UpNorth HealthWatch 10/2003

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ANNOUNCING ST. JOSEPH’S $25 MILLION MEDICAL CENTER EXPANSION.

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It’s an exciting time to live in the Brainerd Lakes area. Our community is growing and getting better every day. With that growth, of course, comes an increased need for healthcare services.

Construction scheduled for completion in 2005.

At St. Joseph’s Medical Center, we’re responding to that need by expanding our medical campus— putting $25 million in construction services and material costs into the local economy.And when we’re done, we’ll bring even more jobs to the community. Our 116,000-square-foot expansion and renovation project will bring us to our licensed capacity of 162 beds and increase the number of private rooms, allowing patients and families greater comfort. It will also increase the capacity of our intensive care and progressive care units, and allow us to bring to our area some of the most advanced medical technology available. It’s better care for all of us, and it’s a sign that our community will continue to stay healthy as it grows.

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OCTOBER 2003


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Down syndrome

Irreversible Only for Now?

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Most people know Down syndrome is a genetic disorder that causes irreversible mental retardation. But that description may not be true in the future. Scientists have pounced on the revolutionary idea that Down syndrome — the most common genetic cause of mental retardation — can be treated. First, they must understand the biological cause of the condition, down to the specific genes responsible for the varied symptoms. Then, they hope, they’ll be able to reverse or eliminate related problems with cognitive function, memory, speech, sleep and even the neurological decline that occurs in older adults with the disorder. Scientists at Stanford University Medical Center already have identified abnormalities in the nerve cell structure of people with Down syndrome, differences that appear to be responsible for much of the brain damage that is the hallmark of the disorder. They’re now trying to home in on the genes that cause that particular abnormality. “People thought that once you’re born with Down syndrome, that’s it; you can’t make the brain better. But we know that is not true about brains,” says Dr. William Mobley, a pediatric neurologist at Lucile Packard Children’s Hospital at Stanford. “Brains are plastic. We may not be able to cure this disease, but we may be able to make people’s lives better.” Several advances have paved the way for this hypothesis. Scientists understand the brain far better than they did even 15 years ago, because sophisticated imaging devices have allowed them to better examine its structure, and the mapping of the human genome provided detailed information on the 21st chromosome. Down syndrome is caused by a third, or extra, copy of this chromosome. The mapping of chromosome 21 revealed that it is the smallest of the 24 human chromosomes, containing about 225 genes. Now scientists such as Mobley, director of the new center for Down syndrome research at Stanford, are working to identify what those genes do. Experiments on Down syndrome mice have shown abnormalities in the synapses, or circuits, between nerve cells. The abnormal structure and function of the synapses lead to the kind of brain damage seen in Down syndrome and Alzheimer’s disease. People with Down syndrome typically develop Alzheimer’s disease in adulthood, Mobley says. Now researchers are trying to figure out which of the genes cause this problem in Down syndrome. Fixing the defect may involve turning off the extra copy of certain genes. “We definitely know that genes cause this,” Mobley says. “If we find an offending gene, theoretically we can make things better by turning off that third copy.” Treating a condition caused by an extra gene, he says, may prove easier than treating other genetic diseases such as cystic fibrosis, in which genes are abnormal or missing. Drugs could be developed to turn off that extra gene and improve cognitive ability in people with Down syndrome. Theoretically, Mobley says, the drugs could be given at any point in the lifespan to improve brain function. “What they’re doing is extremely exciting,” says Myra Madnick, executive director of the National Down Syndrome Society. “The whole research scene has changed dramatically since the mapping of the 21st chromosome.” Scientists caution, however, that potential treatments resulting from this research are at least a decade away.

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From the Editor Lawns are littered with dried, yellow leaves and the grass underneath is frosty when the alarm goes off in the morning. Fall is here, ladies and gentlemen, and along with the change in seasons comes another issue of HealthWatch. Judging by the feedback I received from readers, the first issue of HealthWatch was a success. Thank you to everyone who wrote or e-mailed their comments. It’s nice to know people are actually reading what we worked so hard on. In this issue, free-lance writer Jenny Kringen-Holmes and I put our heads together and came up with some great

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Who we are Publisher — Terry McCollough Advertising Director — Mary Panzer Editor — Heidi Lake Copy Editors — Roy Miller, DeLynn Howard Graphic Designer — Cindy Spilman HealthWatch is a quarterly publication of The Brainerd Daily Dispatch. Read HealthWatch online www.upnorthhealthwatch.com

stories that we hope you’ll find interesting, including the new clinics in Pillager and the benefits of gastric bypass surgery. We even added a low-fat recipe section where we discovered some fun new ways to cook and eat healthy. Once again, feel free to e-mail story ideas or comments to heidi.lake@brainerddispatch.com. Happy reading and happy fall, Heidi Lake Editor

Table of contents 5

COVER STORY: A day in the life of a flight medic

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DISEASE: Cancer doctor battles disease

10

PROCEDURE: Gastric bypass surgery

24

FAMILY: Struggling with infertility

14

NUTRITION: Eating healthy

26

LIVING: Coping with prosthesis

16

RECIPES: Cooking healthy

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MEDICINE: New birth control pill

Story/Jane E. Allen Los Angeles Times

Synthetic marijuana compound shows promise Marijuana can ease pain even for longtime sufferers of disease, but the illegal herb’s mind-altering properties make it less than ideal as a medication. German researchers now have found that a synthetic version of one of many marijuana compounds safely reduced chronic nerve pain without impairing thinking and behavior. If the preliminary findings hold up in larger trials, capsules containing this compound might one day be prescribed for hard-to-treat pain. The principal active ingredient in cannabis is tetrahydrocannabinol, or THC. That compound has been the most studied, but researchers around the world are also looking more closely at the plant’s other chemical compounds for potential health benefits. Scores of them belong to a group called cannabinoids; others include flavonoids, which are thought to have antioxidant properties. “It’s not a surprise that these cannabinoids have medical benefit,” said Dr. Donald I. Abrams, an AIDS specialist conducting clinical trials of marijuana at San Francisco General Hospital. People with cancer, AIDS and other chronic dis-

eases have long attested to the plant’s ability to provide relief from nausea and pain. “That’s why we’re investigating marijuana,” Abrams said. Previous studies have shown some cannabinoids have limited ability to blunt acute nerve pain, typically associated with an injury. But the German study found that a cannabinoid called CT-3 could help sufferers of chronic neuropathy, who often don’t respond to standard medications. CT-3 is related to THC. But the problem with THC is that even at low doses, it can impair thinking and coordination, and create anxiety, panic attacks, psychosis and paranoia, as well as dry mouth, blurred vision, and a drop in blood pressure upon standing. Despite these effects, scientists have remained interested in cannabinoids, because the body has natural cannabinoid receptors that offer potential drug targets. CT-3 first showed promise in animals as an antiinflammatory and as a reliever of two aspects of neuropathy: pain and extreme sensitivity to ordinary sensations. Researchers at Hannover Medical School in

Germany, working with an American colleague, gave various doses of CT-3 to 24 volunteer patients with chronic neuropathic pain in places such as the foot, arm, face and head. Many patients also were taking other pain-relieving medications such as narcotics, muscle relaxants, antidepressants and sedatives. The researchers found that CT-3 was more effective than a placebo at relieving pain; its effects were greatest with milder pain. Increasing the dose brought no greater relief. The major side effects were dry mouth and fatigue. “What’s promising is that there can be a product that stimulates the cannabinoid receptors and does not have the emotional and hallucinatory effects otherwise known for THC,” said Dr. Joel Saper, a neurologist who directs the Michigan Head-Pain and Neurological Institute in Ann Arbor. He’d like to see longer CT-3 studies using larger numbers of patients who aren’t taking other pain medications: “We need to see how this would work in patients not on all these drugs.”

at

For advertising opportunities call Mary Panzer at (218) 855-5844. E-mail your comments to heidi.lake@brainerddispatch.com or write to: Heidi Lake PO Box 974 Brainerd, MN 56401

Kathy, Micha, Steve, Cassie, Michele

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HEALTHCARE: New Pillager clinics

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RESEARCH: Down Syndrome

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FDA approves first birth control pill designed to help women skip periods SAVANNAH, Ga. — Imagine being on combat tour in Iraq and having monthly cramps, headaches, mood swings and heavy bleeding in extremely macho environs. Skipping monthly periods sounds appealing. Especially for women in the military such as Staff Sgt. Cheryl Williams. But would Williams pop a daily birth control pill that suppresses monthly periods? Not a chance. "It's a fabulous idea, but I have misgivings about taking the body cycle out of its natural sync. That is spooky to me," said Williams, who spent about eight months in Iraq this year. "Plus, when I sat in a five ton truck with a 22,000 pound trailer attached, the last thing on my mind is to pop a birth control pill." Stress of combat often causes women to miss their periods naturally, without taking a pill, said Williams, based at Hunter Army Airfield. While menstrual periods are inconvenient and sometimes painful, a new pill could bring an end to women's monthly woes. Seasonale, due out at the end of this month, is the first FDA-approved birth control pill designed to help women skip periods – menstruating only

four times a year instead of 12. Seasonale's cost has yet to be determined. It will be comparable to conventional birth control, about $30 a month. Some insurance plans may pay for it. The trend of suppressing menstruation is nothing new. But Seasonale has divided health experts between those who cheer the new pill as another way for women to control their bodies vs. those who say that period suppression is dangerous. Family nurse practitioner Dellarie Shilling in Statesboro plans to recommend Seasonale to patients, who are mostly college-aged women. "As long as it works smoothly and there are no side effects, it will be popular," Shilling said. "A lot of women have painful periods which wouldn't be missed at all." But Savannah family nurse practitioner Valerie McGowan sees the trend of menstrual suppression as less healthy. McGowan says the no-period pill might be risky, especially for teens and young women. She doesn't plan on recommending it to young patients at Curtis V. Cooper Health Care Center in Savannah, formerly Westside Clinic.

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"The adolescent group is so fragile, you wouldn't want to play around with their cycle too much," McGowan said. Women have already been suppressing their periods for years with standard 28-day birth control packages. They throw out the seven inactive pills that would have triggered their periods and start a new pack of regular pills to suppress menstruation. But the FDA had not approved continuous use of the drugs until now. Seasonale, produced by Barr Laboratories, isn't a new chemical – just a repacking of the conventional oral contraceptives in a purple-and-pink box. The packaging gives women 12 straight weeks of active pills, then a week of dummy pills for their period. Almost 39 million women in the United States use some kind of birth control, according to the Kaiser Family Foundation. Oral contraceptives are the most common, reversible method.

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A day in the life

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of a flight medic

Flying at about 180 miles per hour, North Air Care flight nurse April Aalto keeps a steady arm while filling a syringe with morphine to alleviate the discomfort of her patient. Flight medic John Davis monitors the man’s vital signs and keeps in contact with medical officials on the ground regarding the man’s status. A heart monitor mounted within the helicopter keeps tabs on the man’s heart rate, oxygen levels and blood pressure. Out the chopper’s large side windows you can see the twinkling lights of life proceeding as usual in small towns below.

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In close quarters, this three-person flight crew is transporting a 52-year-old Wisconsin man with chest pains to Duluth for medical attention. It’s a flurry of activity in this emergency room in the sky as a trip which typically would take several hours by ground is accomplished in little over a half hour. In an emergency, every minute is critical. The difference between getting to a hospital by land or air can often be the difference between life and death. The sky provides an open road. Little to no traffic. No stop signs. Rather than going around fields, you go over them. With speeds over 180 miles per hour, its no wonder the air ambulance industry has “taken off” over the last several years. North Memorial Medical Center in Robbinsdale began its North Air Care division in 1985. Now, with three bases, including one in Brainerd, communities across the state and beyond have the opportunity to receive the best, most appropriate care at any hospital regardless of how far they are located from the facility. With the approval of North Memorial, this reporter was allowed to observe a flight crew during a regular Wednesday night shift earlier this month. This is just a glimpse into a day in the life of an Air Care flight crew. 4 p.m. — North Air Care flight medic John Davis is going on the ninth hour of his 24-hour shift. Davis, 31, stands at the sink at the crew’s quarters in a hangar at the Crow Wing County Regional

Airport and finishes dish duty. “Don’t you dare tell my wife,” he says, laughing about his domestic duties. A Brainerd High School graduate, Davis has worked for North Ambulance in Brainerd since 1996 where he worked as a paramedic on the road. When North Memorial Medical Center’s air ambulance program opened a permanent home in Brainerd in October of 2000, Davis was hired on as a flight medic. There’s no doubt in Davis’ mind why he chose to make the switch from road to air. “Because I got to do what I liked to do as a paramedic, but in a really cool ambulance,” he says, noting it’s virtually the same type of job but with it’s own set of differences and challenges. 4:30 p.m. — Davis and Air Care lead pilot Phil James perform a safety briefing, required for any ride-along passenger of the helicopter. North Memorial owns and operates five Augusta C109s in its fleet. These helicopters are the fastest non-military chopper made. Currently, North has three bases for its Air Care operations: Brainerd, the Twin Cities and Redwood Falls. On call at the hangar throughout their shift, the crew aims to be in the air within five minutes of receiving a call. Once arriving at the scene, their goal is to get the patient loaded up and en route to their destination within 10 minutes. 5:45 p.m. — Pilot Ryan Sarvie arrives early for his scheduled 12-hour shift. Sarvie, 32, is one of four full time pilots serving the Brainerd division of North Air Care. A new res-

ident of the Brainerd area, Sarvie previously lived in Buffalo. After graduation from high school, he joined the United States Army where he served 8 1/2 years as a pilot flying Hueys and Black Hawk helicopters. From August 1993 to January 1994, he served in the conflict in Mogadishu, Somalia, which was portrayed in the movie Black Hawk Down. Before coming to work for North Air Care, Sarvie flew the medical helicopter for St. Luke’s Hospital in Duluth. “I wanted to fly helicopters just because they’re different from airplanes,” Sarvie admits, adding he enjoys his current profession as he gets to help save lives “even though I couldn’t do it myself.” Sarvie discusses the stringent training and evaluation processes that go along with being a pilot. All of North Air Care’s pilots are required to be Instrument Flight Rules certified. Every six months, he and his fellow pilots must undergo an evaluation in order to maintain their pilot license where their ability to use and understand the helicopter’s instruments is tested. “It’s kind of like taking a driver’s test every six months,” he says. 6:30 p.m. — The Air Care crew receives a fax from their dispatch center operated out of North Memorial Medical Center in Robbinsdale. They are requested for a “fly in” at Mercy Hospital in Moose Lake where a group of firefighters, law enforcement, first responders and other emergency service providers are gathered to learn more about Air Care’s services as well as how to best work with

Apple Stuffed Tenderloin with Cinnamon Raisin Sauce This hearty entrèe started out as stuffed pork chops. To make the dish leaner and still keep its character, the recipe was switched to stuffing a pork tenderloin. Calories, fat and cholesterol were reduced by: • Using pork tenderloin (26% calories from fat) instead of rib chops (52% calories from fat); • Using no-stick spray instead of butter to sautè the onions; • Eliminating the butter in the sauce. Stuffed Pork Tenderloin: 1 pork tenderloin (1 to 1 1/2 pounds) trimmed of all visible fat 2 medium oranges 1 medium apple, cored and chopped 2 tablespoons finely chopped onions 2/3 cup fine dry plain bread crumbs Sauce: 1 cup unsweetened apple juice 1 tablespoon cornstarch 1/4 teaspoon ground cinnamon 1/4 cup raisins To make the stuffed pork tenderloin: Preheat the oven to 425 degrees. Cut a pocket in the side of the tenderloin by cutting a lengthwise slit from one side to almost the other side and stopping about 1/2” from each of the tapered ends. Set the tenderloin aside. Finely shred the peel from the oranges and set aside. Then squeeze 3 tablespoons of juice from the oranges. In a medium bowl, combine the orange juice and apples. Set the apple mixture aside. Spray an unheated small skillet with no-stick spray. Add the onions. Cook and stir over medium heat until tender. Then add the onions and bread crumbs to the apple mixture. Toss until combined. Spoon the bread mixture into the pocket of the tenderloin. Securely close the pocket with wooden toothpicks. Place the tenderloin on a rack in a shallow roasting pan. Insert a meat thermometer into the meat portion only. Bake for 25 to 30 minutes or until the thermometer registers 160 degrees. Let stand about 5 minutes before slicing. To make the sauce: In a small saucepan, use a wire whisk to stir together two tablespoons of the apple juice and the cornstarch. Then stir in remaining apple juice. Cook and stir over medium heat until boiling. Stir in the reserved orange peel and cinnamon. Add the raisins and cook for five minutes, stirring occasionally. To serve, slice the tenderloin. Spoon the sauce over the slices. Makes 4 to 6 servings. Nutrition Scorecard (per serving) Calories – 245 Fat (g) – 4 % calories from fat – 16% Cholesterol (mg) – 74

North Air Care pilot Ryan Sarvie took to the skies during his scheduled 12-hour shift. Sarvie, 32, of Brainerd, is one of four full-time pilots serving the Brainerd division of North Air Care. Sarvie has been a licensed pilot for 13 years and served as a Black Hawk pilot during the Mogadishu, Somalia, conflict in the 1990s.

Exchanges (per serving) 3 meat 1 fruit

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Monday, November 17 at 6:30 P.M. in the conference room at Cuyuna Regional Medical Center 318 East Main Street, Crosby, Minnesota (Use the main clinic/hospital entrance and follow the signs.)

If you are at least 100 pounds overweight, have a body mass index of 35-50, or have other health related conditions due to your weight and you wish to lose weight, you should plan on attending one of these free informational seminars.

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Big City Medicine, Hometown Care

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(Continued from Page 17)

Top Ten Reasons Why You Should Call

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• Replacing sour cream with fat-free yogurt; • Using evaporated skim milk instead of butter. 2 cups (8 ounces) finely shredded reduced-fat sharp cheddar cheese 1 (10 3/4 ounce) can 99% fat-free condensed cream of chicken soup with 1/3 less salt 1 cup fat-free plain yogurt 3/4 cup evaporated skim milk 1/2 cup very finely chopped onions 2 cups cornflakes 6 medium potatoes (2 pounds), peeled Preheat the oven to 350 degrees. In a large bowl, stir together the cheese, condensed soup, yogurt, milk and onions. Set the soup mixture aside. In a blender or food processor, blend or process the cornflakes into coarse crumbs (you should have about 1 cup). Set the cornflakes aside. Coarsely shred the potatoes. Immediately stir the potatoes into the soup mixture to prevent browning. Spray a 10”x9”x2”or 11”x7”x1 1/2”baking dish with no-stick spray. Transfer the potato mixture to the baking dish. Top with the cornflakes. Bake about 1 hour or until the potatoes are tender. Makes 8 servings. Nutrition Scorecard (per serving) Calories – 230 Fat (g) – 4 % calories from fat – 21% Cholesterol (mg) – 35 Exchanges (per serving) 2 starch 1 lean meat

Harvest Apple Stuffing

This fruit and walnut dressing is the perfect complement to roasted chicken. Calories, fat and cholesterol were reduced by: • Using apple juice instead of butter to sautè the vegetables. 2 cups finely chopped apples 1 teaspoon lemon juice 1 cup coarsely shredded carrots 1 cup thinly sliced celery 1/2 cup chopped onions 1/2 cup apple juice 1/4 teaspoon ground nutmeg 8 cups dry plain bread cubes 1/3 cup chopped walnuts 1/4 cup toasted wheat germ 1-1 1/2 cups chicken broth, defatted Preheat the oven to 350 degrees. Place the apples in a small bowl. Sprinkle with the lemon juice, then toss until coated. Set aside. Spray a large skillet with no-stick spray. Add the carrots, celery, onions and apple juice. Cook over medium heat until tender, stirring occasionally. Stir in the nutmeg. Lightly spray a 3 to 4 quart casserole with no-stick spray. Add the bread cubes, apples, walnuts, wheat germ and the carrot mixture; toss to combine. Drizzle with one cup of the broth. If necessary, drizzle with enough of the remaining 1/2 cup of broth to moisten the bread; gently toss to mix well. Bake, uncovered, for 30 to 40 minutes or until heated through. Makes 8 servings.

Jerome D. Poland, M.D.

Ina Luca, M.D.

Richard L. West, O.D.

One Third Ave. NE Crosby, MN 56441 218-546-5108

Mary Zeise, O.D.

1863 Design Drive Baxter, MN 56425

218-825-1976

www.crosbyeyeclinic.com

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Nurse April Aalto (left), medic John Davis and pilot Ryan Sarvie made up this North Air Care flight crew.

Nutrition Scorecard (per serving) Calories – 197 Fat (g) – 5 % calories from fat – 21% Cholesterol (mg) – 0 Exchanges (per serving) 2 starch 1/2 fruit

them in the event they would be called to Moose Lake. “A big part of our job is safety,”notes flight nurse April Aalto of Monticello. Aalto, a nurse with North Memorial since 1986, commutes to Brainerd to work 24-hour shifts on the helicopter crew. 7:27 p.m. — The Air Care crew leaves the hangar for their 30 minute flight to Moose Lake. Each member of the crew wears a headset with a microphone in order to allow open communication. Along the way, Sarvie points out the city of Aitkin to the left and Lake Mille Lacs out the right. He also notes the helicopter is currently traveling at a speed of 170 miles per hour with a bit of a headwind. 7:55 p.m. — The crew arrives at Mercy Hospital in Moose Lake, greeted by a large gathering of emergency personnel. Aalto is the first to exit the aircraft, as she meets the group. After all three crew members are out of the helicopter they introduce themselves and answer questions regarding the helicopter, their experience and optimal landing situations. As the Moose Lake group walks around the helicopter, looking inside and asking questions, a woman approaches Sarvie questioning how long he’s been a pilot. “Thirteen years,” he tells her. “Oh my,” she replies, obviously surprised. 8:40 p.m. — After giving rides to four individuals from the Moose Lake group and participating in a stretcher-loading exercise, the Air Care crew takes to the skies and heads back to Brainerd. The clear night provides visibility for miles and miles. Sarvie once again comes over the headsets pointing out the cities below and beyond, including

McGregor, Aitkin and the distant lights of St. Cloud and even the Twin Cities area. 9:13 p.m. — The helicopter reaches its hangar at the Brainerd airport. Sarvie calls to request fuel. The Augusta C109 holds 73 gallons on each side, or 146 gallons total which provides for two hours and 20 minutes of flight time. An auxiliary tank can hold an additional 40 gallons, Sarvie points out. With full auxiliary and side tanks, the helicopter has a three hour endurance. At normal cruise, Air Care burns one gallon of fuel per minute. 9:25 p.m. — Davis begins a run sheet, the necessary paperwork, required for the trip to and from Moose Lake. 9:26 p.m. — The North dispatch center calls with a possible flight to Redwood County, but calls back almost immediately to disregard. 9:45 p.m. — In true leader fashion, Sarvie serves up hot chocolate to the crew and starts a batch of chocolate chip cookies in the oven. The hangar where Air Care is stationed provides each member of the scheduled crew with a private bedroom. There’s also a bathroom, shower room, office, living area and kitchen as well as the garage area where the helicopter is stored. 10 p.m. — The cookies are done and the crew sits down to a late dinner of pizza while catching up with the 10 o’clock news. “We’re one big happy family,” Sarvie jokes. 10:55 p.m. — The crew receives a call to transfer a patient from Grantsburg, Wisconsin to Duluth. Details of the call are sketchy, but everyone is up on their feet and heading for the door. 11 p.m. — In the air and heading east, Davis begins more paperwork. A message via his alphanumeric pager tells the pertinent patient informa-

tion. This patient has a potential cardiac situation and is requesting to be transferred to St. Mary’s Hospital in downtown Duluth. The crew explains they provide a service that will take patients to any hospital. In the event of an accident or critical situation, the crew will decide where the patient will be taken. Usually, that means the closest Level 1 trauma center. If the patient is currently at a hospital and being transferred to a different facility for additional treatment, the patient and his/her family as well as the medical staff will determine where that person will be sent to receive the best care for their particular situation. Typically the Air Care base closest to the originating city will respond to the call, but Davis says both the metro and Redwood Falls divisions are out on calls leaving the Brainerd crew up-to-bat. North Air Care isn’t the only show in town, so to speak. Both St. Mary’s and St. Luke’s in Duluth have their own air ambulance service, as well as other medical centers in and around the Twin Cities area. But, the physician requesting the transfer has the discretion of which company they would like to transport their patient. And in this case, they’ve called North Memorial. 11:15 p.m. — Traveling at a speed of 184 miles per hour, Sarvie radios in to say he’s 16 minutes from Grantsburg. Ground ambulances have a set service territory, Davis notes, but the same doesn’t hold true for the air service. Their job can take them anywhere in the state as well as North Dakota, Wisconsin and more. And for that reason, both Davis and Aalto have respective paramedic and nurse licensure in the state of Wisconsin.

7


CMYK

dow during his, approximately, half hour flight to Duluth. 12:10 a.m. — Sarvie calls in to say the crew is 15 minutes from St. Mary’s and is given clearance to land on the hospital’s rooftop helipad upon arrival. The patient notes his pain level has decreased somewhat and is comfortable, although he says he’s having some difficulty taking deep breaths. He asks the pilot how high they’re flying. “Three thousand feet,” Sarvie replies through the headset. 12:26 a.m. — After flying over Lake Superior and the infamous Aerial Lift Bridge, the chopper lands at St. Mary’s and is met by security guards at the rooftop entrance to the hospital. Since the patient’s condition is stable, the crew waits for the helicopter’s rotors to stop completely before exiting the helicopter. “It was a good ride,” the man tells the crew, as he’s unloaded and given North Air Care is virtually an emergency room in the sky. Flight nurse April Aalto and flight medic John Davis ran through a North Air Care baseball cap. “But I thought it’d be their equipment and supplies, ensuring everything is ready before their next call comes in. more exciting.” 12:34 a.m. — The crew Aalto comments the furthest she’s traveled to “Well,” Aalto chides back. “We’ll have to ask the arrives in the coronary care unit and wheels their pick-up a patient came just a few days ago when pilot.” patient directly to a room where they brief staff on she traveled with the Air Care crew to Devils Lake, 11:45 p.m. — After the necessary paperwork the patient’s status and history. N.D. to take a patient to Abbott Northwestern has been signed, the patient is wheeled out to the 12:57 a.m. — With their patient passed on to St. hospital in Minneapolis – about a 2 1/2 hour flight. awaiting helicopter for his trip to Minnesota. It’s a Mary’s staff and their job complete, the crew 11:31 p.m. — An ambulance with flashing team effort as the stretcher is loaded into the air- returns to the helicopter for take off. lights signals the chopper onto the landing pad at craft. Aalto and Davis lift the man and slide the 1:04 a.m. — Sarvie makes a stop at the Superior the Burnett Medical Center in Grantsburg. An stretcher onto the stainless steel platform inside Airport. While he remains in the aircraft, Davis emergency medical technician with North the helicopter while Sarvie stands inside the and Aalto perform a “hot refuel,” or refueling the Ambulance’s service in Grantsburg meets the chopper’s front door and pulls the foot end of the helicopter while it’s still running. crew at the emergency room entrance and escorts stretcher forward. Once he’s adjusted and com1:14 a.m. —Everyone is back in the helicopter them in to meet their awaiting patient. fortable the crew situates themselves and pre- for the ride back to Brainerd, which Sarvie estiDavis introduces his fellow crew members to pares to lift off. The man is also given a headset so mates will take a little over 30 minutes. the patient and begins asking him a series of he too can communicate with the crew. A curtain It’s a quiet ride home as the crew reflects on health history questions as well as his current sta- is drawn to separate the crew and patient from the their shift so far and watches below as the world tus. pilot and cockpit area. whizzes by. “Our primary objective is to keep you as com11:55 p.m. — Off the ground and en route to 1:58 a.m. — The “after flight paperwork” fortable as possible,” Davis tells the 52-year-old Duluth, a flurry of activity takes place inside this, begins as the helicopter is pulled back into the man. As the man rates his pain as a 5 or 6 on a scale now tight, quarters. While Sarvie navigates to hangar until its next call. of 1 to 10, Davis listens to his chest and Aalto pre- northern Minnesota, Davis and Aalto monitor the “It was a quiet day,” Davis reflects. pares the heart monitor which will accompany patient’s heart rate and oxygen levels in his blood, But there’s still another five hours to go in the him on the flight. The ER physician informs the administer medications through his IV and keep day in the life of this flight crew and what’s to crew the man has an extensive cardiac history, in close contact with the man to ensure his com- come on any given Air Care shift is always “up in including two heart attacks and bypass surgery. fort. the air.” “This is nothing new,” the man tells them. The patient is an inquisitive one as he removes As Aalto starts an IV, the man jokes with her. his headset from time to time, touches the IV bags “Can we land at my house so I can pick up my containing saline and medication, pokes at the checkbook?” ceiling of the helicopter and watches out the win-

8

Educating others While there is no formal support group for those facing amputation or those who’ve experienced it, Taylor said Fabian has become a good ambulator in the community. Fabian said he has, on several occasions, talked to those who are contemplating a prosthesis. “When you have someone who’s been there... It’s just a much more supportive means of encouragement,” Taylor said. “There are so many referral sources who feel patients who’ve had an amputation at the hip level can’t have a prosthesis. It’s good to shed light on the patients who’ve had an amputation at this level and show that it can be done.” Fabian said, of his contacts, he has reassured a younger boy that, yes, you can still ride a fourwheeler after receiving a prosthetic and a woman who worried about the way a prosthetic leg would look when wearing shorts. But in keeping with his optimistic attitude, Fabian, a grandfather of two, has turned a tragic event into a learning opportunity and a chance to help others by sharing his experience. “I try to be very encouraging,” he said. “You can make this work. If you have the right attitude and the will, you can make it work.”

Better get a

Taking a look at a prosthetic leg Socket — Upper portion of the prosthetic, made of carbon fiber with a flexible thermo-plastic interior. Hip Joint — A single axis hip joint with an extension mechanism that helps hold the limb straight and allows for safe alignment while standing and walking. Leg — An aircraft aluminum structure with a carbon fiber knee unit. Has a multi axis for sitting ability and ease of swinging when the patient takes each step. Foot — A dynamic multi axis foot allows patient to walk on uneven surfaces. The more energy exerted into the foot, the faster the patient can take their next step. Cover — A cosmetic foam cover with a skin tone, nylon-like exterior provides for improved aesthetic appeal.

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Getting a prosthetic

CMYK

Each prosthetic is custom made. An impression, or a blueprint for the prosthetic socket, is made for each individual, Taylor describes, then the mechanics are added below that. The technology for prosthetics has advanced greatly in the last 20 years, he said. Titanium and aircraft aluminum are now used to allow for a much lighter and stronger device. Taylor notes that Fabian’s particular prosthesis weighs about 11 pounds, compared to his entire leg which likely weighed about 30 pounds or more before amputation. “But any prosthetic always feels heavier than it really is,”Taylor said, explaining it is basically a foreign object suspended from the patient. Taylor, who has worked in the prosthetics field since 1988, said the average prosthesis has a life span anywhere between three and five years. “Like most mechanical devices, the (prosthesis) parts need to be serviced,” he said. In fact, Fabian joked that he already needed work done on his leg when the knee unit housing cracked. “I left my leg here for a total knee replacement,” he laughed, adding that it was covered “under warranty.”

Taylor also comes to Staples to make adjustments to the prosthesis during Fabian’s physical therapy sessions. “It’s kind of like fine tuning,” Taylor said. “The patient is constantly changing physically. For that reason we have to accommodate for those changes.” Living with prosthesis Living with a prosthesis comes with many challenges and discomforts. “There are days where I don’t feel like putting it on,” Fabian concedes. “But I don’t want to spend my life in a wheelchair.” Fabian has had to relearn how to walk as a prosthesis requires its user to swing their hips forward and use their lower back muscles when taking each step. “You use different muscles and different parts of the body that aren’t necessarily intended to be used for walking,” Taylor notes. “So it can be exhausting.” “This is different, but this is something that I can do,” Fabian said. “It gives me the opportunity to be more mobile. There’s a learning curve with it, obviously. I’ve spent many sessions learning to swing my hips. It didn’t take me very long to know I wasn’t going to be one of the 75 percent who wouldn’t make it work.”

Lakeland Psychiatry Welcomes New Physicians St. Joseph’s Medical Center is pleased to announce the addition of three psychiatrists to Lakeland Psychiatry Clinic. ■ Doctor Peter Neifert began seeing patients at Lakeland Psychiatry July 1, 2003. ■ Doctor Twila Germanson will begin seeing patients on August 1, 2003. ■ Doctor Paul Erickson will begin seeing patients on September 1, 2003.

Fabian is almost back to full time at his job as a certified registered nurse anesthetist at Lakewood Health System in Staples. “Its gone pretty well,” he said. “The biggest obstacle at work is endurance at this point, but it’s getting better. “I get really tired. But I guess I was tired before,” Fabian said with a chuckle. Despite the things a prosthesis has enabled Fabian to continue doing, he said he doesn’t want to paint too rosy of a picture. After all, his life has changed drastically over the last year. Fabian said the loss of his leg has forced him to make adjustments from simple daily rituals to chores around the house. “I can’t pick up a tree after a storm,” he said. “I can’t wash windows. Everything isn’t hunkydory. There’s just too many things to enumerate on. It’s a struggle.” The Fabians have had to add grab bars in their Staples home. Fabian must buy largersized pants to accommodate for the prosthesis. He also must wear special undergarments because of the sweat produced from the artificial limb. But with the constant support and care from his wife, Beth, Fabian said he takes each day as it comes — one step at a time. He intends to continue raising and training labrador retrievers and is looking forward to hunting this fall.

Dr. Peter Neifert attended Colorado College in Colorado Springs where he earned a Bachelor of Arts degree in Chemistry in 1990. He received his medical degree from the Mayo Medical School in 1995 and completed his residency in psychiatry in June of 1998. He has been practicing as a psychiatrist with the Air Force for the past 5 years. Dr. Twila Germanson received a Bachelor of Arts degree in Chemistry from Arizona State University in 1994. She received her medical degree in 1999 from the University of Minnesota and completed her residency in psychiatry in June of 2003.

lakeland psychiatry CLINIC

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St. Joseph’s Medical Center 523 North Third Street Brainerd, Minnesota 56401

November 2, 2003

Cool, crisp air is the first indication that fall is on its way. Soon after, leaves turn red and gold. Geese begin to fly south. Change is seen everywhere. But, this fall is unique for the Pillager community— because more than leaves are changing in the area. Lakewood Health System is pleased to announce the opening of our newest clinic in Pillager. The Pillager Clinic will offer you a choice of three physicians: Dr. Arden Beachy, Dr. Renee Nydegger, Dr. Mike Hudulla, as well as physician assistant Becky Bennett and nurse practitioner Kelly Thompson. You also have the option of convenient health care with an on-site pharmacy with drive thru window, three-day-a-week physical therapy services, extended clinic hours and occupational health and educational services.

Lakeland Psychiatry is located on the fourth floor of St. Joseph’s Medical Center.

To Schedule an Appointment Call: (218) 828-7394

Open House

Dr. Paul Erickson completed his undergraduate degrees in Religion and Psychology at Concordia College in Moorhead. He received his medical degree from the University of Minnesota Medical School in 1999 and completed his residency in psychiatry in June of 2003.

To celebrate, Lakewood Health System invites you to an Open House at the new Pillager location. Stop by on Sunday, November 2 between 1:00 – 3:00 p.m. to see our new facility, meet our staff, enjoy refreshments and receive a free gift. Mark your calendar today! With Lakewood Health System you don’t have to go far, it’s right here.

Lakewood Health System Pillager Clinic 631 State Hwy 210W, Pillager, MN 56473

www.lakewoodhealthsystem.com

9


The incredible

stomach

Surgery provides weight loss alternative to obese

CMYK

Story/Heidi Lake Photos/Steve Kohls

Lap-Band uses an adjustable silto lose. CROSBY—Sharon Osbourne has done it. So icone band, separating the stom“Not every patient is a suitable candidate for have Al Roker, Carnie Wilson and Roseanne. ach into two pouches. The band one operation or the other,”McCollister said. “Each Bariatric surgery. Not only is it a weight loss regihas an inflatable inner surface, patient is different and we need to be able to recmen to some of Hollywood’s finest stars, but the allowing the surgeon to adjust the ommend the operation that is safest, and likely to procedure can be done right here in the size of the band depending give the best results.” Brainerd lakes area to everyday people. on how much weight Lap-Band is considered less complicated than Unlike most Minnesota hospitals that the patient Roux-en-Y bypass because neither the stomach perform bariatric surgeries, the wants nor the intestine is cut during the procedure, but Minnesota Institute for Minimally the weight loss results are the same. Invasive Surgery at Cuyuna Regional By shrinking the stomach from the Medical Center in Crosby does them size of a football to the size of a laparoscopically, leaving six one-quarlemon, patients lose an average of ter inch incisions on the abdomen. 100-120 pounds one year after the Dr. Howard McCollister, chief of surgery, McCollister said. Initially surgery at CRMC, said less than a patients can eat a shot glass full of dozen surgeons do bariatric surgerfood, and eventually their stomach ies laparoscopically in Minnesota and stretches depending on how much four of them are at Crosby’s MIMIS. they eat. “It’s a very hard operation to do,” Bariatric surgery is limited to McCollister said of performing surgery patients who are morbidly obese, by using cameras and watching a TV with a body mass index greater than screen. “You’re looking at a two-dimen40, or have a BMI of more than 35 sional image and you have to make it 3-D and have associated health probin your head – kind of like a video lems such as high blood pressure, game.” diabetes, acid reflux or arthritis. The MIMIS surgical team has done BMI is a measurement related to more than 120 bariatric surgeries in the the patient’s body surface area and year and a half they’ve been performis used to determine a patient’s level ing them. of obesity. It is calculated by a stanThere are two types of bariatric surdard chart that correlates a patient’s geries, Roux-en-Y bypass, and Lapheight and weight. A BMI chart can Band. be found at www.cdc.gov/nccdIn Roux-en-Y, the stomach is sewn php/dnpa/bmi/calc-bmi.htm. into two parts. The upper part forms a “Diet and exercise is fine for small pouch that receives food. The some people,” McCollister said, but pouch can hold about one fluid many people with health problems ounce. can’t exercise. A section of the small intestine is McCollister restated the signifiattached to the pouch to allow food to cant dangers of being obese, saying bypass the lower stomach and the obesity-related illnesses are the No. first portion of the small intestine. 2 cause of death in the United Although food does not go through States, second only to smokingthis bypassed segment, it still functions related illnesses. by secreting gastric and digestive juices Tom Bonar of Pine River was diafrom the liver and pancreas and empbetic, had his left leg amputated ties into this area. below the knee and had extremely The Roux-en-Y bypass is considered high blood pressure, heart proba more complicated surgery that requires spending one or two Tom Bonar of Pine River demonstrated his 120-pound weight loss by holding up lems and gastroesophageal days in the hospital following the a pair of pants he wore before he had gastric bypass surgery. Then a size 52, reflux disease, a condition Bonar describes as having constant procedure, whereas Lap-Band can today, one year after surgery, Bonar wears a size 40. (Photo by Nels Norquist) heartburn. be done on an outpatient basis.

10

A healthy, middle-aged man from Staples, Fabian never imagined living without a leg. But when cancer forced the amputation of his entire left leg, there was no question whether he’d try a prosthetic leg. “I have cancer,” Fabian recalls. “I lost my leg. (A prosthetic leg) was one of the positives of the whole thing. I’m going to have a leg and be able to get around.” Cancer takes leg In October of 2002, Fabian, 51, began to experience pain in his left leg. Doctors investigated for the source of the pain but had no answers until later that month when a lump surfaced on Fabian’s upper left thigh. Doctors told Fabian the growth was likely benign. But his symptoms worsened and when a biopsy was done at Fairview-University Medical Center, Fabian’s worst fears came true. The lump was a malignant tumor and a form of sarcoma cancer. “I was devastated,” Fabian said. “But I have this real positive attitude. My family and I decided ‘we’re gonna beat this thing.’” Doctors gave Fabian two options — total amputation of the left leg; or a procedure to attempt to remove the tumor which would include a series of skin, nerve and bone grafts, something that came with its own set of complications. So, in December of 2002, Fabian’s left leg was amputated from the hip joint down. He spent eight days recovering at Fairview-University then returned home to begin his drastically new life. While visiting with his physical therapist in Staples, Fabian learned of the possibility to walk again with the help of a prosthetic leg. In February, he was introduced to Chip Taylor, a certified prosthetist and orthotist with Prosthetic Laboratories in Baxter. Fabian’s doctors had told him half of the individuals who have this type of amputation don’t receive a prosthesis and of the half that do only 25 percent stick with it. Fabian said that statistic was his carrot and gave him the motivation to be one of the 25 percent who successfully use a prosthetic leg on a daily basis. In March, a plaster impression was taken of Fabian’s remaining pelvic area and a “trial” prosthesis was made to utilize full function, comfort and also to accommodate the small tissue shrinkage that follows an amputation. As the area shrunk, padding was added to the hip socket of the prosthesis to ensure a proper fit. In June, the tissue shrinkage stabilized and Fabian was once again cast for another prosthesis — the one he still wears today.

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Chip Taylor of Prosthetic Laboratories in Baxter inspected the knee housing unit of Dave Fabian’s leg prosthesis.

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CMYK

Artificial leg doesn’t slow down Staples man

Story/Jenny Kringen-Holmes Photo/Steve Kohls

Looking at Dave Fabian, you’d never know he has an artificial leg. It’s not until he changes into shorts and pulls down the fabric cover of his prosthesis do you see the mechanics that have made it possible for this cancer survivor to continue doing what he loves best — living a normal life.

E XCELSIOR PLACE Catered Living Community Baxter, MN

Dr. Howard McCollister, chief of surgery at the Minnesota Institute for Minimally Invasive Surgery at Cuyuna Regional Medical Center in Crosby, stood in one of three operating rooms outfitted for laparoscopic surgery. The high-tech rooms have digital video equipment and cameras, along with voicecontrolled lighting and swinging flat screen TV monitors.

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A computer in the operating room at the Minnesota Institute for Minimally Invasive Surgery at Cuyuna Regional Medical Center works as a control center for the room’s video cameras, monitors and other digital equipment.

11


CMYK

In Roux-en-Y bypass, the stomach is sewn into two parts. The upper part forms a small pouch that receives food. Also, a section of the small intestine is attached to the pouch to allow food to bypass the lower stomach and the first portion of the small intestine.

He was 6-foot-4 and 342 pounds. “I was a physical mess,” he said. ‘I didn’t have energy, I didn’t have will and I was just waiting to have a massive coronary or heart attack and die.” He was a 44 year old husband and father of four who was spending an increasing amount of time in the hospital for various weight-related health problems. Bonar tried everything to lose weight, to no avail. He was overweight his whole life. He remembers taking diet pills in sixth-grade and playing high school football at 300 pounds. “I tried TOPS and Weight Watchers ... I’d lose weight for the first five days, then get frustrated and give up,” he said. Bonar first heard about gastric bypass surgery in January 2002. He spoke with his doctors who he came to know all too well after spending so much time in the Crosby hospi-

12

Lap-Band uses an adjustable silicone band, separating the stomach into two pouches.

tal. They decided he should have Roux-en-Y bypass. “I knew this was my last chance,” he said. Before the surgery, Bonar took part in the mandatory preparation program that included a bariatric seminar, giving an overview of the Roux-en-Y and Lap-Band surgeries, and saw a dietitian, physical therapist and psychologist to be sure he was mentally ready for the procedure. On Sept. 6, 2002, Bonar had Roux-en-Y bypass, a surgery that changed his life forever – not without a few bumps along the way. The surgery, which normally causes little or no pain, was giving Bonar severe abdominal pain three days after the surgery. After a CAT scan, doctors found his old stomach was filled with blood caused by a leak from where his intestine was sewn to his stomach.

“If it had burst it would’ve killed me,” Bonar said. McCollister said Bonar is one of two patients who had complications out of the 120 gastric bypass surgeries the MIMIS surgical team has done. By the end of September, Bonar was feeling better and started losing weight. So far he has lost 120 pounds, “And there’s no way I’m going to get it back,” he said. Today Bonar eats about two-thirds of a plate of food every meal and tries to avoid eating carbohydrates and sugars. Along with the weight, Bonar has shed all of his health problems, even diabetes. He takes no medications and for the first time in a long time, he can ride a bike and go camping with his family. “This surgery has given me another chance to live,” Bonar said. “I was going to die.”

In the winter of 1998 two 20-year-olds, Jason and The eggs are fertilized with semen, incubated in a bank in Roseville, the Walkowiaks went online in Darcy Walkowiak, thought they had the world by laboratory dish, and transferred to the woman’s search of a sperm donor. The Web site, www.crythe tail. They were newly married, had good jobs, uterus through the cervix at the appropriate time. olab.com, makes shopping for sperm as easy as The report says IVF is the most common assist- browsing the clothing racks at the mall. The Web and were thrilled by the thought of buying a home ed reproductive treatment done in the United site allows people to identify the race, blood type, and starting a family together. By fall, they bought a three-bedroom house in a States, with less than a 30 percent success rate, ethnic background, hair color, eye color and quaint Brainerd neighborhood, hoping to soon about the same chance healthy couples have of height of the sperm donor. After inputting the conceiving naturally each menstrual cycle. characteristics, Cryogenics provides a list of use one of the spare bedrooms as a baby’s room. “IVF is very common (among infertile couples),” donors who meet the qualifications. The list After a year of unsuccessfully trying to get pregnant the Walkowiaks decided it was time to see a said Uhlman. “IVF has really changed things on the includes detailed information about each donor, forefront (of infertility).” including education, health history and even the doctor. After much research and consideration, the shape of their eyes, nose and mouth. Jason and Darcy both were tested to see why “It’s a completely anonymous program,” Darcy they couldn’t seem to conceive. Darcy said many Walkowiaks decided to try donor insemination. “We didn’t feel comfortable with in vitro said. “(The donor) will never know if his sperm was people assume reproduction problems are due to the female, but statistics say males and females because it was so expensive and the chances of used and he has kids.” The Walkowiaks found their donor, bought have an equal chance of having reproduction getting pregnant weren’t that good,” Darcy said, adding their insurance doesn’t cover infertility pro- every vile of his sperm available, costing $230 per problems. vile, and started the process. Darcy’s ovulation cycle, tubes and uterus were cedures. Through Cryogenics Laboratories, a sperm When Darcy was ovulating, Cryogenics would tested, and the results showed her body was capasend two viles to West Health in ble of producing a child and carrying it Plymouth, to be inserted in Darcy’s throughout a pregnancy. uterus. Jason’s sperm count was tested, and After five attempts, Darcy still wasn’t the results showed he had low motilipregnant. They were down to the last ty. After further testing, it was found three viles of their supply. that Jason had a varicocele, a clump of “We couldn’t afford any more and varicose veins in his scrotum that prothere was no more sperm,” Darcy said. “It duced too much heat, killing the was our last chance.” sperm. During this time of trying and continuJason had surgery to correct the ously failing to get pregnant, Jason and problem and doctors were 60 percent Darcy said they’d never felt so alienated sure the Walkowiaks would be able to and alone. conceive naturally. “We kept asking ourselves, ‘Why is In February 2001, Jason went back to God punishing us?’ and thinking we the doctor and heard words he never weren’t made to be parents,” Darcy said. expected to hear. The surgery was Darcy joined an infertility support unsuccessful and he could never have group in Crosby, where she could speak biological children. to other women dealing with infertility. “It was pretty devastating to find out “It helps to know there’s a lot of peothere’s no chance,” Darcy said. ple out there dealing with (infertility),” “It was an issue for me at first,”Jason Jason said. said of finding out he was the reason Three weeks after the final attempt, they couldn’t conceive. “But it’s not Darcy hadn’t gotten her period. The coulike if Darcy couldn’t hold a baby. Then ple tried not to get their hopes up, prowe would have had no choice but to tecting themselves from getting their adopt.” dreams dashed again, like so many other The doctor gave the couple their times after finding out Darcy wasn’t pregoptions — they could do in vitro fertilnant. She took a home pregnancy test. It ization, donor insemination or adopt. was negative. The Walkowiaks, then 23, spoke By the fourth week, Darcy still didn’t with an adoption agency and found have her period and she said something out until they turn 25, the chances of didn’t feel right. She took another pregthem receiving an infant without spenancy test. It was positive. After about cial needs were slim. That narrowed three other home pregnancy tests and a their choices to IVF or donor insemiblood test at the hospital, it was connation, procedures that are not done firmed. The Walkowiaks were going to in Brainerd or anywhere in the area. have a baby. Dr. Carol Uhlman, a mild fertility On July 4, 2002, Cameron John specialist and obstetrician/gynecoloPeterson Walkowiak entered the world gist at Brainerd Medical Center, said and his two adoring parents couldn’t be BMC can do initial evaluations and happier. hormonal studies on infertile couples, “The joy we get from him is so great,” and even prescribe fertility drugs, but Darcy said. anything more involved, such as IVF, is Today, Cameron is walking, feeding referred to hospitals and clinics in the himself and even saying a few words. Twin Cities. Jason and Darcy have recently started a The Minnesota Fertility Clinic support group to help other couples deal Report describes IVF as a procedure with the struggles infertility brings. For where the woman’s ovaries are stimulated with drugs to release eggs, which Jason and Darcy Walkowiak watched as their son, Cameron, played at more information on Brainerd’s support group, e-mail Darcy at darcyw@brainare retrieved using a needle guided a park near their home. erd.net or call 651-659-0333. through the vagina with ultrasound.

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CMYK

Some of the services we offer include: ◆ Cholesterol tests daily with appointment ◆ Glucose Tests daily with appointment ◆ FREE blood pressure monitoring, taken by a health care professional ◆ Diabetes “A1c” test daily with appointment ◆ FREE local delivery ◆ FREE mailing of prescriptions ◆ Billing MEDICARE for covered diabetic supplies and nebulized medications ◆ “Daily-Dose” packaging available to aid in taking medications properly

Introducing our newest Pharmacist

Jason Hinrichs, Pharm D. I’m originally from Parkers Prairie, MN. I moved to Moorhead, MN to attend North Dakota State University where I received my Doctorate in Pharmacy. While attending NDSU I met my wife, who is originally from Motley, MN. We now have two girls, ages 6 & 2. We are all grateful to be in the beautiful Brainerd lakes area and excited for the opportunities and challenges awaiting us. I look forward to meeting you and offering my pharmaceutical services as best I can. Thank You

One-year-old Cameron Walkowiak doesn’t know it yet, but his parents consider him a miracle. Jason and Darcy Walkowiak suffered through the bumps and bruises of infertility and Darcy finally got pregnant with Cameron after three years of trying.

Call us toll free at 800-498-0347 or locally at 218-829-0347 to have one of our pharmacists assist you in transferring your medications to the pharmacy that’s all about your health.

Order refills online and get health information at www.medicineshoppe.com

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A guide to healthy eating In a generation obsessed with fad diets and quick fixes for weight loss, good eating habits sometimes get lost in the shuffle. Mary Lange, a registered dietitian at Brainerd Medical Center, points out that cutting back on saturated and trans fats, as well as making sure to include enough of the basic food groups on a daily basis, can make a world of difference when striving for a healthier lifestyle.

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CMYK

Cancer doctor finds out what disease is like first hand AUGUSTA, Ga. — Ward Hernandez gets a hand from Dr. David Squires, literally, as Squires helps him lean forward in the bed at University Hospital and then slips a stethoscope around to his back. "OK, lungs sound good," Squires says with a quick smile. There is an almost tangible bond between lymphoma patient Hernandez and his oncologist. "They have a lot in common," said Hernandez's fiancee, Dorothy Glisson. They have both faced cancer. It was a fluke that Squires ended up diagnosing his own acute lymphoblastic leukemia six months before he entered medical school. He was in a histology class at Brigham Young University, and the assignment called for students to examine their own blood with a microscope. "I noticed that I was anemic and had an abnormally high number of lymphocytes (white blood cells) in my peripheral count," Squires said. As luck would have it, the next day he was grading papers for another class, and one dealt with leukemia. When he looked it up, the pieces fell

into place. A week later, he was starting chemotherapy, which would last for three years. Despite that, he graduated as valedictorian of his undergraduate class and would later be inducted into a medical honor society. When it came time to choose a spe-

"Many people can be in academics and do a fine job. What I really have to offer people is the experience I had." cialty, he was naturally interested in cancer and would eventually land a three-year fellowship at the National Cancer Institute. As the fellowship was coming to an end last year, however, he decided not to continue his work with clinical trials. Instead, he wanted to see

Story/Tom Corwin Photo/Jonathan Ernst (Morris News Service) patients full time. He joined Augusta Oncology Associates in August. "Many people can be in academics and do a fine job. What I really have to offer people is the experience I had," he said. The cancer shaped not only his communication with patients but also his view of life and his ability to share that with them. The key is coping with what he calls "the tentativeness of cancer." "This is part of life," he said. "Everyone is living tentatively. Most people just don't realize it until they get some kind of acute, life-threatening illness." Faith has a lot to do with that, he said. "I spend time with them and their families and find out what kind of support they have," he said. "And our discussions inevitably turn to God." Squires can even see a positive in the cancer that invaded his body. His original goal was to become a surgeon. "I actually think it is somewhat of a blessing," he said, "because I don't think I would have enjoyed surgery as much as I enjoy oncology."

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Snack attack When striving to lose weight, Lange says many people will starve themselves between meals. But this can, in fact, backfire. “I often recommend people include an afternoon snack,” Lange said, noting often times when people don’t eat between lunch and dinner they’re much more likely to overeat during their evening meal. Fruit and nuts, herring on whole wheat crackers and yogurt are good, healthy choices,

Lange says, adding each of these foods helps meet daily requirements from the various food groups. Serving it up It used to be recommended that individuals eat five servings a day of fruits and vegetables, but that is changing. Lange says the push now is for nine servings a day for proper nutrition. A common misconception among weight watchers, is that dairy is taboo and high in fat. Lange said she recommends her patients with weight management and high blood pressure issues still get in three servings of low-fat dairy each day. Calcium is a critical signaling agent, helping many cells know what to do, and dairy foods help lead to satiety or a feeling of satisfaction after each meal. As far as protein, working women seem to fall short in getting their requirements, Lange says. Women should consume two servings, or at least 5 ounces, of protein each day. Proteins include lean meats, chicken, fish, eggs, cottage cheese and lowfat cheese. Men need approximately 5 to 8 ounces of protein per day. Cutting those carbs The infamous Atkins diet has done at least one good thing for the public at-large, Lange concedes. It’s helped people recognize which foods contain carbohydrates. Lange agrees it’s best to limit the “bad carbs” found in white bread, white rice and sugary low-fiber cereals. These foods have been

found to create an excessive insulin response where the body secretes more insulin upon consumption of these items leading to early hunger. Rather than cutting carbs completely, Lange suggests the healthier ones, including brown rice, wild rice, baked potatoes, whole grain breads and crackers and high-fiber cereals. Washing it down Lange said she has had patients who consume up to 2,000 calories a day from drinking high sugar sodas alone. She suggests avoiding “regular” pop altogether. If you must get your soda fix, Lange says to switch to diet pop. Other healthier alternatives include non-caffeinated beverages such as Diet Snapple, sugar-free Kool Aid or Crystal Light. Without a doubt, Lange says the best beverage is plain ol’ water. She recommends people drink between 6 and 8 cups a day. “I tell people to fill a mug, with at least 2 cups of water, and keep it on their desk at work during the day.” She says to force yourself to finish it before lunch, then refill it after lunch and finish it before leaving for the day to ensure you get at least 4 cups of water while at the office. Then fill a water bottle to take with you in the evening to sporting events, church functions or anywhere you travel. Getting enough water may help to wash away several health problems, including urinary tract infections, kidney stones, bladder cancer, colon cancer, obesity and constipation.

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That nasty “F” word Often times, the “F” word is given a bad rap, but Lange stresses that fats aren’t all bad. Lange suggests when preparing meals, people use more healthy oils and nuts. Monounsaturated fats lower the risk of heart disease as well as LDL, or bad cholesterol, without lowering the HDL, or good cholesterol. Products with monounsaturated fats include olive and canola oils, olives, avocados and most nuts, including almonds, filberts, macadamias, peanuts, pecans, cashews and pistachios. Lange encourages people to try olive oil or canola oil in place of other vegetable oils, butter or margarine. Another fat to include in your diet is Omega-3 fatty acid, found in high-fat fishes such as salmon, herring, tuna, anchovies and sardines, as well as in green leafy vegetables, and soybean and canola oils. This type of fat has been shown to reduce the risk of heart disease as well as stroke and also lowers LDL cholesterol and raises the HDL cholesterol.

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Healthy cooking

Nutrition Scorecard (per serving) Calories – 123 Fat (g) – 4 % calories from fat – 29% Cholesterol (mg) – 12

24-Hour Layer Salad

Exchanges (per serving) 2 vegetables 1 lean meat 1/2 fat

Here’s a salad you can prepare the day before and the lettuce will stay crisp until you’re ready to serve it. Calories, fat and cholesterol were reduced by: • Replacing bacon with turkey bacon and reducing the total amount; • Reducing the amount of cheddar cheese and using its reduced-fat alternative (less than 5 grams of fat per ounce of cheese); • Using a reduced-fat parmesan dressing instead of mayonnaise; • Using only the egg white portion of the hard cooked eggs.

CMYK

4 cups torn lettuce 1 cup sliced fresh mushrooms 1 (10 ounce) package frozen peas 1 cup coarsely shredded carrots 4 hard-cooked egg whites, chopped; discard yolks 5 slices turkey bacon, cooked, drained and crumbled 1/2 cup (2 ounces) finely shredded reduced-fat cheddar cheese 1 1/4 cups Creamy Parmesan Dressing (see recipe below) 2 tablespoons snipped fresh chives Place the lettuce in a large clear-glass bowl with straight sides. In the following order, layer the mushrooms, frozen peas, carrots, egg whites and turkey bacon on top. Sprinkle with 1/4 cup of cheddar cheese. Then carefully spread the dressing over the top, sealing the dressing to the edge of the bowl. Sprinkle with the remaining 1/4 cup of cheddar cheese and the chives. Cover and refrigerate for 24 hours. To serve, toss the salad until the lettuce and vegetables are coated. Makes 8 side-dish servings.

Creamy Parmesan Dressing

No one will ever guess that this rich, creamy dressing is virtually fat free. Use it on the 24-Hour Layer Salad or with plain lettuce, fresh tomatoes, or as a dip with raw vegetables. Calories, fat and cholesterol were reduced by: • Replacing regular sour cream with a combination of fat-free yogurt and fat-free sour cream; • Using reduced-fat parmesan cheese (3 grams of fat per ounce of cheese) 1/2 cup fat-free plain yogurt 1/2 cup fat-free sour cream 1/4 cup grated reduced-fat parmesan cheese 2 tablespoons fresh lemon juice (see note below) 1 clove garlic, minced In a small bowl, use a wire whisk to stir together the yogurt, sour cream, parmesan cheese, lemon juice and garlic. Cover and chill in the refrigerator for at least 30 minutes to blend the flavors. Makes 1 1/4 cups or 10 servings. Note: This is a tangy dressing. If you prefer a less sour dressing, replace some of the lemon juice with skim milk.

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St. Joseph Medical Center’s Pillager Family Clinic is scheduled to open Nov. 17. The clinic will be home to Dr. Kathy Wimmer, a family practitioner who currently works at Brainerd Medical Center. (Photo by Heidi Lake)

Although egg noodles are fairly low in fat, they still contain much more fat than other types of dried pasta. For this dish, the noodles are replaced with bow tie noodles (but almost any pasta will do). Calories, fat and cholesterol were reduced by: • Replacing egg noodles with bow tie pasta; • Using fat-free cottage cheese; • Replacing sour cream with fat-free plain yogurt; • Using no-stick spray instead of butter to sautè the onions; • Replacing whole milk with a combination of regular skim milk and evaporated skim milk; • Using reduced-fat cheddar cheese (less than 5 grams of fat per ounce of cheese) 8 ounces bow tie pasta 1 cup fat-free cottage cheese 1 cup fat-free plain yogurt 1/4 cup chopped onions 1/2 cup skim milk 1 tablespoon cornstarch 1/2 cup evaporated skim milk 1/2 teaspoon dry mustard 1/2 teaspoon Worcestershire sauce Dash ground red pepper Dash of hot pepper sauce 1/4 cup (1 ounce) finely shredded reduced-fat sharp cheddar cheese 3 tablespoons fine dry seasoned bread crumbs Cook the pasta according to the directions on the package. Drain and set aside. Meanwhile, lightly spray a 2-quart casserole with no-stick spray and set

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Dr. Kathy Wimmer, a family practitioner at Brainerd Medical Center, will soon be transferring her practice to St. Joseph’s Medical Center Pillager Family Clinic. Wimmer has practiced at BMC five and onehalf years. “I thought it’d be nice to have a small town atmosphere,” Wimmer said. “It’ll be more relaxed and not so hectic.” Wimmer expects to serve 20-25 patients each day. Three nurses will be cross-trained as receptionists and will join Wimmer at the Pillager clinic. Tracy Schmidt, Wimmer’s current nurse, Linda Johnson, of St. Joe’s Pine River clinic and Sonja Endreson, who currently works at SJMC, will join the Pillager team. The clinic is scheduled to open Nov. 17. Hours will be 8 a.m. to 4:30 p.m. Monday through Friday. The 3,500 square-foot clinic has five exam rooms and a procedure room. An open house is scheduled 2:30-6 p.m. Nov. 17, which will include tours of the new facility and a dedication ceremony.

Nutrition Scorecard (per serving) Calories – 29 Fat (g) – <1 % calories from fat – 19% Cholesterol (mg) – 0 Exchanges (per serving) 1/2 fat

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aside. Press the cottage cheese through a strainer or sieve into a large bowl. Add the yogurt and stir until well combined. Set the yogurt mixture aside. Preheat the oven to 350 degrees. Lightly spray a medium saucepan with nostick spray. Add the onions. Cook and stir over medium heat about three minutes or until tender. In a custard cup, stir together 2 tablespoons of the skim milk and the cornstarch until smooth. Stir the remaining skim milk, evaporated milk and cornstarch mixture into the onions. Cook and stir over medium heat until thickened and bubbly. Then stir in the dry mustard, Worcestershire sauce, red pepper and hot pepper sauce. Cook and stir for one minute more. Stir in the cheddar cheese and cook until melted. Slowly stir the cheese mixture into the yogurt mixture. Fold in the pasta. Transfer to the prepared casserole. Sprinkle the bread crumbs on top. Bake about 15 minutes or until bubbly. Makes 6 servings. Nutrition Scorecard (per serving) Calories – 245 Fat (g) – 2 % calories from fat – 7% Cholesterol (mg) – 7

A construction worker put finishing touches around the door frames and windows at the Lakewood Health System Pillager Clinic.

Exchanges (per serving) 1 1/2 starch 1 lean meat 1/2 milk

Don’t be alarmed by seeing butter instead of margarine in this recipe. It’s used only a tiny amount to give these carrots a rich, buttery taste. It makes a big difference! Calories, fat and cholesterol were reduced by: • Replacing some of the butter with apple juice. CMYK

Nutrition Scorecard (per serving) Calories – 74 Fat (g) – 1 % calories from fat – 1% Cholesterol (mg) – 3 Exchanges (per serving) 2 vegetable

Classy Potatoes

Glazed Carrots

Construction workers worked on finishing the waiting room of the Lakewood Health System Pillager Clinic. (Photos by Mindy Niemela)

Cut the carrots into 2” long pieces. Then cut lengthwise into quarters. In a large saucepan with a tight-fitting lid, bring about 1” of water to a boil. Place carrots in a steamer basket and set the basket in the saucepan, making sure the basket sits above the water. Cover the saucepan and steam for 8 to 10 minutes or until crisp-tender. Meanwhile, in a 1-cup microwave-safe measuring cup or custard cup, stir together the apple juice, brown sugar and butter. Cook in a microwave oven on high power (100%) about 25 seconds or just until the brown sugar and butter are melted. To serve, transfer the carrots to a serving bowl. Drizzle with the apple juice mixture and toss until coated. If desired, sprinkle with the nutmeg and toss again. Makes 4 servings. Note: Since sodium is a concern for many people, the amount is reduced in this recipe by omitting the salt that’s usually sprinkled on cooked vegetables. You can do that with virtually any vegetable and you’ll never notice the difference.

1 pound carrots 4 teaspoons apple juice 1 tablespoon brown sugar 1 teaspoon butter 1/4 teaspoon ground nutmeg (optional)

Serve this delicious cheese and potato casserole when company’s coming for dinner. It’s ideal because you can prepare it before your guests arrive. This leaves you more time to spend with them instead of being in the kitchen doing last-minute preparations. Calories, fat and cholesterol were reduced by: • Using reduced-fat sharp cheddar cheese (less than 5 grams of fat per ounce of cheese); • Using reduced-fat cream of chicken soup; (Continued on Page 30)

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Plenty of pills in Pillager

Two clinics, pharmacy opening soon

Story/Heidi Lake

A town about 15 miles west of Brainerd has two gas stations, two bars, two restaurants and now two clinics. Although the green sign outside the city of Pillager says, “population 420,” administrators of Staples-based Lakewood Health System and Brainerd-based St. Joseph’s Medical Center are confident the small town can support two clinics. “Just look around the area surrounding Pillager,” said Tim Rice, Lakewood Health System president. “There is a lot of growth in that area.” The clinics, located practically side-by-side near Highway 210 and Cass County Road 1, are both scheduled to open in November.

Lakewood Health System Pillager Clinic Lakewood Health System Pillager Clinic is scheduled to open Nov. 3. The primary care clinic will have three rotating doctors on staff, Dr. Arden Beachy, Dr. Michael Hudalla and Dr. Renee Nydegger. The doctors currently work at the Staples clinic and will rotate between the Pillager and Staples clinics as needed. A physician’s assistant, Rebecca Bennett, and a nurse practitioner, Kelly Thompson, will also staff the Pillager clinic. “(A rotating staff) will give people a choice,” Rice said. “It gives them accessibility to options.” The 7,000 square-foot clinic has six exam rooms, a laboratory, a nurses’ station and an X-ray and minor procedure room. A physical therapist from Lakewood Hospital in Staples will offer physical therapy at the clinic three days a week. Craig Wolhowe, division director of clinic services at Lakewood, said he expects the clinic to serve 18 to 22 patients each day. The clinic will also house Pillager’s only pharmacy, Longbella Drug. An open house is scheduled 1-3 p.m. Nov. 2.

CMYK

Lakewood Health System Pillager Clinic plans to open Nov. 3. The 7,000 square-foot clinic will include a pharmacy and will be located near Highway 210 and Cass County Road 1. (Photo by Mindy Niemela)

Surgery Is An Art. Meet Our Picassos. These are the surgeons who practice their art at the Cuyuna Regional Medical Center in Crosby. Each brings a rare and unique set of skills to the job. Together, they’re helping to shape the future of surgery in this region. They bring the region new procedures and new technologies. They work with computers, scopes and lasers, not simply with scalpels. In many procedures, their incisions are less than three millimeters long,

18

and closed with a band-aid, not with a stitch. Their training has taken them around the world. Their resumes include some of the

most prestigious schools, internships and residency programs in America. They’re teachers, too. No less than four of

our surgeons are actively involved in training other surgeons around the region. Four are on the faculties of regional medical colleges. They’re experts in joint repair and joint replacement. In cataract and laser vision correction. In a multitude of procedures that can improve the quality of your life. If you (or someone you know) is in need of surgery (or considering some form of elective surgery), ask your doctor (or call 1-218-546-2300 and ask) about the surgeons who practice at the Cuyuna Regional Medical Center in Crosby today.

19


Plenty of pills in Pillager

Two clinics, pharmacy opening soon

Story/Heidi Lake

A town about 15 miles west of Brainerd has two gas stations, two bars, two restaurants and now two clinics. Although the green sign outside the city of Pillager says, “population 420,” administrators of Staples-based Lakewood Health System and Brainerd-based St. Joseph’s Medical Center are confident the small town can support two clinics. “Just look around the area surrounding Pillager,” said Tim Rice, Lakewood Health System president. “There is a lot of growth in that area.” The clinics, located practically side-by-side near Highway 210 and Cass County Road 1, are both scheduled to open in November.

Lakewood Health System Pillager Clinic Lakewood Health System Pillager Clinic is scheduled to open Nov. 3. The primary care clinic will have three rotating doctors on staff, Dr. Arden Beachy, Dr. Michael Hudalla and Dr. Renee Nydegger. The doctors currently work at the Staples clinic and will rotate between the Pillager and Staples clinics as needed. A physician’s assistant, Rebecca Bennett, and a nurse practitioner, Kelly Thompson, will also staff the Pillager clinic. “(A rotating staff) will give people a choice,” Rice said. “It gives them accessibility to options.” The 7,000 square-foot clinic has six exam rooms, a laboratory, a nurses’ station and an X-ray and minor procedure room. A physical therapist from Lakewood Hospital in Staples will offer physical therapy at the clinic three days a week. Craig Wolhowe, division director of clinic services at Lakewood, said he expects the clinic to serve 18 to 22 patients each day. The clinic will also house Pillager’s only pharmacy, Longbella Drug. An open house is scheduled 1-3 p.m. Nov. 2.

CMYK

Lakewood Health System Pillager Clinic plans to open Nov. 3. The 7,000 square-foot clinic will include a pharmacy and will be located near Highway 210 and Cass County Road 1. (Photo by Mindy Niemela)

Surgery Is An Art. Meet Our Picassos. These are the surgeons who practice their art at the Cuyuna Regional Medical Center in Crosby. Each brings a rare and unique set of skills to the job. Together, they’re helping to shape the future of surgery in this region. They bring the region new procedures and new technologies. They work with computers, scopes and lasers, not simply with scalpels. In many procedures, their incisions are less than three millimeters long,

18

and closed with a band-aid, not with a stitch. Their training has taken them around the world. Their resumes include some of the

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our surgeons are actively involved in training other surgeons around the region. Four are on the faculties of regional medical colleges. They’re experts in joint repair and joint replacement. In cataract and laser vision correction. In a multitude of procedures that can improve the quality of your life. If you (or someone you know) is in need of surgery (or considering some form of elective surgery), ask your doctor (or call 1-218-546-2300 and ask) about the surgeons who practice at the Cuyuna Regional Medical Center in Crosby today.

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aside. Press the cottage cheese through a strainer or sieve into a large bowl. Add the yogurt and stir until well combined. Set the yogurt mixture aside. Preheat the oven to 350 degrees. Lightly spray a medium saucepan with nostick spray. Add the onions. Cook and stir over medium heat about three minutes or until tender. In a custard cup, stir together 2 tablespoons of the skim milk and the cornstarch until smooth. Stir the remaining skim milk, evaporated milk and cornstarch mixture into the onions. Cook and stir over medium heat until thickened and bubbly. Then stir in the dry mustard, Worcestershire sauce, red pepper and hot pepper sauce. Cook and stir for one minute more. Stir in the cheddar cheese and cook until melted. Slowly stir the cheese mixture into the yogurt mixture. Fold in the pasta. Transfer to the prepared casserole. Sprinkle the bread crumbs on top. Bake about 15 minutes or until bubbly. Makes 6 servings. Nutrition Scorecard (per serving) Calories – 245 Fat (g) – 2 % calories from fat – 7% Cholesterol (mg) – 7

A construction worker put finishing touches around the door frames and windows at the Lakewood Health System Pillager Clinic.

Exchanges (per serving) 1 1/2 starch 1 lean meat 1/2 milk

Don’t be alarmed by seeing butter instead of margarine in this recipe. It’s used only a tiny amount to give these carrots a rich, buttery taste. It makes a big difference! Calories, fat and cholesterol were reduced by: • Replacing some of the butter with apple juice. CMYK

Nutrition Scorecard (per serving) Calories – 74 Fat (g) – 1 % calories from fat – 1% Cholesterol (mg) – 3 Exchanges (per serving) 2 vegetable

Classy Potatoes

Glazed Carrots

Construction workers worked on finishing the waiting room of the Lakewood Health System Pillager Clinic. (Photos by Mindy Niemela)

Cut the carrots into 2” long pieces. Then cut lengthwise into quarters. In a large saucepan with a tight-fitting lid, bring about 1” of water to a boil. Place carrots in a steamer basket and set the basket in the saucepan, making sure the basket sits above the water. Cover the saucepan and steam for 8 to 10 minutes or until crisp-tender. Meanwhile, in a 1-cup microwave-safe measuring cup or custard cup, stir together the apple juice, brown sugar and butter. Cook in a microwave oven on high power (100%) about 25 seconds or just until the brown sugar and butter are melted. To serve, transfer the carrots to a serving bowl. Drizzle with the apple juice mixture and toss until coated. If desired, sprinkle with the nutmeg and toss again. Makes 4 servings. Note: Since sodium is a concern for many people, the amount is reduced in this recipe by omitting the salt that’s usually sprinkled on cooked vegetables. You can do that with virtually any vegetable and you’ll never notice the difference.

1 pound carrots 4 teaspoons apple juice 1 tablespoon brown sugar 1 teaspoon butter 1/4 teaspoon ground nutmeg (optional)

Serve this delicious cheese and potato casserole when company’s coming for dinner. It’s ideal because you can prepare it before your guests arrive. This leaves you more time to spend with them instead of being in the kitchen doing last-minute preparations. Calories, fat and cholesterol were reduced by: • Using reduced-fat sharp cheddar cheese (less than 5 grams of fat per ounce of cheese); • Using reduced-fat cream of chicken soup; (Continued on Page 30)

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Healthy cooking

Nutrition Scorecard (per serving) Calories – 123 Fat (g) – 4 % calories from fat – 29% Cholesterol (mg) – 12

24-Hour Layer Salad

Exchanges (per serving) 2 vegetables 1 lean meat 1/2 fat

Here’s a salad you can prepare the day before and the lettuce will stay crisp until you’re ready to serve it. Calories, fat and cholesterol were reduced by: • Replacing bacon with turkey bacon and reducing the total amount; • Reducing the amount of cheddar cheese and using its reduced-fat alternative (less than 5 grams of fat per ounce of cheese); • Using a reduced-fat parmesan dressing instead of mayonnaise; • Using only the egg white portion of the hard cooked eggs.

CMYK

4 cups torn lettuce 1 cup sliced fresh mushrooms 1 (10 ounce) package frozen peas 1 cup coarsely shredded carrots 4 hard-cooked egg whites, chopped; discard yolks 5 slices turkey bacon, cooked, drained and crumbled 1/2 cup (2 ounces) finely shredded reduced-fat cheddar cheese 1 1/4 cups Creamy Parmesan Dressing (see recipe below) 2 tablespoons snipped fresh chives Place the lettuce in a large clear-glass bowl with straight sides. In the following order, layer the mushrooms, frozen peas, carrots, egg whites and turkey bacon on top. Sprinkle with 1/4 cup of cheddar cheese. Then carefully spread the dressing over the top, sealing the dressing to the edge of the bowl. Sprinkle with the remaining 1/4 cup of cheddar cheese and the chives. Cover and refrigerate for 24 hours. To serve, toss the salad until the lettuce and vegetables are coated. Makes 8 side-dish servings.

Creamy Parmesan Dressing

No one will ever guess that this rich, creamy dressing is virtually fat free. Use it on the 24-Hour Layer Salad or with plain lettuce, fresh tomatoes, or as a dip with raw vegetables. Calories, fat and cholesterol were reduced by: • Replacing regular sour cream with a combination of fat-free yogurt and fat-free sour cream; • Using reduced-fat parmesan cheese (3 grams of fat per ounce of cheese) 1/2 cup fat-free plain yogurt 1/2 cup fat-free sour cream 1/4 cup grated reduced-fat parmesan cheese 2 tablespoons fresh lemon juice (see note below) 1 clove garlic, minced In a small bowl, use a wire whisk to stir together the yogurt, sour cream, parmesan cheese, lemon juice and garlic. Cover and chill in the refrigerator for at least 30 minutes to blend the flavors. Makes 1 1/4 cups or 10 servings. Note: This is a tangy dressing. If you prefer a less sour dressing, replace some of the lemon juice with skim milk.

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St. Joseph Medical Center’s Pillager Family Clinic is scheduled to open Nov. 17. The clinic will be home to Dr. Kathy Wimmer, a family practitioner who currently works at Brainerd Medical Center. (Photo by Heidi Lake)

Although egg noodles are fairly low in fat, they still contain much more fat than other types of dried pasta. For this dish, the noodles are replaced with bow tie noodles (but almost any pasta will do). Calories, fat and cholesterol were reduced by: • Replacing egg noodles with bow tie pasta; • Using fat-free cottage cheese; • Replacing sour cream with fat-free plain yogurt; • Using no-stick spray instead of butter to sautè the onions; • Replacing whole milk with a combination of regular skim milk and evaporated skim milk; • Using reduced-fat cheddar cheese (less than 5 grams of fat per ounce of cheese) 8 ounces bow tie pasta 1 cup fat-free cottage cheese 1 cup fat-free plain yogurt 1/4 cup chopped onions 1/2 cup skim milk 1 tablespoon cornstarch 1/2 cup evaporated skim milk 1/2 teaspoon dry mustard 1/2 teaspoon Worcestershire sauce Dash ground red pepper Dash of hot pepper sauce 1/4 cup (1 ounce) finely shredded reduced-fat sharp cheddar cheese 3 tablespoons fine dry seasoned bread crumbs Cook the pasta according to the directions on the package. Drain and set aside. Meanwhile, lightly spray a 2-quart casserole with no-stick spray and set

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Dr. Kathy Wimmer, a family practitioner at Brainerd Medical Center, will soon be transferring her practice to St. Joseph’s Medical Center Pillager Family Clinic. Wimmer has practiced at BMC five and onehalf years. “I thought it’d be nice to have a small town atmosphere,” Wimmer said. “It’ll be more relaxed and not so hectic.” Wimmer expects to serve 20-25 patients each day. Three nurses will be cross-trained as receptionists and will join Wimmer at the Pillager clinic. Tracy Schmidt, Wimmer’s current nurse, Linda Johnson, of St. Joe’s Pine River clinic and Sonja Endreson, who currently works at SJMC, will join the Pillager team. The clinic is scheduled to open Nov. 17. Hours will be 8 a.m. to 4:30 p.m. Monday through Friday. The 3,500 square-foot clinic has five exam rooms and a procedure room. An open house is scheduled 2:30-6 p.m. Nov. 17, which will include tours of the new facility and a dedication ceremony.

Nutrition Scorecard (per serving) Calories – 29 Fat (g) – <1 % calories from fat – 19% Cholesterol (mg) – 0 Exchanges (per serving) 1/2 fat

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CMYK

Cancer doctor finds out what disease is like first hand AUGUSTA, Ga. — Ward Hernandez gets a hand from Dr. David Squires, literally, as Squires helps him lean forward in the bed at University Hospital and then slips a stethoscope around to his back. "OK, lungs sound good," Squires says with a quick smile. There is an almost tangible bond between lymphoma patient Hernandez and his oncologist. "They have a lot in common," said Hernandez's fiancee, Dorothy Glisson. They have both faced cancer. It was a fluke that Squires ended up diagnosing his own acute lymphoblastic leukemia six months before he entered medical school. He was in a histology class at Brigham Young University, and the assignment called for students to examine their own blood with a microscope. "I noticed that I was anemic and had an abnormally high number of lymphocytes (white blood cells) in my peripheral count," Squires said. As luck would have it, the next day he was grading papers for another class, and one dealt with leukemia. When he looked it up, the pieces fell

into place. A week later, he was starting chemotherapy, which would last for three years. Despite that, he graduated as valedictorian of his undergraduate class and would later be inducted into a medical honor society. When it came time to choose a spe-

"Many people can be in academics and do a fine job. What I really have to offer people is the experience I had." cialty, he was naturally interested in cancer and would eventually land a three-year fellowship at the National Cancer Institute. As the fellowship was coming to an end last year, however, he decided not to continue his work with clinical trials. Instead, he wanted to see

Story/Tom Corwin Photo/Jonathan Ernst (Morris News Service) patients full time. He joined Augusta Oncology Associates in August. "Many people can be in academics and do a fine job. What I really have to offer people is the experience I had," he said. The cancer shaped not only his communication with patients but also his view of life and his ability to share that with them. The key is coping with what he calls "the tentativeness of cancer." "This is part of life," he said. "Everyone is living tentatively. Most people just don't realize it until they get some kind of acute, life-threatening illness." Faith has a lot to do with that, he said. "I spend time with them and their families and find out what kind of support they have," he said. "And our discussions inevitably turn to God." Squires can even see a positive in the cancer that invaded his body. His original goal was to become a surgeon. "I actually think it is somewhat of a blessing," he said, "because I don't think I would have enjoyed surgery as much as I enjoy oncology."

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Snack attack When striving to lose weight, Lange says many people will starve themselves between meals. But this can, in fact, backfire. “I often recommend people include an afternoon snack,” Lange said, noting often times when people don’t eat between lunch and dinner they’re much more likely to overeat during their evening meal. Fruit and nuts, herring on whole wheat crackers and yogurt are good, healthy choices,

Lange says, adding each of these foods helps meet daily requirements from the various food groups. Serving it up It used to be recommended that individuals eat five servings a day of fruits and vegetables, but that is changing. Lange says the push now is for nine servings a day for proper nutrition. A common misconception among weight watchers, is that dairy is taboo and high in fat. Lange said she recommends her patients with weight management and high blood pressure issues still get in three servings of low-fat dairy each day. Calcium is a critical signaling agent, helping many cells know what to do, and dairy foods help lead to satiety or a feeling of satisfaction after each meal. As far as protein, working women seem to fall short in getting their requirements, Lange says. Women should consume two servings, or at least 5 ounces, of protein each day. Proteins include lean meats, chicken, fish, eggs, cottage cheese and lowfat cheese. Men need approximately 5 to 8 ounces of protein per day. Cutting those carbs The infamous Atkins diet has done at least one good thing for the public at-large, Lange concedes. It’s helped people recognize which foods contain carbohydrates. Lange agrees it’s best to limit the “bad carbs” found in white bread, white rice and sugary low-fiber cereals. These foods have been

found to create an excessive insulin response where the body secretes more insulin upon consumption of these items leading to early hunger. Rather than cutting carbs completely, Lange suggests the healthier ones, including brown rice, wild rice, baked potatoes, whole grain breads and crackers and high-fiber cereals. Washing it down Lange said she has had patients who consume up to 2,000 calories a day from drinking high sugar sodas alone. She suggests avoiding “regular” pop altogether. If you must get your soda fix, Lange says to switch to diet pop. Other healthier alternatives include non-caffeinated beverages such as Diet Snapple, sugar-free Kool Aid or Crystal Light. Without a doubt, Lange says the best beverage is plain ol’ water. She recommends people drink between 6 and 8 cups a day. “I tell people to fill a mug, with at least 2 cups of water, and keep it on their desk at work during the day.” She says to force yourself to finish it before lunch, then refill it after lunch and finish it before leaving for the day to ensure you get at least 4 cups of water while at the office. Then fill a water bottle to take with you in the evening to sporting events, church functions or anywhere you travel. Getting enough water may help to wash away several health problems, including urinary tract infections, kidney stones, bladder cancer, colon cancer, obesity and constipation.

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That nasty “F” word Often times, the “F” word is given a bad rap, but Lange stresses that fats aren’t all bad. Lange suggests when preparing meals, people use more healthy oils and nuts. Monounsaturated fats lower the risk of heart disease as well as LDL, or bad cholesterol, without lowering the HDL, or good cholesterol. Products with monounsaturated fats include olive and canola oils, olives, avocados and most nuts, including almonds, filberts, macadamias, peanuts, pecans, cashews and pistachios. Lange encourages people to try olive oil or canola oil in place of other vegetable oils, butter or margarine. Another fat to include in your diet is Omega-3 fatty acid, found in high-fat fishes such as salmon, herring, tuna, anchovies and sardines, as well as in green leafy vegetables, and soybean and canola oils. This type of fat has been shown to reduce the risk of heart disease as well as stroke and also lowers LDL cholesterol and raises the HDL cholesterol.

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A guide to healthy eating In a generation obsessed with fad diets and quick fixes for weight loss, good eating habits sometimes get lost in the shuffle. Mary Lange, a registered dietitian at Brainerd Medical Center, points out that cutting back on saturated and trans fats, as well as making sure to include enough of the basic food groups on a daily basis, can make a world of difference when striving for a healthier lifestyle.

CMYK

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One-year-old Cameron Walkowiak doesn’t know it yet, but his parents consider him a miracle. Jason and Darcy Walkowiak suffered through the bumps and bruises of infertility and Darcy finally got pregnant with Cameron after three years of trying.

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CMYK

In Roux-en-Y bypass, the stomach is sewn into two parts. The upper part forms a small pouch that receives food. Also, a section of the small intestine is attached to the pouch to allow food to bypass the lower stomach and the first portion of the small intestine.

He was 6-foot-4 and 342 pounds. “I was a physical mess,” he said. ‘I didn’t have energy, I didn’t have will and I was just waiting to have a massive coronary or heart attack and die.” He was a 44 year old husband and father of four who was spending an increasing amount of time in the hospital for various weight-related health problems. Bonar tried everything to lose weight, to no avail. He was overweight his whole life. He remembers taking diet pills in sixth-grade and playing high school football at 300 pounds. “I tried TOPS and Weight Watchers ... I’d lose weight for the first five days, then get frustrated and give up,” he said. Bonar first heard about gastric bypass surgery in January 2002. He spoke with his doctors who he came to know all too well after spending so much time in the Crosby hospi-

12

Lap-Band uses an adjustable silicone band, separating the stomach into two pouches.

tal. They decided he should have Roux-en-Y bypass. “I knew this was my last chance,” he said. Before the surgery, Bonar took part in the mandatory preparation program that included a bariatric seminar, giving an overview of the Roux-en-Y and Lap-Band surgeries, and saw a dietitian, physical therapist and psychologist to be sure he was mentally ready for the procedure. On Sept. 6, 2002, Bonar had Roux-en-Y bypass, a surgery that changed his life forever – not without a few bumps along the way. The surgery, which normally causes little or no pain, was giving Bonar severe abdominal pain three days after the surgery. After a CAT scan, doctors found his old stomach was filled with blood caused by a leak from where his intestine was sewn to his stomach.

“If it had burst it would’ve killed me,” Bonar said. McCollister said Bonar is one of two patients who had complications out of the 120 gastric bypass surgeries the MIMIS surgical team has done. By the end of September, Bonar was feeling better and started losing weight. So far he has lost 120 pounds, “And there’s no way I’m going to get it back,” he said. Today Bonar eats about two-thirds of a plate of food every meal and tries to avoid eating carbohydrates and sugars. Along with the weight, Bonar has shed all of his health problems, even diabetes. He takes no medications and for the first time in a long time, he can ride a bike and go camping with his family. “This surgery has given me another chance to live,” Bonar said. “I was going to die.”

In the winter of 1998 two 20-year-olds, Jason and The eggs are fertilized with semen, incubated in a bank in Roseville, the Walkowiaks went online in Darcy Walkowiak, thought they had the world by laboratory dish, and transferred to the woman’s search of a sperm donor. The Web site, www.crythe tail. They were newly married, had good jobs, uterus through the cervix at the appropriate time. olab.com, makes shopping for sperm as easy as The report says IVF is the most common assist- browsing the clothing racks at the mall. The Web and were thrilled by the thought of buying a home ed reproductive treatment done in the United site allows people to identify the race, blood type, and starting a family together. By fall, they bought a three-bedroom house in a States, with less than a 30 percent success rate, ethnic background, hair color, eye color and quaint Brainerd neighborhood, hoping to soon about the same chance healthy couples have of height of the sperm donor. After inputting the conceiving naturally each menstrual cycle. characteristics, Cryogenics provides a list of use one of the spare bedrooms as a baby’s room. “IVF is very common (among infertile couples),” donors who meet the qualifications. The list After a year of unsuccessfully trying to get pregnant the Walkowiaks decided it was time to see a said Uhlman. “IVF has really changed things on the includes detailed information about each donor, forefront (of infertility).” including education, health history and even the doctor. After much research and consideration, the shape of their eyes, nose and mouth. Jason and Darcy both were tested to see why “It’s a completely anonymous program,” Darcy they couldn’t seem to conceive. Darcy said many Walkowiaks decided to try donor insemination. “We didn’t feel comfortable with in vitro said. “(The donor) will never know if his sperm was people assume reproduction problems are due to the female, but statistics say males and females because it was so expensive and the chances of used and he has kids.” The Walkowiaks found their donor, bought have an equal chance of having reproduction getting pregnant weren’t that good,” Darcy said, adding their insurance doesn’t cover infertility pro- every vile of his sperm available, costing $230 per problems. vile, and started the process. Darcy’s ovulation cycle, tubes and uterus were cedures. Through Cryogenics Laboratories, a sperm When Darcy was ovulating, Cryogenics would tested, and the results showed her body was capasend two viles to West Health in ble of producing a child and carrying it Plymouth, to be inserted in Darcy’s throughout a pregnancy. uterus. Jason’s sperm count was tested, and After five attempts, Darcy still wasn’t the results showed he had low motilipregnant. They were down to the last ty. After further testing, it was found three viles of their supply. that Jason had a varicocele, a clump of “We couldn’t afford any more and varicose veins in his scrotum that prothere was no more sperm,” Darcy said. “It duced too much heat, killing the was our last chance.” sperm. During this time of trying and continuJason had surgery to correct the ously failing to get pregnant, Jason and problem and doctors were 60 percent Darcy said they’d never felt so alienated sure the Walkowiaks would be able to and alone. conceive naturally. “We kept asking ourselves, ‘Why is In February 2001, Jason went back to God punishing us?’ and thinking we the doctor and heard words he never weren’t made to be parents,” Darcy said. expected to hear. The surgery was Darcy joined an infertility support unsuccessful and he could never have group in Crosby, where she could speak biological children. to other women dealing with infertility. “It was pretty devastating to find out “It helps to know there’s a lot of peothere’s no chance,” Darcy said. ple out there dealing with (infertility),” “It was an issue for me at first,”Jason Jason said. said of finding out he was the reason Three weeks after the final attempt, they couldn’t conceive. “But it’s not Darcy hadn’t gotten her period. The coulike if Darcy couldn’t hold a baby. Then ple tried not to get their hopes up, prowe would have had no choice but to tecting themselves from getting their adopt.” dreams dashed again, like so many other The doctor gave the couple their times after finding out Darcy wasn’t pregoptions — they could do in vitro fertilnant. She took a home pregnancy test. It ization, donor insemination or adopt. was negative. The Walkowiaks, then 23, spoke By the fourth week, Darcy still didn’t with an adoption agency and found have her period and she said something out until they turn 25, the chances of didn’t feel right. She took another pregthem receiving an infant without spenancy test. It was positive. After about cial needs were slim. That narrowed three other home pregnancy tests and a their choices to IVF or donor insemiblood test at the hospital, it was connation, procedures that are not done firmed. The Walkowiaks were going to in Brainerd or anywhere in the area. have a baby. Dr. Carol Uhlman, a mild fertility On July 4, 2002, Cameron John specialist and obstetrician/gynecoloPeterson Walkowiak entered the world gist at Brainerd Medical Center, said and his two adoring parents couldn’t be BMC can do initial evaluations and happier. hormonal studies on infertile couples, “The joy we get from him is so great,” and even prescribe fertility drugs, but Darcy said. anything more involved, such as IVF, is Today, Cameron is walking, feeding referred to hospitals and clinics in the himself and even saying a few words. Twin Cities. Jason and Darcy have recently started a The Minnesota Fertility Clinic support group to help other couples deal Report describes IVF as a procedure with the struggles infertility brings. For where the woman’s ovaries are stimulated with drugs to release eggs, which Jason and Darcy Walkowiak watched as their son, Cameron, played at more information on Brainerd’s support group, e-mail Darcy at darcyw@brainare retrieved using a needle guided a park near their home. erd.net or call 651-659-0333. through the vagina with ultrasound.

25


CMYK

Artificial leg doesn’t slow down Staples man

Story/Jenny Kringen-Holmes Photo/Steve Kohls

Looking at Dave Fabian, you’d never know he has an artificial leg. It’s not until he changes into shorts and pulls down the fabric cover of his prosthesis do you see the mechanics that have made it possible for this cancer survivor to continue doing what he loves best — living a normal life.

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Dr. Howard McCollister, chief of surgery at the Minnesota Institute for Minimally Invasive Surgery at Cuyuna Regional Medical Center in Crosby, stood in one of three operating rooms outfitted for laparoscopic surgery. The high-tech rooms have digital video equipment and cameras, along with voicecontrolled lighting and swinging flat screen TV monitors.

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A computer in the operating room at the Minnesota Institute for Minimally Invasive Surgery at Cuyuna Regional Medical Center works as a control center for the room’s video cameras, monitors and other digital equipment.

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The incredible

stomach

Surgery provides weight loss alternative to obese

CMYK

Story/Heidi Lake Photos/Steve Kohls

Lap-Band uses an adjustable silto lose. CROSBY—Sharon Osbourne has done it. So icone band, separating the stom“Not every patient is a suitable candidate for have Al Roker, Carnie Wilson and Roseanne. ach into two pouches. The band one operation or the other,”McCollister said. “Each Bariatric surgery. Not only is it a weight loss regihas an inflatable inner surface, patient is different and we need to be able to recmen to some of Hollywood’s finest stars, but the allowing the surgeon to adjust the ommend the operation that is safest, and likely to procedure can be done right here in the size of the band depending give the best results.” Brainerd lakes area to everyday people. on how much weight Lap-Band is considered less complicated than Unlike most Minnesota hospitals that the patient Roux-en-Y bypass because neither the stomach perform bariatric surgeries, the wants nor the intestine is cut during the procedure, but Minnesota Institute for Minimally the weight loss results are the same. Invasive Surgery at Cuyuna Regional By shrinking the stomach from the Medical Center in Crosby does them size of a football to the size of a laparoscopically, leaving six one-quarlemon, patients lose an average of ter inch incisions on the abdomen. 100-120 pounds one year after the Dr. Howard McCollister, chief of surgery, McCollister said. Initially surgery at CRMC, said less than a patients can eat a shot glass full of dozen surgeons do bariatric surgerfood, and eventually their stomach ies laparoscopically in Minnesota and stretches depending on how much four of them are at Crosby’s MIMIS. they eat. “It’s a very hard operation to do,” Bariatric surgery is limited to McCollister said of performing surgery patients who are morbidly obese, by using cameras and watching a TV with a body mass index greater than screen. “You’re looking at a two-dimen40, or have a BMI of more than 35 sional image and you have to make it 3-D and have associated health probin your head – kind of like a video lems such as high blood pressure, game.” diabetes, acid reflux or arthritis. The MIMIS surgical team has done BMI is a measurement related to more than 120 bariatric surgeries in the the patient’s body surface area and year and a half they’ve been performis used to determine a patient’s level ing them. of obesity. It is calculated by a stanThere are two types of bariatric surdard chart that correlates a patient’s geries, Roux-en-Y bypass, and Lapheight and weight. A BMI chart can Band. be found at www.cdc.gov/nccdIn Roux-en-Y, the stomach is sewn php/dnpa/bmi/calc-bmi.htm. into two parts. The upper part forms a “Diet and exercise is fine for small pouch that receives food. The some people,” McCollister said, but pouch can hold about one fluid many people with health problems ounce. can’t exercise. A section of the small intestine is McCollister restated the signifiattached to the pouch to allow food to cant dangers of being obese, saying bypass the lower stomach and the obesity-related illnesses are the No. first portion of the small intestine. 2 cause of death in the United Although food does not go through States, second only to smokingthis bypassed segment, it still functions related illnesses. by secreting gastric and digestive juices Tom Bonar of Pine River was diafrom the liver and pancreas and empbetic, had his left leg amputated ties into this area. below the knee and had extremely The Roux-en-Y bypass is considered high blood pressure, heart proba more complicated surgery that requires spending one or two Tom Bonar of Pine River demonstrated his 120-pound weight loss by holding up lems and gastroesophageal days in the hospital following the a pair of pants he wore before he had gastric bypass surgery. Then a size 52, reflux disease, a condition Bonar describes as having constant procedure, whereas Lap-Band can today, one year after surgery, Bonar wears a size 40. (Photo by Nels Norquist) heartburn. be done on an outpatient basis.

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A healthy, middle-aged man from Staples, Fabian never imagined living without a leg. But when cancer forced the amputation of his entire left leg, there was no question whether he’d try a prosthetic leg. “I have cancer,” Fabian recalls. “I lost my leg. (A prosthetic leg) was one of the positives of the whole thing. I’m going to have a leg and be able to get around.” Cancer takes leg In October of 2002, Fabian, 51, began to experience pain in his left leg. Doctors investigated for the source of the pain but had no answers until later that month when a lump surfaced on Fabian’s upper left thigh. Doctors told Fabian the growth was likely benign. But his symptoms worsened and when a biopsy was done at Fairview-University Medical Center, Fabian’s worst fears came true. The lump was a malignant tumor and a form of sarcoma cancer. “I was devastated,” Fabian said. “But I have this real positive attitude. My family and I decided ‘we’re gonna beat this thing.’” Doctors gave Fabian two options — total amputation of the left leg; or a procedure to attempt to remove the tumor which would include a series of skin, nerve and bone grafts, something that came with its own set of complications. So, in December of 2002, Fabian’s left leg was amputated from the hip joint down. He spent eight days recovering at Fairview-University then returned home to begin his drastically new life. While visiting with his physical therapist in Staples, Fabian learned of the possibility to walk again with the help of a prosthetic leg. In February, he was introduced to Chip Taylor, a certified prosthetist and orthotist with Prosthetic Laboratories in Baxter. Fabian’s doctors had told him half of the individuals who have this type of amputation don’t receive a prosthesis and of the half that do only 25 percent stick with it. Fabian said that statistic was his carrot and gave him the motivation to be one of the 25 percent who successfully use a prosthetic leg on a daily basis. In March, a plaster impression was taken of Fabian’s remaining pelvic area and a “trial” prosthesis was made to utilize full function, comfort and also to accommodate the small tissue shrinkage that follows an amputation. As the area shrunk, padding was added to the hip socket of the prosthesis to ensure a proper fit. In June, the tissue shrinkage stabilized and Fabian was once again cast for another prosthesis — the one he still wears today.

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Chip Taylor of Prosthetic Laboratories in Baxter inspected the knee housing unit of Dave Fabian’s leg prosthesis.

DEPEND ON THE BEST Brainerd Medical Supply is proud to say we’ve become central Minnesota’s most respected medical supply service for the home, earning the loyalty and trust of clients and medical participants throughout the region. Our staff of expert consultants includes registered pharmacists and licensed respiratory care practitioners. Our largest selection of special equipment features the finest names in the industry. Brainerd Medical Supply is your complete medical service center for the home, for everything from first aid supplies and oxygen service to wheelchairs and hospital beds. We will work with your Medicare, Medicaid, and similar insurance programs. • Apnea Monitors • Commodes • Diabetic Supplies • Incontinence Supplies • Oxygen • Dressings • Bathroom Safety Aids • Walking Aids and Accessories • Hospital Beds and accessories • Ostomy Supplies • Respiratory Equipment • Wheelchairs • Handicapped Accessible/Parking • 24-Hour Call for Emergency Oxygen • Rental Programs • Prompt Delivery • Complete Service and Repair • Professional, Experienced Staff • Trained Technicians • First Aid Supplies • Educational Seminars Available • Cpaps/Bipaps

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Getting a prosthetic

CMYK

Each prosthetic is custom made. An impression, or a blueprint for the prosthetic socket, is made for each individual, Taylor describes, then the mechanics are added below that. The technology for prosthetics has advanced greatly in the last 20 years, he said. Titanium and aircraft aluminum are now used to allow for a much lighter and stronger device. Taylor notes that Fabian’s particular prosthesis weighs about 11 pounds, compared to his entire leg which likely weighed about 30 pounds or more before amputation. “But any prosthetic always feels heavier than it really is,”Taylor said, explaining it is basically a foreign object suspended from the patient. Taylor, who has worked in the prosthetics field since 1988, said the average prosthesis has a life span anywhere between three and five years. “Like most mechanical devices, the (prosthesis) parts need to be serviced,” he said. In fact, Fabian joked that he already needed work done on his leg when the knee unit housing cracked. “I left my leg here for a total knee replacement,” he laughed, adding that it was covered “under warranty.”

Taylor also comes to Staples to make adjustments to the prosthesis during Fabian’s physical therapy sessions. “It’s kind of like fine tuning,” Taylor said. “The patient is constantly changing physically. For that reason we have to accommodate for those changes.” Living with prosthesis Living with a prosthesis comes with many challenges and discomforts. “There are days where I don’t feel like putting it on,” Fabian concedes. “But I don’t want to spend my life in a wheelchair.” Fabian has had to relearn how to walk as a prosthesis requires its user to swing their hips forward and use their lower back muscles when taking each step. “You use different muscles and different parts of the body that aren’t necessarily intended to be used for walking,” Taylor notes. “So it can be exhausting.” “This is different, but this is something that I can do,” Fabian said. “It gives me the opportunity to be more mobile. There’s a learning curve with it, obviously. I’ve spent many sessions learning to swing my hips. It didn’t take me very long to know I wasn’t going to be one of the 75 percent who wouldn’t make it work.”

Lakeland Psychiatry Welcomes New Physicians St. Joseph’s Medical Center is pleased to announce the addition of three psychiatrists to Lakeland Psychiatry Clinic. ■ Doctor Peter Neifert began seeing patients at Lakeland Psychiatry July 1, 2003. ■ Doctor Twila Germanson will begin seeing patients on August 1, 2003. ■ Doctor Paul Erickson will begin seeing patients on September 1, 2003.

Fabian is almost back to full time at his job as a certified registered nurse anesthetist at Lakewood Health System in Staples. “Its gone pretty well,” he said. “The biggest obstacle at work is endurance at this point, but it’s getting better. “I get really tired. But I guess I was tired before,” Fabian said with a chuckle. Despite the things a prosthesis has enabled Fabian to continue doing, he said he doesn’t want to paint too rosy of a picture. After all, his life has changed drastically over the last year. Fabian said the loss of his leg has forced him to make adjustments from simple daily rituals to chores around the house. “I can’t pick up a tree after a storm,” he said. “I can’t wash windows. Everything isn’t hunkydory. There’s just too many things to enumerate on. It’s a struggle.” The Fabians have had to add grab bars in their Staples home. Fabian must buy largersized pants to accommodate for the prosthesis. He also must wear special undergarments because of the sweat produced from the artificial limb. But with the constant support and care from his wife, Beth, Fabian said he takes each day as it comes — one step at a time. He intends to continue raising and training labrador retrievers and is looking forward to hunting this fall.

Dr. Peter Neifert attended Colorado College in Colorado Springs where he earned a Bachelor of Arts degree in Chemistry in 1990. He received his medical degree from the Mayo Medical School in 1995 and completed his residency in psychiatry in June of 1998. He has been practicing as a psychiatrist with the Air Force for the past 5 years. Dr. Twila Germanson received a Bachelor of Arts degree in Chemistry from Arizona State University in 1994. She received her medical degree in 1999 from the University of Minnesota and completed her residency in psychiatry in June of 2003.

lakeland psychiatry CLINIC

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St. Joseph’s Medical Center 523 North Third Street Brainerd, Minnesota 56401

November 2, 2003

Cool, crisp air is the first indication that fall is on its way. Soon after, leaves turn red and gold. Geese begin to fly south. Change is seen everywhere. But, this fall is unique for the Pillager community— because more than leaves are changing in the area. Lakewood Health System is pleased to announce the opening of our newest clinic in Pillager. The Pillager Clinic will offer you a choice of three physicians: Dr. Arden Beachy, Dr. Renee Nydegger, Dr. Mike Hudulla, as well as physician assistant Becky Bennett and nurse practitioner Kelly Thompson. You also have the option of convenient health care with an on-site pharmacy with drive thru window, three-day-a-week physical therapy services, extended clinic hours and occupational health and educational services.

Lakeland Psychiatry is located on the fourth floor of St. Joseph’s Medical Center.

To Schedule an Appointment Call: (218) 828-7394

Open House

Dr. Paul Erickson completed his undergraduate degrees in Religion and Psychology at Concordia College in Moorhead. He received his medical degree from the University of Minnesota Medical School in 1999 and completed his residency in psychiatry in June of 2003.

To celebrate, Lakewood Health System invites you to an Open House at the new Pillager location. Stop by on Sunday, November 2 between 1:00 – 3:00 p.m. to see our new facility, meet our staff, enjoy refreshments and receive a free gift. Mark your calendar today! With Lakewood Health System you don’t have to go far, it’s right here.

Lakewood Health System Pillager Clinic 631 State Hwy 210W, Pillager, MN 56473

www.lakewoodhealthsystem.com

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CMYK

dow during his, approximately, half hour flight to Duluth. 12:10 a.m. — Sarvie calls in to say the crew is 15 minutes from St. Mary’s and is given clearance to land on the hospital’s rooftop helipad upon arrival. The patient notes his pain level has decreased somewhat and is comfortable, although he says he’s having some difficulty taking deep breaths. He asks the pilot how high they’re flying. “Three thousand feet,” Sarvie replies through the headset. 12:26 a.m. — After flying over Lake Superior and the infamous Aerial Lift Bridge, the chopper lands at St. Mary’s and is met by security guards at the rooftop entrance to the hospital. Since the patient’s condition is stable, the crew waits for the helicopter’s rotors to stop completely before exiting the helicopter. “It was a good ride,” the man tells the crew, as he’s unloaded and given North Air Care is virtually an emergency room in the sky. Flight nurse April Aalto and flight medic John Davis ran through a North Air Care baseball cap. “But I thought it’d be their equipment and supplies, ensuring everything is ready before their next call comes in. more exciting.” 12:34 a.m. — The crew Aalto comments the furthest she’s traveled to “Well,” Aalto chides back. “We’ll have to ask the arrives in the coronary care unit and wheels their pick-up a patient came just a few days ago when pilot.” patient directly to a room where they brief staff on she traveled with the Air Care crew to Devils Lake, 11:45 p.m. — After the necessary paperwork the patient’s status and history. N.D. to take a patient to Abbott Northwestern has been signed, the patient is wheeled out to the 12:57 a.m. — With their patient passed on to St. hospital in Minneapolis – about a 2 1/2 hour flight. awaiting helicopter for his trip to Minnesota. It’s a Mary’s staff and their job complete, the crew 11:31 p.m. — An ambulance with flashing team effort as the stretcher is loaded into the air- returns to the helicopter for take off. lights signals the chopper onto the landing pad at craft. Aalto and Davis lift the man and slide the 1:04 a.m. — Sarvie makes a stop at the Superior the Burnett Medical Center in Grantsburg. An stretcher onto the stainless steel platform inside Airport. While he remains in the aircraft, Davis emergency medical technician with North the helicopter while Sarvie stands inside the and Aalto perform a “hot refuel,” or refueling the Ambulance’s service in Grantsburg meets the chopper’s front door and pulls the foot end of the helicopter while it’s still running. crew at the emergency room entrance and escorts stretcher forward. Once he’s adjusted and com1:14 a.m. —Everyone is back in the helicopter them in to meet their awaiting patient. fortable the crew situates themselves and pre- for the ride back to Brainerd, which Sarvie estiDavis introduces his fellow crew members to pares to lift off. The man is also given a headset so mates will take a little over 30 minutes. the patient and begins asking him a series of he too can communicate with the crew. A curtain It’s a quiet ride home as the crew reflects on health history questions as well as his current sta- is drawn to separate the crew and patient from the their shift so far and watches below as the world tus. pilot and cockpit area. whizzes by. “Our primary objective is to keep you as com11:55 p.m. — Off the ground and en route to 1:58 a.m. — The “after flight paperwork” fortable as possible,” Davis tells the 52-year-old Duluth, a flurry of activity takes place inside this, begins as the helicopter is pulled back into the man. As the man rates his pain as a 5 or 6 on a scale now tight, quarters. While Sarvie navigates to hangar until its next call. of 1 to 10, Davis listens to his chest and Aalto pre- northern Minnesota, Davis and Aalto monitor the “It was a quiet day,” Davis reflects. pares the heart monitor which will accompany patient’s heart rate and oxygen levels in his blood, But there’s still another five hours to go in the him on the flight. The ER physician informs the administer medications through his IV and keep day in the life of this flight crew and what’s to crew the man has an extensive cardiac history, in close contact with the man to ensure his com- come on any given Air Care shift is always “up in including two heart attacks and bypass surgery. fort. the air.” “This is nothing new,” the man tells them. The patient is an inquisitive one as he removes As Aalto starts an IV, the man jokes with her. his headset from time to time, touches the IV bags “Can we land at my house so I can pick up my containing saline and medication, pokes at the checkbook?” ceiling of the helicopter and watches out the win-

8

Educating others While there is no formal support group for those facing amputation or those who’ve experienced it, Taylor said Fabian has become a good ambulator in the community. Fabian said he has, on several occasions, talked to those who are contemplating a prosthesis. “When you have someone who’s been there... It’s just a much more supportive means of encouragement,” Taylor said. “There are so many referral sources who feel patients who’ve had an amputation at the hip level can’t have a prosthesis. It’s good to shed light on the patients who’ve had an amputation at this level and show that it can be done.” Fabian said, of his contacts, he has reassured a younger boy that, yes, you can still ride a fourwheeler after receiving a prosthetic and a woman who worried about the way a prosthetic leg would look when wearing shorts. But in keeping with his optimistic attitude, Fabian, a grandfather of two, has turned a tragic event into a learning opportunity and a chance to help others by sharing his experience. “I try to be very encouraging,” he said. “You can make this work. If you have the right attitude and the will, you can make it work.”

Better get a

Taking a look at a prosthetic leg Socket — Upper portion of the prosthetic, made of carbon fiber with a flexible thermo-plastic interior. Hip Joint — A single axis hip joint with an extension mechanism that helps hold the limb straight and allows for safe alignment while standing and walking. Leg — An aircraft aluminum structure with a carbon fiber knee unit. Has a multi axis for sitting ability and ease of swinging when the patient takes each step. Foot — A dynamic multi axis foot allows patient to walk on uneven surfaces. The more energy exerted into the foot, the faster the patient can take their next step. Cover — A cosmetic foam cover with a skin tone, nylon-like exterior provides for improved aesthetic appeal.

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(Continued from Page 17)

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• Replacing sour cream with fat-free yogurt; • Using evaporated skim milk instead of butter. 2 cups (8 ounces) finely shredded reduced-fat sharp cheddar cheese 1 (10 3/4 ounce) can 99% fat-free condensed cream of chicken soup with 1/3 less salt 1 cup fat-free plain yogurt 3/4 cup evaporated skim milk 1/2 cup very finely chopped onions 2 cups cornflakes 6 medium potatoes (2 pounds), peeled Preheat the oven to 350 degrees. In a large bowl, stir together the cheese, condensed soup, yogurt, milk and onions. Set the soup mixture aside. In a blender or food processor, blend or process the cornflakes into coarse crumbs (you should have about 1 cup). Set the cornflakes aside. Coarsely shred the potatoes. Immediately stir the potatoes into the soup mixture to prevent browning. Spray a 10”x9”x2”or 11”x7”x1 1/2”baking dish with no-stick spray. Transfer the potato mixture to the baking dish. Top with the cornflakes. Bake about 1 hour or until the potatoes are tender. Makes 8 servings. Nutrition Scorecard (per serving) Calories – 230 Fat (g) – 4 % calories from fat – 21% Cholesterol (mg) – 35 Exchanges (per serving) 2 starch 1 lean meat

Harvest Apple Stuffing

This fruit and walnut dressing is the perfect complement to roasted chicken. Calories, fat and cholesterol were reduced by: • Using apple juice instead of butter to sautè the vegetables. 2 cups finely chopped apples 1 teaspoon lemon juice 1 cup coarsely shredded carrots 1 cup thinly sliced celery 1/2 cup chopped onions 1/2 cup apple juice 1/4 teaspoon ground nutmeg 8 cups dry plain bread cubes 1/3 cup chopped walnuts 1/4 cup toasted wheat germ 1-1 1/2 cups chicken broth, defatted Preheat the oven to 350 degrees. Place the apples in a small bowl. Sprinkle with the lemon juice, then toss until coated. Set aside. Spray a large skillet with no-stick spray. Add the carrots, celery, onions and apple juice. Cook over medium heat until tender, stirring occasionally. Stir in the nutmeg. Lightly spray a 3 to 4 quart casserole with no-stick spray. Add the bread cubes, apples, walnuts, wheat germ and the carrot mixture; toss to combine. Drizzle with one cup of the broth. If necessary, drizzle with enough of the remaining 1/2 cup of broth to moisten the bread; gently toss to mix well. Bake, uncovered, for 30 to 40 minutes or until heated through. Makes 8 servings.

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Nurse April Aalto (left), medic John Davis and pilot Ryan Sarvie made up this North Air Care flight crew.

Nutrition Scorecard (per serving) Calories – 197 Fat (g) – 5 % calories from fat – 21% Cholesterol (mg) – 0 Exchanges (per serving) 2 starch 1/2 fruit

them in the event they would be called to Moose Lake. “A big part of our job is safety,”notes flight nurse April Aalto of Monticello. Aalto, a nurse with North Memorial since 1986, commutes to Brainerd to work 24-hour shifts on the helicopter crew. 7:27 p.m. — The Air Care crew leaves the hangar for their 30 minute flight to Moose Lake. Each member of the crew wears a headset with a microphone in order to allow open communication. Along the way, Sarvie points out the city of Aitkin to the left and Lake Mille Lacs out the right. He also notes the helicopter is currently traveling at a speed of 170 miles per hour with a bit of a headwind. 7:55 p.m. — The crew arrives at Mercy Hospital in Moose Lake, greeted by a large gathering of emergency personnel. Aalto is the first to exit the aircraft, as she meets the group. After all three crew members are out of the helicopter they introduce themselves and answer questions regarding the helicopter, their experience and optimal landing situations. As the Moose Lake group walks around the helicopter, looking inside and asking questions, a woman approaches Sarvie questioning how long he’s been a pilot. “Thirteen years,” he tells her. “Oh my,” she replies, obviously surprised. 8:40 p.m. — After giving rides to four individuals from the Moose Lake group and participating in a stretcher-loading exercise, the Air Care crew takes to the skies and heads back to Brainerd. The clear night provides visibility for miles and miles. Sarvie once again comes over the headsets pointing out the cities below and beyond, including

McGregor, Aitkin and the distant lights of St. Cloud and even the Twin Cities area. 9:13 p.m. — The helicopter reaches its hangar at the Brainerd airport. Sarvie calls to request fuel. The Augusta C109 holds 73 gallons on each side, or 146 gallons total which provides for two hours and 20 minutes of flight time. An auxiliary tank can hold an additional 40 gallons, Sarvie points out. With full auxiliary and side tanks, the helicopter has a three hour endurance. At normal cruise, Air Care burns one gallon of fuel per minute. 9:25 p.m. — Davis begins a run sheet, the necessary paperwork, required for the trip to and from Moose Lake. 9:26 p.m. — The North dispatch center calls with a possible flight to Redwood County, but calls back almost immediately to disregard. 9:45 p.m. — In true leader fashion, Sarvie serves up hot chocolate to the crew and starts a batch of chocolate chip cookies in the oven. The hangar where Air Care is stationed provides each member of the scheduled crew with a private bedroom. There’s also a bathroom, shower room, office, living area and kitchen as well as the garage area where the helicopter is stored. 10 p.m. — The cookies are done and the crew sits down to a late dinner of pizza while catching up with the 10 o’clock news. “We’re one big happy family,” Sarvie jokes. 10:55 p.m. — The crew receives a call to transfer a patient from Grantsburg, Wisconsin to Duluth. Details of the call are sketchy, but everyone is up on their feet and heading for the door. 11 p.m. — In the air and heading east, Davis begins more paperwork. A message via his alphanumeric pager tells the pertinent patient informa-

tion. This patient has a potential cardiac situation and is requesting to be transferred to St. Mary’s Hospital in downtown Duluth. The crew explains they provide a service that will take patients to any hospital. In the event of an accident or critical situation, the crew will decide where the patient will be taken. Usually, that means the closest Level 1 trauma center. If the patient is currently at a hospital and being transferred to a different facility for additional treatment, the patient and his/her family as well as the medical staff will determine where that person will be sent to receive the best care for their particular situation. Typically the Air Care base closest to the originating city will respond to the call, but Davis says both the metro and Redwood Falls divisions are out on calls leaving the Brainerd crew up-to-bat. North Air Care isn’t the only show in town, so to speak. Both St. Mary’s and St. Luke’s in Duluth have their own air ambulance service, as well as other medical centers in and around the Twin Cities area. But, the physician requesting the transfer has the discretion of which company they would like to transport their patient. And in this case, they’ve called North Memorial. 11:15 p.m. — Traveling at a speed of 184 miles per hour, Sarvie radios in to say he’s 16 minutes from Grantsburg. Ground ambulances have a set service territory, Davis notes, but the same doesn’t hold true for the air service. Their job can take them anywhere in the state as well as North Dakota, Wisconsin and more. And for that reason, both Davis and Aalto have respective paramedic and nurse licensure in the state of Wisconsin.

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In close quarters, this three-person flight crew is transporting a 52-year-old Wisconsin man with chest pains to Duluth for medical attention. It’s a flurry of activity in this emergency room in the sky as a trip which typically would take several hours by ground is accomplished in little over a half hour. In an emergency, every minute is critical. The difference between getting to a hospital by land or air can often be the difference between life and death. The sky provides an open road. Little to no traffic. No stop signs. Rather than going around fields, you go over them. With speeds over 180 miles per hour, its no wonder the air ambulance industry has “taken off” over the last several years. North Memorial Medical Center in Robbinsdale began its North Air Care division in 1985. Now, with three bases, including one in Brainerd, communities across the state and beyond have the opportunity to receive the best, most appropriate care at any hospital regardless of how far they are located from the facility. With the approval of North Memorial, this reporter was allowed to observe a flight crew during a regular Wednesday night shift earlier this month. This is just a glimpse into a day in the life of an Air Care flight crew. 4 p.m. — North Air Care flight medic John Davis is going on the ninth hour of his 24-hour shift. Davis, 31, stands at the sink at the crew’s quarters in a hangar at the Crow Wing County Regional

Airport and finishes dish duty. “Don’t you dare tell my wife,” he says, laughing about his domestic duties. A Brainerd High School graduate, Davis has worked for North Ambulance in Brainerd since 1996 where he worked as a paramedic on the road. When North Memorial Medical Center’s air ambulance program opened a permanent home in Brainerd in October of 2000, Davis was hired on as a flight medic. There’s no doubt in Davis’ mind why he chose to make the switch from road to air. “Because I got to do what I liked to do as a paramedic, but in a really cool ambulance,” he says, noting it’s virtually the same type of job but with it’s own set of differences and challenges. 4:30 p.m. — Davis and Air Care lead pilot Phil James perform a safety briefing, required for any ride-along passenger of the helicopter. North Memorial owns and operates five Augusta C109s in its fleet. These helicopters are the fastest non-military chopper made. Currently, North has three bases for its Air Care operations: Brainerd, the Twin Cities and Redwood Falls. On call at the hangar throughout their shift, the crew aims to be in the air within five minutes of receiving a call. Once arriving at the scene, their goal is to get the patient loaded up and en route to their destination within 10 minutes. 5:45 p.m. — Pilot Ryan Sarvie arrives early for his scheduled 12-hour shift. Sarvie, 32, is one of four full time pilots serving the Brainerd division of North Air Care. A new res-

ident of the Brainerd area, Sarvie previously lived in Buffalo. After graduation from high school, he joined the United States Army where he served 8 1/2 years as a pilot flying Hueys and Black Hawk helicopters. From August 1993 to January 1994, he served in the conflict in Mogadishu, Somalia, which was portrayed in the movie Black Hawk Down. Before coming to work for North Air Care, Sarvie flew the medical helicopter for St. Luke’s Hospital in Duluth. “I wanted to fly helicopters just because they’re different from airplanes,” Sarvie admits, adding he enjoys his current profession as he gets to help save lives “even though I couldn’t do it myself.” Sarvie discusses the stringent training and evaluation processes that go along with being a pilot. All of North Air Care’s pilots are required to be Instrument Flight Rules certified. Every six months, he and his fellow pilots must undergo an evaluation in order to maintain their pilot license where their ability to use and understand the helicopter’s instruments is tested. “It’s kind of like taking a driver’s test every six months,” he says. 6:30 p.m. — The Air Care crew receives a fax from their dispatch center operated out of North Memorial Medical Center in Robbinsdale. They are requested for a “fly in” at Mercy Hospital in Moose Lake where a group of firefighters, law enforcement, first responders and other emergency service providers are gathered to learn more about Air Care’s services as well as how to best work with

Apple Stuffed Tenderloin with Cinnamon Raisin Sauce This hearty entrèe started out as stuffed pork chops. To make the dish leaner and still keep its character, the recipe was switched to stuffing a pork tenderloin. Calories, fat and cholesterol were reduced by: • Using pork tenderloin (26% calories from fat) instead of rib chops (52% calories from fat); • Using no-stick spray instead of butter to sautè the onions; • Eliminating the butter in the sauce. Stuffed Pork Tenderloin: 1 pork tenderloin (1 to 1 1/2 pounds) trimmed of all visible fat 2 medium oranges 1 medium apple, cored and chopped 2 tablespoons finely chopped onions 2/3 cup fine dry plain bread crumbs Sauce: 1 cup unsweetened apple juice 1 tablespoon cornstarch 1/4 teaspoon ground cinnamon 1/4 cup raisins To make the stuffed pork tenderloin: Preheat the oven to 425 degrees. Cut a pocket in the side of the tenderloin by cutting a lengthwise slit from one side to almost the other side and stopping about 1/2” from each of the tapered ends. Set the tenderloin aside. Finely shred the peel from the oranges and set aside. Then squeeze 3 tablespoons of juice from the oranges. In a medium bowl, combine the orange juice and apples. Set the apple mixture aside. Spray an unheated small skillet with no-stick spray. Add the onions. Cook and stir over medium heat until tender. Then add the onions and bread crumbs to the apple mixture. Toss until combined. Spoon the bread mixture into the pocket of the tenderloin. Securely close the pocket with wooden toothpicks. Place the tenderloin on a rack in a shallow roasting pan. Insert a meat thermometer into the meat portion only. Bake for 25 to 30 minutes or until the thermometer registers 160 degrees. Let stand about 5 minutes before slicing. To make the sauce: In a small saucepan, use a wire whisk to stir together two tablespoons of the apple juice and the cornstarch. Then stir in remaining apple juice. Cook and stir over medium heat until boiling. Stir in the reserved orange peel and cinnamon. Add the raisins and cook for five minutes, stirring occasionally. To serve, slice the tenderloin. Spoon the sauce over the slices. Makes 4 to 6 servings. Nutrition Scorecard (per serving) Calories – 245 Fat (g) – 4 % calories from fat – 16% Cholesterol (mg) – 74

North Air Care pilot Ryan Sarvie took to the skies during his scheduled 12-hour shift. Sarvie, 32, of Brainerd, is one of four full-time pilots serving the Brainerd division of North Air Care. Sarvie has been a licensed pilot for 13 years and served as a Black Hawk pilot during the Mogadishu, Somalia, conflict in the 1990s.

Exchanges (per serving) 3 meat 1 fruit

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FDA approves first birth control pill designed to help women skip periods SAVANNAH, Ga. — Imagine being on combat tour in Iraq and having monthly cramps, headaches, mood swings and heavy bleeding in extremely macho environs. Skipping monthly periods sounds appealing. Especially for women in the military such as Staff Sgt. Cheryl Williams. But would Williams pop a daily birth control pill that suppresses monthly periods? Not a chance. "It's a fabulous idea, but I have misgivings about taking the body cycle out of its natural sync. That is spooky to me," said Williams, who spent about eight months in Iraq this year. "Plus, when I sat in a five ton truck with a 22,000 pound trailer attached, the last thing on my mind is to pop a birth control pill." Stress of combat often causes women to miss their periods naturally, without taking a pill, said Williams, based at Hunter Army Airfield. While menstrual periods are inconvenient and sometimes painful, a new pill could bring an end to women's monthly woes. Seasonale, due out at the end of this month, is the first FDA-approved birth control pill designed to help women skip periods – menstruating only

four times a year instead of 12. Seasonale's cost has yet to be determined. It will be comparable to conventional birth control, about $30 a month. Some insurance plans may pay for it. The trend of suppressing menstruation is nothing new. But Seasonale has divided health experts between those who cheer the new pill as another way for women to control their bodies vs. those who say that period suppression is dangerous. Family nurse practitioner Dellarie Shilling in Statesboro plans to recommend Seasonale to patients, who are mostly college-aged women. "As long as it works smoothly and there are no side effects, it will be popular," Shilling said. "A lot of women have painful periods which wouldn't be missed at all." But Savannah family nurse practitioner Valerie McGowan sees the trend of menstrual suppression as less healthy. McGowan says the no-period pill might be risky, especially for teens and young women. She doesn't plan on recommending it to young patients at Curtis V. Cooper Health Care Center in Savannah, formerly Westside Clinic.

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"The adolescent group is so fragile, you wouldn't want to play around with their cycle too much," McGowan said. Women have already been suppressing their periods for years with standard 28-day birth control packages. They throw out the seven inactive pills that would have triggered their periods and start a new pack of regular pills to suppress menstruation. But the FDA had not approved continuous use of the drugs until now. Seasonale, produced by Barr Laboratories, isn't a new chemical – just a repacking of the conventional oral contraceptives in a purple-and-pink box. The packaging gives women 12 straight weeks of active pills, then a week of dummy pills for their period. Almost 39 million women in the United States use some kind of birth control, according to the Kaiser Family Foundation. Oral contraceptives are the most common, reversible method.

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of a flight medic

Flying at about 180 miles per hour, North Air Care flight nurse April Aalto keeps a steady arm while filling a syringe with morphine to alleviate the discomfort of her patient. Flight medic John Davis monitors the man’s vital signs and keeps in contact with medical officials on the ground regarding the man’s status. A heart monitor mounted within the helicopter keeps tabs on the man’s heart rate, oxygen levels and blood pressure. Out the chopper’s large side windows you can see the twinkling lights of life proceeding as usual in small towns below.

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From the Editor Lawns are littered with dried, yellow leaves and the grass underneath is frosty when the alarm goes off in the morning. Fall is here, ladies and gentlemen, and along with the change in seasons comes another issue of HealthWatch. Judging by the feedback I received from readers, the first issue of HealthWatch was a success. Thank you to everyone who wrote or e-mailed their comments. It’s nice to know people are actually reading what we worked so hard on. In this issue, free-lance writer Jenny Kringen-Holmes and I put our heads together and came up with some great

CMYK

Who we are Publisher — Terry McCollough Advertising Director — Mary Panzer Editor — Heidi Lake Copy Editors — Roy Miller, DeLynn Howard Graphic Designer — Cindy Spilman HealthWatch is a quarterly publication of The Brainerd Daily Dispatch. Read HealthWatch online www.upnorthhealthwatch.com

stories that we hope you’ll find interesting, including the new clinics in Pillager and the benefits of gastric bypass surgery. We even added a low-fat recipe section where we discovered some fun new ways to cook and eat healthy. Once again, feel free to e-mail story ideas or comments to heidi.lake@brainerddispatch.com. Happy reading and happy fall, Heidi Lake Editor

Table of contents 5

COVER STORY: A day in the life of a flight medic

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DISEASE: Cancer doctor battles disease

10

PROCEDURE: Gastric bypass surgery

24

FAMILY: Struggling with infertility

14

NUTRITION: Eating healthy

26

LIVING: Coping with prosthesis

16

RECIPES: Cooking healthy

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MEDICINE: New birth control pill

Story/Jane E. Allen Los Angeles Times

Synthetic marijuana compound shows promise Marijuana can ease pain even for longtime sufferers of disease, but the illegal herb’s mind-altering properties make it less than ideal as a medication. German researchers now have found that a synthetic version of one of many marijuana compounds safely reduced chronic nerve pain without impairing thinking and behavior. If the preliminary findings hold up in larger trials, capsules containing this compound might one day be prescribed for hard-to-treat pain. The principal active ingredient in cannabis is tetrahydrocannabinol, or THC. That compound has been the most studied, but researchers around the world are also looking more closely at the plant’s other chemical compounds for potential health benefits. Scores of them belong to a group called cannabinoids; others include flavonoids, which are thought to have antioxidant properties. “It’s not a surprise that these cannabinoids have medical benefit,” said Dr. Donald I. Abrams, an AIDS specialist conducting clinical trials of marijuana at San Francisco General Hospital. People with cancer, AIDS and other chronic dis-

eases have long attested to the plant’s ability to provide relief from nausea and pain. “That’s why we’re investigating marijuana,” Abrams said. Previous studies have shown some cannabinoids have limited ability to blunt acute nerve pain, typically associated with an injury. But the German study found that a cannabinoid called CT-3 could help sufferers of chronic neuropathy, who often don’t respond to standard medications. CT-3 is related to THC. But the problem with THC is that even at low doses, it can impair thinking and coordination, and create anxiety, panic attacks, psychosis and paranoia, as well as dry mouth, blurred vision, and a drop in blood pressure upon standing. Despite these effects, scientists have remained interested in cannabinoids, because the body has natural cannabinoid receptors that offer potential drug targets. CT-3 first showed promise in animals as an antiinflammatory and as a reliever of two aspects of neuropathy: pain and extreme sensitivity to ordinary sensations. Researchers at Hannover Medical School in

Germany, working with an American colleague, gave various doses of CT-3 to 24 volunteer patients with chronic neuropathic pain in places such as the foot, arm, face and head. Many patients also were taking other pain-relieving medications such as narcotics, muscle relaxants, antidepressants and sedatives. The researchers found that CT-3 was more effective than a placebo at relieving pain; its effects were greatest with milder pain. Increasing the dose brought no greater relief. The major side effects were dry mouth and fatigue. “What’s promising is that there can be a product that stimulates the cannabinoid receptors and does not have the emotional and hallucinatory effects otherwise known for THC,” said Dr. Joel Saper, a neurologist who directs the Michigan Head-Pain and Neurological Institute in Ann Arbor. He’d like to see longer CT-3 studies using larger numbers of patients who aren’t taking other pain medications: “We need to see how this would work in patients not on all these drugs.”

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For advertising opportunities call Mary Panzer at (218) 855-5844. E-mail your comments to heidi.lake@brainerddispatch.com or write to: Heidi Lake PO Box 974 Brainerd, MN 56401

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HEALTHCARE: New Pillager clinics

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RESEARCH: Down Syndrome

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Down syndrome

Irreversible Only for Now?

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Most people know Down syndrome is a genetic disorder that causes irreversible mental retardation. But that description may not be true in the future. Scientists have pounced on the revolutionary idea that Down syndrome — the most common genetic cause of mental retardation — can be treated. First, they must understand the biological cause of the condition, down to the specific genes responsible for the varied symptoms. Then, they hope, they’ll be able to reverse or eliminate related problems with cognitive function, memory, speech, sleep and even the neurological decline that occurs in older adults with the disorder. Scientists at Stanford University Medical Center already have identified abnormalities in the nerve cell structure of people with Down syndrome, differences that appear to be responsible for much of the brain damage that is the hallmark of the disorder. They’re now trying to home in on the genes that cause that particular abnormality. “People thought that once you’re born with Down syndrome, that’s it; you can’t make the brain better. But we know that is not true about brains,” says Dr. William Mobley, a pediatric neurologist at Lucile Packard Children’s Hospital at Stanford. “Brains are plastic. We may not be able to cure this disease, but we may be able to make people’s lives better.” Several advances have paved the way for this hypothesis. Scientists understand the brain far better than they did even 15 years ago, because sophisticated imaging devices have allowed them to better examine its structure, and the mapping of the human genome provided detailed information on the 21st chromosome. Down syndrome is caused by a third, or extra, copy of this chromosome. The mapping of chromosome 21 revealed that it is the smallest of the 24 human chromosomes, containing about 225 genes. Now scientists such as Mobley, director of the new center for Down syndrome research at Stanford, are working to identify what those genes do. Experiments on Down syndrome mice have shown abnormalities in the synapses, or circuits, between nerve cells. The abnormal structure and function of the synapses lead to the kind of brain damage seen in Down syndrome and Alzheimer’s disease. People with Down syndrome typically develop Alzheimer’s disease in adulthood, Mobley says. Now researchers are trying to figure out which of the genes cause this problem in Down syndrome. Fixing the defect may involve turning off the extra copy of certain genes. “We definitely know that genes cause this,” Mobley says. “If we find an offending gene, theoretically we can make things better by turning off that third copy.” Treating a condition caused by an extra gene, he says, may prove easier than treating other genetic diseases such as cystic fibrosis, in which genes are abnormal or missing. Drugs could be developed to turn off that extra gene and improve cognitive ability in people with Down syndrome. Theoretically, Mobley says, the drugs could be given at any point in the lifespan to improve brain function. “What they’re doing is extremely exciting,” says Myra Madnick, executive director of the National Down Syndrome Society. “The whole research scene has changed dramatically since the mapping of the 21st chromosome.” Scientists caution, however, that potential treatments resulting from this research are at least a decade away.

Story/Shari Roan Los Angeles Times

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ANNOUNCING ST. JOSEPH’S $25 MILLION MEDICAL CENTER EXPANSION.

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It’s an exciting time to live in the Brainerd Lakes area. Our community is growing and getting better every day. With that growth, of course, comes an increased need for healthcare services.

Construction scheduled for completion in 2005.

At St. Joseph’s Medical Center, we’re responding to that need by expanding our medical campus— putting $25 million in construction services and material costs into the local economy.And when we’re done, we’ll bring even more jobs to the community. Our 116,000-square-foot expansion and renovation project will bring us to our licensed capacity of 162 beds and increase the number of private rooms, allowing patients and families greater comfort. It will also increase the capacity of our intensive care and progressive care units, and allow us to bring to our area some of the most advanced medical technology available. It’s better care for all of us, and it’s a sign that our community will continue to stay healthy as it grows.

A day in the life of ...

A flight medic Page 5 Lose weight fast

Life is good. We’ll help keep it that way.

Gastric Bypass surgery Page 10

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OCTOBER 2003


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