HealthWatch Magazine Summer 2014 by Brainerd Dispatch and Echo Journal

Table of Contents Who we are Publisher • Tim Bogenschutz Advertising • Susie Alters and Phil Seibel Editor • Sarah Nelson Katzenberger Cover Design • Jan Finger Contributing writers Jenny Holmes, Sheila Helmberger, Jessie Perrine and Jodie Tweed

Learning about labels . . . . . . . . . . . . . . . . . . . . . . . Nutrition labels and what they really mean

By Sheila Helmberger

Technically sleeping . . . . . . . . . . . . . . . . . . . . . . . Chronicles of a voluntary sleep study

By Amber Houselog

When good weather brings bad allergies . . . . . . . .

By Dr. Minto Porter Healthwatch is a quarterly publication of the Brainerd Dispatch.

Read Healthwatch online at www.brainerddispatch.com

Furry therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . Brainerd couple shares four-legged friends just to bring joy to strangers

By Jenny Holmes

Change of heart . . . . . . . . . . . . . . . . . . . . . . . . . For advertising opportunities call Susie Alters at 218-855-5836. Email your comments to sarah.nelsonkatzenberger@brainerddispatch. com or write to:

Sarah Nelson Katzenberger Brainerd Dispatch P.O. Box 974 Brainerd, MN 56401

Pequot Lakes man changes his lifestyle after life-saving angiogram

By Sarah Nelson Katzenberger

Falling on deaf ears? . . . . . . . . . . . . . . . . . . . . . . Hearing loss is more common than you think

By Jessie Perrine

Doctor’s orders . . . . . . . . . . . . . . . . . . . . . . . . . . . Dealing with urinary incontinence

By Cuyuna Regional Medical Center

Rapid Recovery . . . . . . . . . . . . . . . . . . . . . . A game-changer for joint replacement surgery

By Jodie Tweed

CRMC offers minimally invasive procedure . . . . . for the treatment of GERD

By Dr. Rachel Cady

On the cover Traci and Donny Vosen with their dogs Briley and Boston. Steve Kohls • steve.kohls@brainerddispatch.com

Learning about labels By SHEILA HELMBERGER Contributing Writer

Nutrition labels and what they really mean

he only numbers we looked at before we purchased something at the grocery store used to be the price.

These days we can learn all kinds of things about the food we eat from the labels on the packaging — like how much we should have, and what exactly is in it. Reading all of those labels can mean doing a little bit of math, but it might also change some of the choices we make when it comes to the things we eat, drink, and snack on. Jamie Withrow, a clinical dietician at Cuyuna Regional Medical Center (CRMC), said the biggest surprise on the labels for most of us is probably how much we should be eating. “The first thing to look at when you are reading a label is the portion size. And then measure it out,” she said, “For example, find out how much cereal should be in a bowl. Something like granola might only be a third of a cup for a serving. Then everything on that label would have to be adjusted accordingly if you have more than a third of a cup.” Next, look at the total calories there is per serving. If you are eating double the servings, then don’t forget you have to double the calories and nutrients you are eating too. There are buzzwords now that get our attention and make us sigh with a sense of relief when we shop, like ‘fat free’ and ‘low fat’. An item that is fat free will have less fat but often has other undesirable ingredients added as a substitute. “When manufacturers take the fat out of a product, they often have to add in more sugar and sodium to improve the taste and mouth-feel for customer satisfaction,” said Withrow. “And that does not mean it’s better for us.“ “I’m a firm promoter of good fat. Sugar is more damaging to our health than the fat will ever be,” said Withrow. “The added sugar in our food is part of the reason that low-fat diets rarely work. Fat isn’t that bad for us. My opinion is the regular item is often better. That’s not across the board, but look at the rest of the label and you might be surprised.” Ingredients are typically listed by weight. That means if sugar is one

of the first items on the list, diabetics and others limiting their sugar intake should take note that, because there’s probably a lot of it in the product. Sugar is also listed as other names on our food labels so be sure to look for words like corn syrup, dextrose, honey, fruit juice concentrate, maltose, sucrose, and maple syrup. Withrow has another tip to keep in mind when you are shopping the aisles at the grocery store: “The shorter an ingredient list is, the better it probably is for you. Fat free products usually have a list that is quite a bit longer.” One important change to our labels is on the way. “Food companies are going to be forced to use more realistic portions,” Withrow said. “Some of the things that people buy regularly, ice cream for instance, trail mix, even Pop Tarts look like they are packaged in single servings, but a lot of times they are packaged in two servings, and sometimes more.” The information on the food labels can guide us in purchasing items high in some of the content we should be getting, too, like 100 percent of our fiber, vitamins and other nutrients. The daily percentages on our products are often based on a 2,000 or 2,500 calorie per day diet. Know what your daily target is and then vary your calorie intake accordingly if you are looking to gain, lose, or stay at a certain weight. Health experts recommend that you keep your intake of saturated fat, trans fat and cholesterol as low as possible for a balanced diet. On the flip-side, a lot of us need to eat more fiber, vitamin A, vitamin C, calcium, and iron. Getting enough calcium reduces the risk of osteoporosis. A diet high in fruits, grain and vegetables that contain fiber and are low in saturated fat and cholesterol might help reduce the risk of heart disease.

By AMBER HOUSELOG Special contributor, Lakewood Health System

Technically sleeping Chronicles of a voluntary sleep study

here are some things in life you just need to experience for yourself. Whether it’s in order to have a great story to tell at parties, being able to say you did it, or just for the experience itself,

each situation and person is different.

In my case, I wanted to dispel some misconceptions, and maybe find a way to ease not only my reservations and apprehension, but those of others as well. And so, one Monday evening, with my photographer/co-worker Emily at my side, promising to not take too many embarrassing photos, I prepared for my first sleep study. During a sleep study, a patient’s sleep patterns are observed and monitored for possible sleep problems. Things like excessive daytime sleepiness, loud or disruptive snoring and gasping or choking during sleep are a few of the more common symptoms associated with a disorder called sleep apnea. Sleep apnea is caused by the airway closing and preventing the flow of air into the lungs. Because of this, patients can experience pauses in their breathing, which can occur 30 times or more in an hour. Without treatment, sleep apnea can cause serious health conditions that may lead to high blood pressure, heart disease, stroke or heart attack. While my reason for doing the study had little to do with health, I hoped the end result would help those whose reasons were. Walking into the room, I was pleasantly surprised to see that instead of the sterile, hospital-like room I was expecting it was instead much more akin to a hotel room, complete with a private bathroom, coffee maker and television. A couple of differences between a hotel room and the sleep study room are the camera on the ceiling and the large piece of equipment sitting next to the bed, to which 24 electrode wires are hooked. These small, colorful wires are laid out on the bed when I entered, causing some appar-

ent apprehension to cross my face. This look, trodes on my face, to track eye and chin movein turn, caused Lakewood Health System sleep ment; two on each leg to monitor leg movetechnician Emma Howe, who had also just en- ment; two on my collar bone and four on my tered the room from the adjacent observation torso, all to monitor my heart; eight on my room, to give me a small laugh and an under- head to monitor brain waves, and a sensor on standing look. my finger to monitor my heart rate. Having worked at Lakewood for about six By the time I was fully hooked up and in years, Emma has done hundreds of studies, bed, I also had a cannula in my nose to moniand has pretty much seen it all. Her experience and knowledge are obvious in the way she answers questions, talks you through the study and is able to put at ease whatever apprehension, fear or curiosity a patient may be experiencing. As one would imagine, the idea of being hooked up to wires and other equipment while sleeping in a strange room, knowing someone in the next room is watching don’t exactly scream “FUN!” However, I immediately felt more comfortable as Emma began to explain the process; though the clicking of Emily’s camera reminded me that in my case, whatever happens here, will not stay here… Though my study was a shortened (three hours) version of the normally 10 hour study, I experienced everything an average patient would, except the eight hours of sleep. After I changed into my pajamas, I was seated on a chair by the bed while Emma explained the next step: attaching the electrodes. As she attached each electrode, she explained what information it will monitor and why it’s important to have that information recorded. • Submitted photo In total, I ended up with six elecLakewood Health System sleep technician prepares sleep study patient Amber Houselog for a wired-up night of rest.

“While my reason for doing the study had little to do with health, I hoped the end result would help those whose reasons were.” tor my breath temperature. Each electrode is painlessly attached with a temporary adhesive, which is easily removed after the study. A disclaimer for those with hair: while water soluble and easily removed when washing your hair, the adhesive pomade used to attach electrodes to your head is a little sticky, so if you’re going out in public immediately following your study, perhaps have someone check you over first. I may have learned that the hard way. After being hooked up, I got in bed while Emma attached all the wires to the monitoring device next to the bed. With a few final instructions from Emma, and a few more pictures taken by Emily, they turned off the light and left the room. Surprisingly quiet and dark, it took me a few minutes to adjust and get my bearings, all while being very aware of the camera on the ceiling, aimed at me. Through a speaker next to the bed, Emma administered a quick test of ‘do this’, ‘move that’, ‘snore louder’ in order to make sure everything was working and hooked up correctly. With that being done, I was on my own. I’ll be honest, I didn’t think, especially with my shortened study, I’d fall asleep. There were a lot of thoughts going through my head, I knew two people were watching me in the next room and I was hooked

up to a machine with 24 wires. All that being said, I slept for about an hour. The wires were surprisingly non-obtrusive and really did move with you, as Emma had predicted they would. On occasion an electrode may become detached and it will need to be reattached, during which time the sleep technician may need to wake you up. After I woke up, to give me the full experience, Emma had me put on the continuous positive airway pressure (CPAP) mask. This mask is the top treatment for those with sleep apnea, and if, during a patient’s first sleep study, they are found to have symptoms of the disorder, they are brought back for a second study, which is conducted while they wear the mask. It helps to open the airway, ensuring patients are able to breathe properly while they sleep. When all was said and done, I sat on the bed while Emma removed all the electrodes and answered the barrage of questions Emily and I were firing at her. Then I got the behind-the-scenes tour of what goes on in the observation room during the study. I was able to see the information the electrodes collected and sent, what all the squiggly lines on the screen meant (to those who know what they’re doing anyway) and what exactly it is Emma does with the information. In an average study, the sleep technician goes

Amber Houselog awaits final instructions from sleep technician Emma Howe before drifting out of a highly monitored state of consciousness.

through the eight hours of a patient’s sleep study and makes note of events, or disruptions, in the sleep patterns that may indicate sleep apnea. Once those events are noted, the information is sent to a board-certified sleep physician who will review it and determine next steps. If sleep apnea is diagnosed, the patient will meet with their physician to discuss treatment options. Among the many things I learned during my study were some interesting facts, like the average age of a sleep study patient is between 55 and 60, more studies are done on women than men and studies can be done on patients as young as 13. While perhaps not the most glamorous three hours of my life, it was an experience I’ll not soon forget. Like many, I’d often wondered about the mysterious sleep study and it’s oh, so many wires. And now I know far more than I’d ever have thought. My misconceptions and apprehensions erased, I would recommend the sleep study program to anyone who may have symptoms, or just feel they would benefit from a study. But I suggest leaving the photographer at home. If you think you could benefit from a sleep study, talk to your provider. For more information about sleep studies call 218-894-8291 to speak with either of Lakewood’s sleep techs, Emma Howe or Amanda Shaw.

By DR. MINTO PORTER Allergy and asthma specialist Essentia Health - St. Josephâ&#x20AC;&#x2122;s Brainerd Clinic

When good weather brings on bad allergies

s we look forward to springtime, many of us dream of warm beautiful days filled with hiking, biking, gardening and a host of other outdoor activities.

For some, season changes and warm weather can bring itchy eyes, runny nose, sneezing, sinus conges-

and fall months. An allergy means that our immune

tion and even difficult breathing:

system produces an antibody (IgE)

symptoms of allergies.

against an otherwise harmless ele-

For over 50 million Americans, seasonal allergies may prevent them

from enjoying the spring, summer

ment in our environment.

Common spring allergens in Central

Minnesota include trees such as birch, ash, oak, maple, and hickory which will cause allergy symptoms as they pollinate, typically occurring in mid-March until late May. Unfortunately, as tree pollen dissipates, we begin grass season, which begins in early May and lasts until early June. While late June and July may provide allergy sufferers with a brief respite to their symptoms, this relief is often short-lived as we progress into weed season. Common ragweed as well as other weeds such as lambsquarters, pigweed, sagebrush and English plantain pollinate mid-August until the first frost. Seasonal changes can also increase outdoor mold activity, producing literally billions of airborne spores which can trigger similar symptoms. Rural residents may sometimes consider relocating to a more urban environment, but pollen can travel over 300 miles so even such drastic moves may prove futile. Most allergy sufferers require daily medications which may include antihistamines, nasal sprays, eye drops, decongestants or even sinus rinses. For patients who do not receive adequate relief from their daily medication regimens, allergy shots can provide long term, permanent treatment of their seasonal allergies. Allergy shots (immunotherapy) have been successfully used for well over 100 years and help the body develop a protective antibody (IgG) against the various allergens many people suffer from such as pollens, pets, and dust mites.

“As winter draws to a close and we look forward to longer days, allergy sufferers may feel they are destined for weeks or even months of misery ...” While immunotherapy requires a significant time commitment - shots may need to be continued on a regular basis for three to five years - the time commitment is well worth it, as most will receive nearly lifelong improvement in their allergy symptoms. Individuals with asthma often will experience more symptoms during times of season change due to increased allergen exposure as well as frequent weather fluctuations. If you have a history of allergy induced asthma, now is a perfect time to check in with your doctor to assure your asthma is under optimal control before the weather changes and to assure you have plenty of refills for the spring, summer and fall. It is imperative to take your physician-prescribed controller asthma medication on a regular basis before the weather is expected to warm up to assure good asthma control. Allergies can cause more than sneezing and itchy eyes; warm weather also brings out stinging insects that can cause severe anaphylaxis or even death for some individuals. In the Midwest, we have five stinging insects that can cause anaphylaxis, including: yellow jackets, white-faced hornets, yellow-faced hornets, wasps and the honeybee. Anaphylaxis resulting from a sting can cause

a person to experience difficult breathing, hives, itching, throat swelling, drop in blood pressure and even loss of consciousness; individuals experiencing these symptoms after a sting need immediate medical attention. People with a history of this type of reaction to a sting should carry a minimum of two doses of injectable epinephrine, which is the only medication that can prevent an episode of anaphylaxis from progressing. These people should also undergo allergy testing for the five stinging insects mentioned. Stinging insect allergy can also be treated with allergy shots, which can greatly reduce the risk of anaphylaxis and death with subsequent stings. It should be noted that although a large amount of swelling at the site of a sting can be painful and dramatic, it alone is not typically an indication for allergy testing or shots. As winter draws to a close and we look forward to longer days, allergy sufferers may feel they are destined for weeks or even months of misery, however with new medications and other therapies available we should all be able to get out and enjoy the warm weather!

• Submitted photo

Dr. Minto Porter is an allergist and asthma specialist at Essentia Health St. Joseph’s - Brained Clinic.

For an appointment with Dr. Minto Porter, Allergy and Asthma Specialist at Essentia Health St. Joseph’s - Brainerd Clinic, call 218-828-2880.

By JENNY HOLMES Contributing Writer

Furry therapy Brainerd couple share four-legged friends just to bring joy to strangers

trip to your local Department of Motor Vehicles would hardly constitute as therapeutic. But Traci and Donny Vosen have significantly changed that stigma over the past several years.

The Vosens, who operate the DMV office in Brainerd, have always loved dogs and recognize the powerful ways dogs can diffuse stressful situations — which, for some, includes getting new license tabs or renewing a driver’s license. So the Vosens have enlisted the help of their two gentle giants to bring a sense of calm to their workplace. And Briley and Boston have gladly taken on the 9-to-5 pace to do their part. Boston, an 8-year-old Golden Retriever, was Traci’s first experience with training a therapy dog. Prior to owning Boston, the couple had smaller terriers. But something just clicked with this guy. “I decided to try some basic obedience with him, and he was so easy to train,” Traci recalled. “We also took him when he was about 10-months-old to hunt and we were surprised to see how well he did.” Traci trained Boston for therapy dog certification through the Brainerd Kennel Club, where she met Carol Manley. “Carol picked up on my passion for training and suggested we also try competition training,” Traci said. “So we went to a dog show to watch how it was done and I decided, ‘yeah, I want to do this!’” While Boston caught on quickly to commands; and, despite passing his therapy certification with flying colors — Traci could tell he was more interested in pleasing his handlers than pleasing others. That drove both Traci and Donny to add a second dog to their family. “We primarily wanted a second hunting dog, but once we saw this one’s temperament, we knew we wanted to pursue therapy work with him and continue to focus on obedience with Boston.” Enter Briley — a, now, 7-year-old Gordon Setter. Don’t let his droopy brown eyes fool you. Steve Kohls • steve.kohls@brainerddispatch.com

Traci (left) and Donny Vosen with their dogs, Briley and Boston.

“When you’re coming in to give your money to the government, you tend to get people who aren’t so happy ... but there are people who will come in and ask for the dogs.” “He’s always happy,” Traci said. “He is the happiest dog I’ve ever known, no matter what. And clingy.” “He doesn’t look like it,” Donny said of 72pound Briley, “but he’s a lap dog.” Together, the dynamic duo — also dubbed the ‘DMV Dogs,’ — show up to work each day and do their rounds behind the counter. Occasionally they’ll belly up, paws on the desk, and gladly take a head pat or scratch behind the ears by willing visitors. “We’ve noticed that it really diffuses people,” Traci said. “When you’re coming in to give your money to the government, you tend to get people who aren’t so happy,” Donny added. “But there are people who will come in and ask for the dogs.” “And everybody has a dog story,” Traci not-

ed. “And all of a sudden they forget why they were upset.” In addition to bringing a calming factor to the public, Boston and Briley also offer a sense of relaxation to the staff. “This place can get stressful. It gets busy,” Donny said, adding that having the dogs around relaxes staff. And the dogs recognize and respect those who aren’t dog fans and keep their distance. When the dogs aren’t doing their pro bono work, the Vosens also take advantage of other opportunities throughout the community where therapy dogs are requested. One of Traci and Donny’s favorite memories was when Briley was 2 and they took him to Nisswa Elementary School to “read” with children. The Vosens were instructed to sit with one

particular student who, they were told, struggled with reading and just to get him to sit still and read to the dog would be wonderful. Lo and behold, the student read through three books without hesitation. “I remember looking at the teacher and her jaw was on the floor,” Traci said. The couple has also taken the dogs to Essentia-St. Joseph’s Medical Center to visit various floors upon request. Donny particularly noted a visit to the Grace Unit. The couple admitted to feeling hesitant at first, but said they immediately saw the benefit to having the dogs there. “There were bedridden people who responded so positively to the dogs,” Donny said. “As tough as things were for them, you could see it and feel it when their faces softened as they saw and touched the dogs.” See DOGS, Page 12

Steve Kohls • steve.kohls@brainerddispatch.com

Boston rested on his bed at the Brainerd DMV operated by his owners, Traci and Donny Vossen.

Briley and Boston followed owners Traci (front) and Donny Vosen through the Brainerd DMV.

The Vosens receive requests from hospice, individuals for one-on-one contact and visits, nursing homes, schools for reading, and also visit Central Lakes College twice each year during finals week for student stress management. Because of liability reasons, individuals wanting to do therapy work with their dog must go through training together and become certified as a team. Traci, herself, offers courses along with friend Barb Schilling through the Brainerd Kennel Club at Hunt’s Point near Pequot Lakes. “There’s a lot to learn,” she said. “We cover what it’s all about to be a therapy dog, being a team, what makes a good therapy dog

… We cover worse case scenarios, including watching out for IV cords with tails, different commands, overcoming distractions, visiting with people in wheelchairs. We do field trips, practice in elevators and stairways. And, most importantly, leaving the tennis balls alone from the bottoms of walkers,” she laughed. “When I tested, nobody told me all of that. So we are here to teach people and prepare them.” Traci said she highly recommends basic to novice obedience training before attempting therapy training. “The certification process has gotten more intense over time.” But once a team becomes therapy certified through BKC’s class, if interested they are put

Steve Kohls • steve.kohls@brainerddispatch.com

into a local database and linked up with various volunteer opportunities throughout the community as they become available. Observing a typical Tuesday morning at the Brainerd DMV, Boston and Briley certainly know how to work the crowd. Boston shows off a big red ball, as large as his head, while Briley plays with a piece of cardboard given to him by a DMV employee. “There’s so much reward that comes in being a handler,” Traci said. “There’s something so special about a therapy dog. You just need to find that special dog to make it as a therapy team. An obedience-trained dog, oftentimes, is more into pleasing their handler. But a therapy dog wants to please others.”

Just what the ‘dog’tor ordered There are at least five scientifically-proven health benefits of therapy dogs... 1. Lowering blood pressure High blood pressure is often associated with rapid heart rate, anxiety, or stressful life. In many cases, such conditions are mainly psychological problems which can be cured by certain therapy methods. It is a fact that petting a dog can create a positive atmosphere such as friendship and affection. This type of therapy is often practiced to reduce anxiety that will finally lower blood pressure and heart rate. 2. Lowering levels of Epinephrine and Norepinephrine Epinephrine and Norepinephrine are both important neurotransmitters which are highly essential hormones in the brain. They are nervous system stimulants; the human body needs the proper level of these substances to reduce depression or anxiety. They affect heart rate, blood pressure, glucose level, and many other important factors related to proper functioning of the body. The interaction created between human and therapy dogs is a nonmedication cure that helps to lower the levels of epinephrine and norepinephrine. Most people will agree that petting a good dog will relax the mind, which will eventually promote healthier conditions. A scientific study revealed that patients who received visits from therapy dogs experienced greater decrease of norepinephrine and epinephrine compared to patients who only received visits from volunteers. 3. Reducing patient anxiety Therapy dogs often visit hospitals and other health institutions. As a matter of fact, many hospitals are greatly helped by the animals in reducing patients’ anxieties before certain health examination, for example MRI scanning.

Steve Kohls • steve.kohls@brainerddispatch.com

4. Increasing the level of endorphin One of the greatest benefits of therapy dogs is increasing the level of endorphin. It is a natural substance produced by the body, which works by manipulating the perceptions of pain or stress. Endorphin is a neurotransmitter in the brain and it has very similar functions to opiate drugs. However, Endorphin does not lead to any type of addiction as commonly found with chemically processed drugs such as morphine or codeine. Petting a therapy dog brings happiness and the feeling of euphoria; such conditions promote better immune response, and reduce the negative effects of stress. 5. Increasing the level of oxytocin Additional benefits of therapy dogs are that the animals can boost happiness, improve empathy, stimulate better pair bonding, and promote happier life. Therapy dogs can do all these things by simply increasing the level of oxytocin — the hormone that plays a major role in breast feeding, sexual reproduction, and other maternal behaviors. Some suggest the interactions between therapy dogs and human will increase the level of oxytocin. Both physical and psychological aspects are greatly affected. The best benefits of therapy dogs are that they can simply bring healthier and happier life. The positive interactions affect the releases of many important hormones and neurotransmitters in the brain which promote proper body functions.

By JODIE TWEED Contributing Writer

Change of heart Pequot Lakes man changes his lifestyle after life-saving angiogram

ark Jurchen figured his lingering chest cold had developed into pneumonia, and didn’t even think to mention it to his wife, Trudy, when he took off from Pequot Lakes to Baxter for an Urgent Care visit on Jan. 15, 2013.

Jurchen thought the doctor would simply give him an antibiotic and he’d be on his way. Instead, Dr. Paul Carey took note of Jurchen’s family history and symptoms – his lungs were clear – and urged him to go to the Emergency Department at Essentia Health-St. Joseph’s Medical Center. Carey believed Jurchen had coronary heart disease and was at risk for a heart attack. Jurchen took his advice and checked in at the Emergency Department, where he happened to find his family doctor, Dr. Brett Nienaber, working a shift there. Tests revealed that he had suffered a small heart attack and was at high risk for another. Dr. Michael Rich, a cardiologist at the Brainerd Lakes Heart and Vascular Center, was called in. “I was coughing up phlegm. I thought my lungs were full of fluid and instead, my arteries were 95 percent and 80 percent blocked,” recalled Jurchen. “When your arteries are blocked like Mark’s, he was really having symptoms every day,” explained Rich. Jurchen underwent an angiogram the next morning, which identified where his coronary arteries had narrowed due to blockage. Dr. Mark Johnson, an interventional cardiologist at Brainerd Lakes Heart and Vascular Center, placed two stents inside the major artery in Jurchen’s heart that had blockage. Jurchen spent one more night in the hospital before he was able to go home. Jurchen, 63, said it didn’t occur to him that he could be suffering from heart disease because he’s always tried to take care of himself. He walked or ran each morning and played basketball. But after his diagnosis, Jurchen realized that he did remember experiencing chest

discomfort that was likely the small heart attack, and he would experience a tightness or chest pain after physically exerting himself. After his heart event, Jurchen started taking statins, blood pressure medications and nutritional supplements. He and his wife are eating healthier and speed walk four to five miles nearly every day. They have both lost about 30 pounds. “I had all the symptoms of what I thought was pneumonia, but they are also the symptoms of heart disease,” said Jurchen, who is the agency manager at Lakeland Insurance Agency in Pequot Lakes. “I wasn’t one who went to the doctor very much, but I am now. If you’re having any symptoms, you need to go in and get it checked out.” “Mark is truly the epitome of what we hope our heart patients do after a risk like this,” said Rich. “Mark was a pretty healthy guy already, but he’s been able to make some substantial improvements with diet and medications.” Jurchen said the angiogram was a relatively simple and pain-free procedure that he had on a Thursday, and he was able to return to work on Monday. He said he felt good about the care he received from the moment he walked into Urgent Care until the stents were implanted, all within a 24-hour period. Johnson said that Jurchen’s angiogram was performed using a thin catheter accessed • Submitted photo

Mark Jurchen speed-walks every day to help keep his heart healthy. He thought he was suffering from pneumonia last winter but instead needed two stents to open a narrowed artery in his heart.

“I had all the symptoms of what I thought was pneumonia, but they are also the symptoms of heart disease.”

The Brainerd Lakes Heart and Vascular Center team at Essentia Health – St. Joseph’s Medical Center provides patient and family centered care (L to R): Nurse Practitioner Rebecca Wirtz; Radiology Technologist Kara Staniger; Martha Jendro, RN; Nurse Practitioner Annie Kvamme; Patient Mark Jurchen; Cardiologist Dr. Michael Rich; Interventional Cardiologist Dr. Mark Johnson; Jane Curran, RN; Radiology Technologist Melinda Garnhardt; and Registered Cardiovascular Invasive Specialist Brian Lahr.

through his leg. However, for the last several months he and his staff have been performing the procedure by accessing the arteries in a patient’s wrist. Patients tend to be more comfortable following the procedure. Johnson said about 75 percent of angiograms are now done through

the wrist at the Brainerd Lakes Heart and Vascular Center. Rich said if you’ve had ongoing symptoms, including chest pain while at rest, you need to see a doctor immediately. Don’t wait three or four hours at home to see if the pain subsides,

call an ambulance, he said. Emergency personnel have the training and equipment to take care of you and potentially prevent permanent heart damage and perhaps save your life. Don’t get in your car and drive yourself to the Emergency Department, he said.

“I feel better than I’ve felt in a long time,” said Jurchen. “I look at it as a second lease on life. I’m very thankful. The folks at Essentia did a great job.” JODIE TWEED is a freelance writer living in Pequot Lakes.

CUYUNA REGIONAL MEDICAL CENTER

CRMC offers minimally invasive procedure for treatment of

GERD C

uyuna Regional Medical Center (CRMC) in Crosby is one of three places in Minnesota where patients can obtain a new, minimally invasive treatment for Gastroesophageal Reflux Disease (GERD). The LINX Reflux Management System is a new, U.S. Food and Drug Administration-approved medical device.

CRMC’s Minnesota Institute for Minimally Invasive Surgery (MIMIS) surgeons are trained to perform the state-of-the-art procedure. The two other locations are the Mayo Clinic and Abbott Northwestern Hospital. Gary Norwood of Merrifield was the first patient to have the LINX device implanted at CRMC. The 45-year-old had been taking Nexium daily for four or five years. Sometimes it worked and sometimes it wouldn’t. “Then it started getting worse, just about every single day and every time I ate,” he said. Norwood’s wife works for MIMIS’ Dr. Howard McCollister and when she mentioned her husband’s trouble, the surgeon suggested that he come in. He had the surgery on a Friday, was out of the hospital on Sunday, and back at work excavating on Monday. Now he has no reflux and takes no medication. “You gotta eat a little slower. You have to eat slightly smaller portions,” he said. “If I eat too fast, I feel a little cramping pain because the magnet doesn’t release pressure fast enough.” LINX is recommended for patients 21 years and older who have been diagnosed with GERD and continue to have heartburn or regurgitation despite taking medication. GERD is a chronic, often progressive disease resulting from a weak lower esophageal sphincter. Numerous studies have shown that reflux

symptoms persist in up to 40 percent of patients who receive acid suppression medications and that these symptoms have a negative impact on quality of life and health care utilization. “The biggest challenge in treating patients with GERD is that medicines available alleviate the

Merrifield resident Gary Norwood was the first patient to have the LINX device implanted at CRMC.

“You gotta eat a little slower. You have to eat slightly smaller portions. ... If I eat too fast, I feel a little cramping pain because the magnet doesn’t release pressure fast enough.” symptoms but are unable to treat the underlying problem of a weak sphincter,” said Dr. McCollister. “The only other surgical option, Nissen fundoplication, was developed decades ago and involved wrapping the stomach around the esophagus like a collar. While this operation is very effective, it can be associated with side effects that can be a problem for some patients. LINX is an excellent alternative that is designed to treat the group of patients for whom medication isn’t totally effective, and for whom fundoplication surgery is much more than they need. That’s a lot of people...about 30-percent of the nation’s GERD sufferers.” The LINX System is a small implant comprised of interlinked titanium beads with magnetic cores.

It allows surgeons to leave the stomach intact and support the weak sphincter with a small device placed around the sphincter. The device uses magnet attraction to help prevent the sphincter from opening to reflux. A recently study by the New England Journal of Medicine reported that after sphincter augmentation with the LINX System, the majority of patients were able to substantially reduce or resolve their reflux symptoms, while eliminating use of reflux medications. Severe regurgitation was eliminated in 100- percent of patients and 93-percent of patients reported a significant decrease in the need for medication. 94-percent of patients reported satisfaction with their overall condition after having the LINX System, compared to 13percent before treatment while taking medication.

By SARAH NELSON KATZENBERGER Healthwatch Editor

Rapid Recovery C

A game-changer for joint replacement surgery

ROSBY — Joint replacement is a big deal. It’s a surgery that involves hammers and chisels and lots of post-surgery pain. At least it used to.

The whole joint replacement protocol has gotten a makeover at Cuyuna Regional Medical Center (CRMC) in Crosby and Riverwood Healthcare Center in Aitkin. Thanks to new technology that changes the way anaesthesia is administered, patients are experiencing less pain, quicker mobility and less time in hospital care after their operation. Drs. Erik Severson and Leo Chough, both orthopedic surgeons, have worked with anesthesiologists, Drs. Fawn Atchison and Mark Gujer to develop a new protocol that was modeled after similar programs in Columbus, Ohio and Chicago. “We kind of tweaked it a bit and made it our own,” Severson explained. Severson said the new protocol drastically cuts the pain patients experience and reduces the time they spend in the hospital post-operation. “We’ve cut the length of stay more than in half,” Severson said. “Our discharge criteria is exactly the same. The patients are so comfortable and confident, they want to go home.” Severson explained the change is not

in the surgical procedure — it’s based on the approach to patient service. Nurse Adam English is available to patients 24 hours a day seven days a week for any post-op questions they have plus any other questions they have about anything. “He’s basically like a joints concierge,” Severson said. “(Patients) call him for whatever they want.” Severson credits English’s accessibility with the height in patient satisfaction. The procedural side of Rapid Recovery involves a change to the way patients receive anaesthesia . With a standard joint replacement, anaesthesia is administered through a catheter nerve blocker which tends to limit a patient’s mobility post-operation. Rapid Recovery involves an enhanced pain management regimen administering a combination of medications before, during and after surgery. Atchinson said patients are far more mobile post-op and face fewer side affects — like nausea and pain — making

Steve Kohls • steve.kohls@brainerddispatch.com

CRMC ortheopedic surgical staff discussed the way rapid recovery is changing how patients recover after joint replacement surgery.

them ready for physical therapy and ulAt 67, Johnson said she is active timately ready to go home sooner. Prior and healthy having never had any mato Rapid Recovery she felt that CRMC jor health problems. “No one believed had a pretty good orthopedic program. me when I told them something was “After the initiation of this program, we wrong,” she said. “It just hit me really had different patients who had a prior hard and fast.” joint replacement under the previous Johnson said she sought out help regimen,” she said. “Even those pa- from Dr. Chough because of friends tients’ satisfaction is much higher.” who had been patients of his. “I just In addition to the fast recovery time, knew I had to see him,” she said. Severson said Rapid Recovery has cut She said she spent one day in the down on post-op complications, re- hospital following her minimally invaadmission and infection. “It’s because sive surgery at CRMC. Within a couple these people are not on a lot of narcot- of weeks, she was back to walking on ics,” he said, adding the old protocol her own — minus some help from a contributed to surgical patients becom- cane when going up and down steps. ing a fall risk once they return home. “Now it feels like I never had any probRandall resident Ricky Turner was lem at all,” she said. “It is just like I used a two-time hip replacement patient of to be.” Severson’s. Turner, 55, said he had one Severson said Rapid Recovery ofhip replaced under the old protocol ficially began in July 2013. As of early and one with Rapid Recovery. April 187 patients have had a joint reWith his first surgery in June 2013, placed under the new protocol. BeTurner said he spent five days in the tween the two hospitals, the surgeons hospital. “You’re more tired. You can’t are able to collect all of the data from pull out of that anaesthesia,” Turner re- each patient to discuss with the Rapcalled. id Recovery team. “We meet and talk After his second surgery in Decem- about constant improvement,” Sevber, Turner said he was discharged af- erson said. “We’re able to learn from ter 25 hours. “I was ready to go in 20, what we’re doing.” but they said they had to hold me for Severson said the only reason this 24 (hours),” Turner said. Turner said the is so successful is we have had compart of the Rapid Recovery that made it plete cooperation from Atchison and something he would recommend was Gujer as well as the entire orthopedics his access to Adam English after being department. Severson said the anesdischarged. “I can contact him 24-7,” thesiologists completely retrained the Turner said. “That makes you feel bet- post-anaesthesia care unit and all of the ter. It’s nice to know you can contact nursing staff, and the surgeons worked someone immediately and they can get with the physical therapy department to in touch with the surgeon. And Adam change their standard treatment under always picks up.” the new protocol. Mary Beth Johnson of Baxter said “This is not something that is neceship replacement was the furthest thing sarily translatable to any facility,” Severfrom her mind when she found out she son said. “It kind of this perfect blend would either need surgery or to live of people that made this possible.” with debilitating pain caused by osThe Rapid Recovery program at teoarthritis. CRMC and Riverwood is the one of “I couldn’t walk. I knew I had to do only of its kind in Minnesota. something,” Johnson said. SARAH NELSON KATZENBERGER may be reached at sarah.nelsonkatzenberger@brainerdispatch.com or 855-5879.

By JESSIE PERRINE Contributing Writer

Falling on deaf ears? Hearing loss is more common than you think

t starts with a “what?” and sometimes ends with a pair of hearing aids. It’s a tough subject for plenty of Brainerd lakes area residents, but hearing loss is very real, said Dr. Whitnea Engelbrecht, audiologist at Essentia Health St. Joseph’s Brainerd Clinic. And it’s a lot more common than people think. High frequency hearing loss is prevalent, Engelbrecht said. Especially for those whose hearing loss is due to noise exposure, age or family history. It’s caused by nerve damage to the inner ear and can’t be fixed. Most people don’t notice the loss right away because it’s very slow over a long period of time. It’s because that hearing loss is so slow that many people don’t realize it until a family member or friend points it out (often many, many times), Engelbrecht said. Often, it takes a lot of urging from those closest to the patient to go in for a hearing test. Why? Because there are the stereotypes that go along with hearing loss. The biggest being that only the elderly face it. Contrary to that belief, even youngsters can, Engelbrecht said. Infants are now given a hearing screening. Children who suffer from chronic ear infections are at higher risk for hearing loss, she added. Continuing on later into life, a person can lose some hearing because of the noise they surround themselves with.

That’s why audiologists tell people to wear hearing protection when using the following: Lawn mowers, leaf blowers, chain saws, four-wheeler, motorcycles, race cars, construction equipment, machinery, fireworks and power tools. In the Brainerd lakes area, where there’s plenty of industrial work, this is a common culprit for hearing loss, Engelbrecht said. Even if loud machinery is being used for just a couple of seconds, it’s important to wear hearing protection, Engelbrecht said. Damage can happen instantly or over time. Simple foam ear plugs will do, Engelbrecht said, but the best protection is ear muff style. There’s an increasing problem among teens and young adults who listen to loud music, some professionals say. A good rule of thumb while listening with headphones is that if the person next to you can hear the words of the song, it’s too loud. When driving in the car, if your ears ring after turning the tunes off, it’s too loud. The same goes for after a concert. If that ringing continues for a couple of days after, there could be done damage, Engelbrecht said. Damage can sometimes correct itself over time, but if you keep up the loud habit, hearing loss will most likely continue to grow. Contrary to popular belief, it’s not only senior citizens who start to lose hearing. It can actually start very slowly in your 30s, continuing to your 50s to 70s when most people typically notice it, Engelbrecht said. People often put off appointments because they’re in denial, Engelbrecht said. But once they’re inside the clinic doors, it’s not as bad as they’ve built up in their heads. The test itself takes just a few minutes, but the appointment can take around 45 minutes total as the specialist will gather your information, concerns and then go over post-test recommendations. The test starts once the patent is in the sound-proof booth and has ear muff style headphones on. Press the button when you hear the beep. Next, repeat the words you hear. It’s that simple. JESSIE PERRINE may be reached at jessica.perrine@brainerddispatch.com or 855-5859. Follow me on Twitter at www.twitter.com/brainerdnews.

o r d e r s D o c t o r ’s

By Rachel Cady, M.D. Obstetrician/Gynecologist

Dealing with urinary incontinence

o you experience unplanned, sudden loss while laughing, sneezing, coughing, or exercise? Do you limit or avoid any activities? When planning a trip or event, does the availability of restroom facilities affect your decision? Do you wear a pad to absorb urine leakage?

A woman’s pelvic region is an important part of her wellbeing. The pelvic region includes the vagina, uterus, and bladder. Pelvic problems are conditions associated with these structures such as urinary incontinence. This condition is very common and can significantly affect the quality of a woman’s life. Studies show that at least one–third of all women will experience one or more pelvic health conditions in their lifetime. Many women have incontinence, and most never describe symptoms to physicians. The good news, however, is that there are effective treatments available for incontinence and women can feel normal again. Urinary incontinence is a common and often embarrassing problem. The severity of urinary incontinence ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you cannot get to a toilet in time. There are two main types of urinary incontinence: stress and urge. Stress urinary incontinence, or SUI, is leaking of urine when laughing, coughing, or sneezing. While it is the most common form of incontinence in women—typically caused by pregnancy and childbearing, obesity, and menopause—it is significantly under–reported in women. It is more common in women under 65 years of age. Urge incontinence involves an involuntary contraction of the bladder, usually with no activity. A strong urge to urinate will occur and then subside. However, in some women the bladder contraction will

be strong enough to cause the bladder to leak before they are able to empty on a toilet. Women with incontinence often times will describe a pelvic pressure sensation like something is “falling out.” This can be a symptom of pelvic organ prolapse. Pelvic organ prolapse is a broad term describing conditions when the bladder, vagina, uterus, and/or rectum are protruding out frequently in the vaginal region causing a pressure feeling. It is estimated that approximately 30 percent of women at some point in their lives will have symptomatic prolapse. Other common symptoms experienced by women with pelvic organ prolapse are abdominal pain, low back pain, problems emptying their bowels or bladder, bowel urgency and pain with sex. These conditions are easily evaluated in an office exam. Treatments range from non-surgical to surgical. Many patients simply want information and options. It is important to note that approximately 7 percent of women with urinary incontinence will also have involuntary loss of stool, otherwise known as fecal incontinence. Unfortunately, most patients are hesitant to bring this up at clinic visits or have never been asked about it by their health care provider. Fortunately, in most cases, there are treatment options for this condition to improve one’s quality of life. Thanks to the greater emphasis on excellence in women’s health care, advancements in the medical field, longer

life expectancy and further emphasis on quality of life improvement, the stigma of talking about all of these problems is going away. These are not uncommon problems and left untreated can gradually lead to other medical issues and a worse quality of life. Seeking consultation with a specialist is welcomed and advisable. For more information, contact the Minnesota Center for Obstetrics and Gynecology, a group of experienced clinicians who specialize in the health of women of all ages, at 218-546-7462 or 888-420-2778.

Dr. Cady, who practices in Baxter, Crosby, and Aitkin, is Board Certified by the American College of Obstetrics and Gynecology. She received her Medical Degree at the University of Minnesota and completed her residency at Spectrum Health in Grand Rapids, Mich.