remembers. Alissa appreciates that Lily wasn’t bathed or measured until she decided to take a shower the next morning. Lily didn’t have to leave the room, which was different than when her son Jack was born and she was encouraged to send him to the nursery so she could rest. The change is a result of aligning care of mother and newborns to achieve “BabyFriendly” designation that aims to provide the gold standard of care, explains Dr. Alicia Prahm, an obstetrician and gynecologist with Essentia Health. Skin-to-skin contact helps mother and baby transition from the birth. “Babies are surprised at their entrance into the world after birth and they’re crying and screaming. Then we give them skin-to-skin contact on mom’s chest,” says Jill Lechner, a registered nurse who cared for Alissa and Lily. “Babies instinctively know it’s all right. They smell their mothers and look at them. They calm down.” Mothers have the same reaction, which helps regulate their vital signs. “Mothers begin bonding with their babies,” Jill explains. “They begin breastfeeding quicker and get a better start. It’s absolutely beautiful to watch. Baby gets to know Mom, Mom gets to know baby and they know what to do together.” Alissa says Lily picked up breastfeeding from the beginning while she and Jack had a
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‘ B A BY - F R I E N D LY ’ few problems that a lactation counselor helped solve. She also noticed that nurses didn’t offer her a pacifier for Lily as they did with Jack, which is another strategy for successful breastfeeding. While breastfeeding aids bonding, the nurses know not all mothers want to breastfeed and respect that decision. They encourage mothers to have skin-to-skin contact, talk with their babies and learn the babies’ cues that they’re hungry or need affection. Keeping mother and baby together throughout their hospital stay strengthens their bond. Essentia Health-St. Joseph’s Medical Center has earned international recognition as a “Baby-Friendly” birth facility. The designation means its Family Birthplace offers the gold standard in care for mothers and babies. The Baby-Friendly Hospital Initiative is a global program sponsored by the World Health Organization and the United Nations Children’s Fund. It recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. “We’re achieving the international best practice and standard of care for mothers and babies,” said Prahm, an Essentia Health obstetrician/gynecologist. “It is well recognized that hospital practices in the first hours and days after birth make a difference in breastfeeding success.” Prahm said national health leaders, including the surgeon general, rank breastfeeding as a top health initiative, like cancer screening and reducing rates of obesity and smoking. The federal Centers for Disease Control are tracking the number of “BabyFriendly” hospitals as part of its assessment of community health. Based on the “Ten Steps to Successful Breastfeeding,” this Baby-Friendly award recognizes birth facilities that offer breastfeeding mothers the information, confidence and skills needed to successfully initiate and continue breastfeeding their babies. Essentia Health-St. Joseph’s Medical Center is the only facility north of the Twin Cities to earn the international award. Only nine facilities in Minnesota have achieved the designation after a rigorous on-site survey. To learn more about prenatal care and obstetric services at the Family Birthplace, go to EssentiaHealth.org/MatchOB.
“I take whatever comes my way, and I stay positive.” – Ramona B., Brainerd Early detection has helped Ramona survive not one, but two cancers. Like most people diagnosed with lung cancer, the tumor in Ramona’s left lung was discovered when she had an X-ray for another condition. Until recently, there was no screening test for lung cancer. Low-dose CT scans are now being offered for people ages 55-77 who are longtime smokers and therefore at high risk for developing lung cancer.
When Whenit’s it’scancer, cancer, we’re we’rehere herewith with you ’s cancer, To schedule a lung cancer screening, you need youevery everyday. day. to first meet with your primary care physician ere with Close Closetotohome. home. to determine if you meet the criteria and to ry day. risks and benefits of a low-dose Essentia Health’s cancer expertsdiscuss are deeplythe committed Essentia Health’s cancer experts are deeply committed From left to right: Missy Laposky, RN, BA, OCN; Laura Joque, MD; RN, Lakes BSN, OCN; to caring for cancer patients inBarb the Morris, Brainerd to caring for cancer patients inZ.the Brainerd Lakes Aby Philip, MBBSto and Area. From participating in community events raise Area. From participating in Jessica community events to raise Nybakken, AOCNP awareness about the importance of cancer screenings
home.
Essentia Health’s cancer experts are here to make sure that the best care is available close to home, family and friends.
Dr. Laura Joque
Dr. Anusha Madadi
Dr. Aby Philip
Jessica Nybakken, AOCNP
Erin Kennedy, RN, Clinical Patient Navigator
Missy Laposky, RN, BA, OCN Clinical Patient Navigator
From left to right: From left toRN, right: Missy Laposky, BA, OCN; Missy Laposky, Laura Joque, MD; RN, BA, OCN; Laura Joque, MD; Barb Morris, RN, BSN, OCN; Morris, RN,and BSN, OCN; Aby Barb Z. Philip, MBBS AbyNybakken, Z. Philip, MBBS and Jessica AOCNP Jessica Nybakken, AOCNP
The Essentia Health Cancer Center team The Essentia Health Cancer Center team
continues to demonstrate a commitment CT scan. To make an appointment with your continuesthe to highest demonstrate a commitment to delivering level of cancer to delivering the families. highest level of cancer care to patients and Our Center primary care provider, callcare 218.828.2880. to patients and families. Our Center
is certified, accredited and recognized by awareness about the importance of cancer screenings to raising money that directly impacts the patients we is certified, accredited and recognized by the following: to raising money that directly impacts the patients we cer experts are deeply committed care for, we are here with you The in every way.Health Cancer Center team the following: Essentia care for, we are here with you in every way. continues to demonstrate a commitment patients in the Brainerd Lakes Our team consists of oncologytoand hematology delivering the highest level of cancer ing in community events to raise ting Our team consists of oncology and hematology care to patients and and families. Our Center EssentiaHealth.org/BrainerdCancerCenter providers, specialized surgeons, radiologists importance of cancer screenings providers, specialized surgeons, radiologists and is certified, accredited and recognized by pathologists, dieticians, specialized nurses and t directly impacts the patients we pathologists, dieticians, specialized nurses and the following: therapists, a nurse navigator, social worker, clinical with you in every way. therapists, a nurse navigator, social worker, clinical research nurse, and so many more. We understand research nurse, and so many more. We understand oncology andthat hematology patients want personalized care and we are here that patients personalized care and we are here d surgeons, radiologists andthatwant to make sure the best care is available close to to make sure that the best care is available close to ns, specializedhome nurses and and close to family and friends. home clinical and close to family and friends. avigator, social worker, o many more.EssentiaHealth.org We understand EssentiaHealth.org ersonalized care and we are here e best care is available close to mily and friends.
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By JODIE TWEED Contributing Writer
TEEN DEPRESSION—
Watch for the WARNING SIGNS When teenagers commit suicide, their parents and friends are left behind in grief and with unanswered questions. Unfortunately, many teens who suffer from depression often don’t ask for help. Untreated depression is the No. 1 cause of suicide. More than 90 percent of people who died by suicide were struggling with a mental illness at the time of their death. Kenneth Fogal, a licensed psychologist at Cuyuna Regional Medical Center in Crosby, works with many teens, as well as adults, struggling with depression. Fogal said he sees many teens today who are struggling with anxiety due to external pressures to be “perfect” in school and/or with their external appearance. They may be dealing with family problems or are being bullied or harassed at school or on social media networks, often without their parents or teachers knowing. Fogal said social media has changed how teens are bullied. Teens may not be physically bullied at school. Instead, bullying takes a different, more invasive form, often through text or Snapchat messages — which make it easier to bully without being identified. “They often don’t think anybody can help,” Fogal explained. “Life can be difficult for all of us, but in the adolescent world, especially. They can become isolated and withdrawn, and that’s a big warning sign.” One of Fogal’s patients, a 16-year-old girl being treated for depression and for cutting herself, said she was always afraid to say something about the bullying and harassment she was experiencing from other teens. Instead, she internalized her pain. “I’ve never really gone to a teacher for help,” she said. “I felt alone. I couldn’t talk to anybody about it. I felt like nothing could be done.” She said most teens don’t talk to others about how they feel.
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• Illustration by Jan Finger
“Keeping it bottled up really hurts you. I know that for sure,” she said. Fogal said the teen began therapy about three months ago. As a result, she’s no longer harming herself and is working on building her own personal empowerment skills. She is learning how to love and respect herself and identify skills and strategies to deal with conflict. Life is beginning to turn around for her. “She’s feeling stronger and empowered with therapy,” Fogal said of his 16-year-old patient. “She has also reached out more with her mom for support.” Fogal said many parents tell him that their teens won’t talk to them, and they’re not likely to open up to a therapist. This is not always true. Fogal said he’s had teens seated in his office, slumped down in their chairs, arms crossed and their sweatshirt hoods pulled over their heads, angry that they’re being forced to be there. It may take 10 minutes or maybe even a couple of sessions, but they almost always open up, sharing their pain and struggles. Sometimes they may need a neutral party to come forward and offer advice and support. “Take the time to ask the questions. Listen. If you know something is wrong, get some help,” Fogal said. “Get them in, even if they don’t want to.” Fogal recommends starting with the school counselor, or another adult that you feel they can connect with, whether it is your pastor or an adult relative, someone who can offer support and direction. “A lot of adolescents are not going to talk to their parents about this stuff,” he said. “Yet, by making the extra effort to listen and spend quality one-to-one time with your teens can make all the difference. Encouragement, keeping open communication and creating an environment which fosters love and trust can go a long way.” JODIE TWEED, a former Brainerd Dispatch reporter, is a freelance writer and editor who lives in Pequot Lakes.
Depression in Teens: Warning Signs
S
ometimes it is difficult to determine whether your teen’s emotions and behaviors are all just part of being a teen or the result of depression. If you’ve noticed any of these emotional and behavioral changes in your teen, or anyone in your life, talk to them. If depression is interfering in their life, get them some help. Depression won’t get better on its own, and it may lead to other problems if left untreated. Teens can be at risk of suicide even if signs and symptoms don’t appear to be severe.
■ LOOK FOR THESE EMOTIONAL CHANGES • Feelings of sadness; which may include crying for no apparent reason. • Feeling hopeless or empty. • Acting irritable or annoyed. • Exhibiting frustration or anger, even over small problems. • Loss of interest or pleasure in normal activities. • Low self-esteem. • Feelings of worthlessness or guilt. • Fixation on past failures or exaggerated self-blame or selfcriticism. • Extreme sensitivity to rejection or failure, and the need for excessive reassurance. • Trouble thinking, concentrating, making decisions and remembering things. • Ongoing sense that life and the future are grim and bleak. • Frequent thoughts of death, dying or suicide.
■ WATCH FOR THESE BEHAVIORAL CHANGES • Tiredness and loss of energy. • Insomnia or sleeping too much. • Changes in appetite, either decreased appetite and weight loss or increased food cravings and weight gain. • Use of alcohol and drugs. • Agitation or restlessness. • Slowed thinking, speaking or body movements. • Frequent complaints of unexplained body aches and headaches, which might include frequent visits to the school nurse. • Social isolation. • Poor school grades or frequent absences from school. • Neglected personal appearance. • Angry outbursts, disruptive or risky behavior, or other ways of acting out. • Self-harm, such as cutting, burning or excessive piercing or tattooing. • Making a suicide plan or a suicide attempt. Information provided by Mayo Clinic.
Need someone to talk to? Call the Crisis Line and Referral Service The Crisis Line and Referral Service was established in 1988 in response to an alarming increase in the suicide rate in Crow Wing County. It is a 24-hour crisis line that serves people in Crow Wing, Cass, Aitkin, Morrison, Todd and Wadena counties. It is meant to help people when they are in a crisis or before their problems become a crisis. You can also call for a referral for resources in the Brainerd lakes area and surrounding counties. If you need help or support, call the Crisis Line and Referral Service at 800-462-5525 or 218-828-HELP (4357).
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By JENNY HOLMES Contributing Writer
So fresh P EQUOT L AKES
clean
WOMAN EMBARKS ON A M I S SI O N TO P ROV I DE NATURA L MAKEU P LINE FOR WOM EN
PEQUOT LAKES — Having grown up the daughter of a farmer, Joanie Weg Wegman has always had an appreciation and respect for nature. Calling herself a “country girl,” Wegman strives to surround herself with all things healthy and natural – both personally and professionally. Nine years ago, Wegman and husband Adam moved to the lakes area to purchase a historical building on Main Street in Pequot Lakes. What originally was home to a church and later a coffee house, was renovated into a wellness salon and spa. “When we first walked into this place, I knew it was going to be the salon,” Wegman said, looking around at the ornate features of the 109-yearold structure. Ironically, the grand opening of J’Amelia Wellness Spa and Salon was also the building’s centennial. Wegman offers full service spa and salon services, including massages in the church’s old choir loft and a variety of spa services including facials, body wraps, haircuts, hair color, manicures and pedicures. Her personal specialty is special event hair and makeup. She styles roughly 30 weddings each year. In keeping with organic products for her clients, Wegman said she began to research makeup lines with clean, pure ingredients but, after months of searching, came up empty handed. “I just couldn’t find lines that did what I wanted them to do as far as performance,” Wegman noted. “Having a wellness salon and spa, I have a goal to bring healthy, clean lines to people. Our Eufora shampoo line was the start of it, but I couldn’t find that in makeup.”
Joan Wegman applies natural make up to a client at her salon and spa, J’Ameilia, in Pequot Lakes.
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Instead, Wegman opted to create her own line that combined performance with purity — products she felt good offering her clients. After four months and exploring 25 different manufacturers, Wegman found a reputable company she would partner with to create and customize her product line of makeup and skincare. From ingredients gathered in Italy, down to the packaging, Wegman was able to hand pick and personalize this labor of love. J’Amelia’s Botanical Mineral Makeup and Skincare is “gluten free, dye free, paraben free, everything free. But still performs,” Wegman said. After a four-month production process, the line was released to the public, sold in her spa and salon, as well as online at cherrypicksmakeup.com. Wegman said she and husband Adam came up with domain name ‘Cherrypicks’ since ingredients are cherry picked or chosen exclusively. “The response has been amazing,” Wegman said, noting she is currently shipping throughout the country, including Hawaii. Her website allows women to complete a profile to help them get exactly what they want and need for their individual skin types. Items in the makeup line include foundation, mineral eye shadows, all-in-one applicator for loose powder foundation, lip gloss, eyeliner, cream cheek rouge, bronzer, skin tone balancing foundation, baked trio eye shadows with moisture, self-adjusting colors, and mascara. For skin care, Wegman offers cleansers, toners, serums, scrubs, masks and moisturizers. All are available for women with sensitive skin, combination skin or those looking for products with anti-aging properties. “My passion is for offering women amazing prod-
ucts that aren’t full of chemicals that will harm them. I’m really health conscious about what goes into our bodies and how it affects us. If I’m going to offer and stand behind a product that I know is full of chemicals — I just can’t do it. Yes, this is a business but that’s not where my heart is.” The makeup and skincare lines are created for women of all ages, skin colors and types. Wegman said ingredients are botanically based, including rosemary, lavender, thyme, and green tea; all created to treat a woman’s skin as she wears them. “Wellness is overlooked in this industry. So I feel that’s part of what I’ve been called to do. It’s a perfect combination. Many women react to chemicals in a typical salon. Allergies prohibit women from wearing makeup. This is something they can finally try.” Wegman said she also wanted to create lines that are easy for women to apply, knowing many women who admit they don’t know how to wear makeup the “right way.” “It’s not complicated makeup. I wanted to target people that I know were struggling. I would hear that a lot: ‘I just don’t know how to put makeup on.’” Wegman also posts start-to-finish makeup application videos on her website and Facebook page, The Hairstylist Homesteader, offering tips and tricks for colors and effects. “Beauty comes from the inside,” Wegman said. “But sometimes it starts for women to be able to grow in other areas. They believe things they’ve heard before — that they’re ugly or not enough. “Women want to feel beautiful. It’s more about bringing out beauty and empowering them to be who God created them to be, not comparing themselves to other women, but being beautiful in their own skin.”
Pequot Lakes resident Joanie Wegman launched a wellness salon and spa and just recently has added her own line of clean beauty products.
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By SHEILA HELMBERGER Contributing Writer
CentraCare KIDNEY Program at Essentia Health provides LIFELINE This morning I had three cups of coffee. This afternoon I had a soda with ice and a decent sized glass of orange juice in hopes of fighting a cold I feel coming on. I had another glass of water after that and then a glass of wine with dinner and then another cup of coffee after. These were not options for my own mother,
who
spent
seven
years on dialysis before she passed away. Seven years of tri-weekly trips to a dialysis clinic where needles were always a part of the process and she was forced to limit her beverage intake every single day, lest she go in to her next appointment with too much fluid that would make her feel like she was suffocating. It was a tall order for a lifelong lover of coffee and a lady who could appreciate a cold can of soda — basic pleasures I am acutely aware I take for granted. Knowing that she would need dialysis for the rest of her life was not news my mom welcomed. Years of medication for other ailments took a toll on her kidneys. Traveling to a facility three times a week to be hooked to a machine for three hours each visit, meant the people she saw there became another family. The nurses and other patients there became an important part of
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Healthwatch contributor Sheila Helmberger (right) with her mother. Her mother died last fall after spend spending seven years on kidney dialysis.
technology, capitalizing on the skills my parents’ lives. They celebrated birthdays, holidays of a multidisciplinary kidney team and one another’s good news and bad all the while symbiotically working news. Besides accounting for her flu- closely with the physicians, advanced id intake, my mother, depending on practice providers and nurses at Essenwhether it was the day before, the day tia Health,” explained Dr. Haroldson. The dialysis center at of, or the day after a dialythe Brainerd Clinic is a sis treatment, would feel very busy place. Over 70 exhausted, energetic and patients are seen for at in acute pain from crampleast thrice weekly dialying. dialy sis appointments. Some Sitting with her while patients are lucky and the her blood snaked in and treatment is temporary or out of tubes was always until a transplant can be hard to watch, but the done. Other health issues treatments gave us seven meant my own mother more years. The kidneys, it was not a candidate for turns out, have very impor impora transplant, and one lolo tant jobs. Although most people DR. DIPAL PATELL cal patient in Brainerd has been on dialysis for more don’t even know it’s there, than 30 years. the CentraCare Kidney ProDialysis is done through a machine gram, located at the Essentia Health St Joseph’s-Brainerd Clinic, has been that works as an artificial filtration sysproviding comprehensive kidney care tem for your blood to remove waste for patients and those in end-stage and excess water when your kidneys renal disease in the Brainerd area for can’t do the job. During my mother’s time on dialyover two decades. Comprised of a team of physicians, sis we learned how critical the work nurses, dieticians, social workers and of kidneys truly is, how well hydrogen administrative staff, the work they do peroxide removes blood from clothing is no doubt as valuable to their pa- and other items when her port would tients and their families as my mother’s leak, and how important a good dialysis family is in making a bad experidialysis team was to us. A kidney doctor is called a ne- ence just a little bit easier. The kidneys are also responsible phrologist. This past summer, Essentia Health added nephrologist Dr. Dipal for producing important hormones Patell to their staff. She sees patients at to control blood pressure, blood cell the Brainerd Clinic. The medical direc- production and bone health. Hemoditor for the CentraCare Kidney Program alysis uses an access point that is put is Board Certified Nephrologist Chad in the arm during a surgical procedure and the dialysis machine pumps the Haroldson, MD. “The CentraCare Kidney Program blood out and through the dialyzer has developed a patient-centered team and returns the cleaned blood back approach, utilizing the latest medical into the body.
Hemodialysis patients also take medications to replace hormones their kidneys can no longer create. Peritoneal dialysis uses the blood supply in the large lining of your abdominal cavity. An access point is put into the abdomen and a solution called dialysate is sent to the midsection to absorb the waste and extra fluid and drains it out of the catheter. These patients may also need medications to replace hormones the kidneys no longer generate.
Patell says she chose nephrology for many reasons, “Mostly because it’s so interesting to me,” she said, “and managing the complexity of patients with kidney disease really keeps me on my toes. I love the detailed thought processes that go into caring for these patients. My goal is to treat my patients the way I would treat my own family members and to do whatever it takes to provide them with the best possible care.”
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International medicine —
CRMC OB NURSE USES EVER EVERYDAY YDAY SKILLS TO CHANGE LIVES IN HAITI
nts at a treats patie en tu es ag H elly OB nurse K ical Center ed M al n io Cuyuna Reg aiti. in Pignon, H mobile clinic
CROSBY — Delivering a baby is a life changing experience no matter where it takes place. For most women in the U.S., childbirth involves a controlled, sterile environment
with
plenty
of
medical
personnel present and the tools and technology necessary to ensure the safest delivery possible. This is the environment Cuyuna Regional Medical Center (CRMC) OB nurse Kelly Hagestuen works in everyday. And she loves it. Hagestuen’s passion for her everyday work is what has compelled her to share her expertise abroad so that women with less privilege have the same chance of health pregnancy, safe delivery and full recovery from childbirth. Since 2006, Hagestuen has traveled to Haiti nine
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Hagestuen examines an infant at a mobile clinic in Pignon, Haiti. Hagestuen has traveled to Haiti since 2006 to help treat patients and train medical staff.
times help educate and empower Haitian health care providers to improve the care provided to mothers and babies. “We really feel like we can make a huge difference,” Hagestuen said. On her first two trips to Haiti Hagestuen traveled with a surgical team to the city of Pignon. Not trained as a surgical nurse, Hagestuen said she most spent her time teaching nurses how to provide recovery care after surgery and what kinds of things to watch for post-operation. “Instead of just throwing patients in a room after surgery and letting them wake up when they wake up, the goal is to provide that extra education,” Hagestuen said, “And to listen to their stories.” Hagestuen was so moved by the stories shared, she said she knew she wanted to do more. “There’s just such an incredible need,” Hagestuen said. “I came home saying, ’This is something I want to do.” Feeling like she would be more effective in an OB educational setting, Hagestuen said she searched the
Internet for medical missions opportunities in Haiti and came across an organization called Midwives for Haiti. “I contacted them and just said, “I’m an OB nurse — I’m not an OBGYN, I’m not a midwife — but is there anything I could possibly do,” Hagestuen recalled. “Three days later I got a phone call.” Since 2010, Hagestuen has traveled to Haiti to serve with the Midwives for Haiti, whose goal is provide education on life saving intervention from prenatal care, delivery and postpartum care. The effort was just getting off the ground and Hagestuen said initial efforts involved working with mobile clinics to provide medical supplies to villages. The organization is also a school that prepares Haitian women to become midwives and skilled birth attendants as a greater effort to decrease the infant and mother mortality rate from preventable complications. Things like postpartum hemorrhaging can quickly lead to tragic loss. “But we can teach them how to stop (hemorrhaging) or understand when to intervene — that means
Cuyuna Regional Medical Center O B nurse Kelly Hagestuen (back row, center) along with clinical nurse educator Lis a Slepica (bottom left) served alongside a medica l team in Haiti. Ha gestuen and Slepica plan to retu rn to Haiti later th is spring.
Cuyuna Regional Medic al Center OB nurse Kelly Hagestuen is pictured with school childr en in Haiti. Hagestuen has traveled to Haiti since 2006 to help treat patients and train medic al staff.
You get so much more back than you even give. life,” she said. Hagestuen said what she loves most about working with Midwives for Haiti is they way they educate and empower nationals to take on the responsibility for themselves. Every graduate from Midwives for Haiti is employed either in a hospital or rural setting. “They’re not just going in and doing it for them,” she said. “They educating them in skills that are very basic, but they teach them to use them in a safe manner.” Hagestuen said in her time in Haiti she has witnessed the repercussions of poor birthing environments with unsanitary surgical conditions, rusted, out-dated equipment, and uneducated mothers with little recovery support. “It can be so devastating, but the goal is to teach them that it doesn’t need to be,” she said. Hagestuen recalled one experience when she was in the operating room where a cesarean-section was to be performed. Before the operation began, the doctor turned on the air conditioning unit and dust flew throughout what should have been a sterile environment “Thankfully, things have changed since then,” Hagestuen said. Often times, something as basic as access to care can be a challenge for Haitians. Women might have to walk
miles through rough terrain and extreme climate just to get to a prenatal visit making normally monitored issues like preeclampsia and high blood pressure a much greater risk factor. “It’s much easier if we can go to them,” Hagestuen said. Midwives for Haiti visits remote villages in its neon pink mobile clinic to take care to the women to cut back on the unnecessary increase in risk due to environmental factors. On Jan. 12, 2010, the day Haiti was devastated by a massive 7.0 earthquake, Hagestuen said she has a very clear memory of what she was doing when she heard the news. “I was packing,” she said. “I was set to go three days later.” Hagestuen said all that ran through her head was how fast she could get to Haiti and what she could do to help. “I know these people — these are friends,” she said. Three weeks later, Hagestuen was able to get to Haiti to help. “Their need for care continued,” she said. Hagestuen has returned to Haiti every year, except for 2015, “It killed me not to go,” she said. Hagestuen along with CRMC clinical nurse educator Lisa Slepica plan to return to Haiti later this spring. Hagestuen said though she’s returned so often each
KELLY HAGESTUEN
trip really puts things into perspective. “You get so much more back than you even give,” she said. “We are incredibly blessed by what we have here.”
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al Center ional Medic Cuyuna Reg tuen treats Kelly Hages OB nurse in Pignon, mobile clinic patients at a traveled tuen has Haiti. Hages p treat 2006 to hel to Haiti since staff. train medical patients and
By SARAH NELSON KATZENBERGER Contributing Editor Writer
‘It just hurt REALLY BAD’ APPENDICITIS
SIDELINES H O C K E Y P L AY E R
Logan and Wyatt Verville take center ice at the Breezy Point Ice Arena recently. Photos by Steve Kohls • steve.kohls@brainerddispatch.com
SYMPTOMS OF APPENDICITIS
BREEZY POINT— For 10-year-old Logan Verville, hockey is life. He’s been skating since he was 3, his dad, Steve, is a former player and coach and his younger brother, Wy Wyatt, 7, is also a hockey player. “I like to score a lot,” Logan said from the rink he’s been practicing at since he first learned to skate. “And I just like to be on the ice.” After scoring three goals in a home game last October, Logan’s mom, Diana Verville, said her son came home complaining his hip was hurting. Chalking the pain up to a hard fought game and typical post game soreness, Diana sent Logan to bed to get some rest. By morning, Logan was still in pain and told his mom he was worried about causing further injury at school and in gym class. “It just hurt really bad,” Logan recalled. With Logan
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being such an avid student and athlete, his parents knew it wasn’t like him to want to stay home from school. “I’m not really the mom who makes a big deal out of sick kids,” Diana said. “We don’t do a lot of meds. It’s just got to run its course.” With no fever, and no other real symptoms, Diana sent Logan back to bed, but she said she knew something was off. And she was right. Though he put on a brave front, Logan’s appendix had ruptured, something Diana has first hand experience with. Her own appendix ruptured when she was 7. “It was in the back of my mind for sure,” Diana recalled looking at Logan. “But you were just so tough.” Most cases of appendicitis occur between the ages of 10 and 30 and there is added risk for boys and men with family history of the illness. Logan was a prime candidate.
• Sudden pain that begins on the right side of the lower abdomen. • Sudden pain that begins around your navel and often shifts to your lower right abdomen. • Pain that worsens if you cough, walk or make other jarring movements. • Nausea and vomiting. • Loss of appetite. • Low-grade fever that may worsen as the illness progresses. • Constipation or diarrhea. • Abdominal bloating. Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen. The appendix doesn’t seem to have a specific purpose. Appendicitis causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes severe. Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.
By JOSHUA KEMPF, DO Contributing Writer
At the Breezy Point Hockey Arena recently, Wyatt (left), Diana, Steve, and Logan Verville talk about Logan’s close call with a ruptured appendix.
Logan was a prime candidate. Diana kept a close eye on Logan and when he woke up an hour or so later, she put pressure on his lower right abdomen, where he complained of pain the night before. It was still tender and Logan was starting to show other symptoms of appendicitis. It was time to see the doctor. Diana contacted the Essentia Health Clinic in Pequot Lakes, but was ultimately sent to the Essentia Health-Baxter Clinic for necessary blood testing. Logan underwent a blood test and a CT scan to confirm his appendix had in fact ruptured and he would need emergency surgery — something Logan was not excited about. “I thought they were going to put weird stuff on me. They told me I had to go to sleep,” he recalled. “I was really scared. I didn’t want to not wake up.” Logan said he remembers going into the operating room and later waking up to the anesthesiologist showing him a video of a great goal scored by the Minnesota Wild on his phone. “And I remember I got lots of popsicles,” Logan said. Appendicitis is fairly common, affecting approximately 1 in 1,000 people in the U.S. and providing the most common need for emergency abdominal surgery in children. However, the statistics provide little comfort for parents of children requiring emergency surgery. Even with her own personal experience with appendicitis, Diana said Logan’s experience was a nightmare. She said it wasn’t until she arrived home after Logan’s surgery that she really came face to face with her emotion. “I just lost it,” she recalled. “You stay strong for the kids — you’re just in mom mode, but of course you’re terrified.” Diana said there was a great deal of peace that came with working with the staff at Essentia who took time to talk directly to Logan and answer all of his questions. “We knew they really cared,” she said. After his surgery, Logan was eager to get back on the ice, even asking his mom to see if they could schedule his follow-up appointment sooner so his doctor could clear him to play again. Two weeks later, with a small, but “pretty cool” scar on his abdomen, Logan was cleared to play hockey again. He says his game is still better than Wyatt’s, but Wyatt is quick to point out, “Yeah, but you’re not as good as Dad.”
Osteopathic Medicine A H EALTHY T OUCH
The body has an inherent ability to heal and is truly a reflection of the master mechanic, our creator. Unfortunately, life comes with trauma and disease. The goal of Osteopathic Medicine is to find any dysfunction, fix it and allow the body to do the rest of the work. Osteopathic manipulative treatment consists of numerous forms of hands-on manipulation to the body’s muscles, bones, ligaments, and joints including restrictions that affect the nerves, blood vessels, internal organs and lymphatic system. For example, cervical and cranial restrictions are often found in people suffering from ear infections, upper respiratory infections, headache, migraine and vertigo. Restrictions in the rib cage and thoracic spine may contribute to or not allow a person to fully heal from pneumonia, bronchitis and other chronic breathing disorders including asthma and COPD. Pelvic floor disorders can lead to congestion which can play a substantial role in patients with urinary dysfunctions, prostate disease as well as pelvic pain. Rather than focus only a patient’s disease, Doctors of Osteopathy are trained to take a “whole person” approach toward finding health. Osteopathic medicine has been a part of Minnesota history for 120 years. In fact, the third Osteopathic medical school, the Northern Institute of Osteopathy was founded in Minneapolis in 1896 and later merged with the Des Moines Osteopathic medical school. Today there are over 600 Osteopathic physicians practicing in Minnesota. DOs are fully licensed physicians and along with their MD counterparts, are able to specialize in every medical and surgical field. Growing in popularity, there are 30 Osteopathic medical schools throughout the U.S. It is estimated that by the year 2019, one in four graduating physicians will be a DO. In addition to medicine, DOs learn OMT during four years of medical school and many continue this training during residency. Osteopaths may even go on to specialize in Neuromuscular Medicine and Osteopathic Manipulative Medicine. Osteopathic physicians with this additional training are well versed in recognizing and often treating patients with a variety of neurologic, rheumatologic, orthopedic and musculoskeletal dysfunctions. One of the
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tools available for treating this patient population is osteopathic manipulative treatment as often there is a mechanical component contributing to their disease symptoms. Osteopaths who specialize in manipulation are able to treat the whole body including restrictions in the head, the chest/rib cage, arms, legs, feet, pelvis/ sacrum and along the entire spinal column. Because the body is such a tightly connected network, a restriction in one part of the body can cause dysfunction and pain in another part of the body. A well trained Osteopathic Physician can recognize this important point to make correction of the most restricted area and affect the entire body including the nervous system, the circulation, the lymphatics, through the muscles, ligaments/tendons and bones. It is also important to apply the correct technique that best suits the patient’s particular dysfunction. Everything has to work in harmony for proper health. This includes the mind, body and spirit. The treatments are unique to each person’s body type, skeletal structure and health goals. Types of Osteopathic techniques include: myofascial, articulatory, muscle energy, indirect and cranialsacral. Most are gentle but powerful techniques used to restore normal structure and function. Examples of patients who may benefit from Osteopathic manipulative treatment include those who experience: • Acute or chronic back and neck pain. • Migraine and headache. • Misshapen head, feeding difficulties, colic and torticollis in newborn and pediatric patients. • Joint pain, arthritis and soft tissue sprains and strains as a result of sports injuries. • Pelvic pain. • Pain during and after pregnancy. OMT can help restore normal function by relieving dysfunction that is causing or contributing to one’s symptoms and/or disease. This may be one of the best forms of preventative medicine with the least side effects. OMT can promote healing, ease pain, reduce stress by relieving mechanical restrictions in the musculoskeletal system, balance the autonomic nervous system, and improve overall mobility. DR. JOSHUA KEMPF, DO recently joined the Family Medicine Department at the Essentia Health St. Joseph’s-Baxter Clinic in Baxter, and specializes in Osteopathic Manipulative Treatment. To schedule an appointment with Dr. Kempf, call 218-828-2880. To see his full profile, visit EssentiaHealth.org and click on “Find a Medical Professional.”
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