HealthWatch Magazine Summer 2015

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Table of Contents One bite is all it takes . . . . . . . . . . . . . . . . . . . . . . . . . .

Publisher • Tim Bogenschutz Advertising • Susie Alters and Phil Seibel Editor • Sarah Nelson Katzenberger

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Parents, physicians and teachers talk food allergies . . . . By Sarah Nelson Katzenberger

Ladies Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Gynecologist changes women’s health care experience . . . . . . . . . By Jenny Holmes

Concussion: the sprained ankle of the brain . . . . . . . . . . . .

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Local family physician explains common brain injury . . . . . By Dr. Bruce Cunningham Art Direction/Design • Jan Finger

Every second counts . . . . . . . . . . . . . . . . . . . . . . . . . .

Contributing Writers Sheila Helmberger • Jodie Tweed • Dr. Michael Thurmes • Sarah Nelson Katzenberger • Dr. Bruce Cunningham • Jenny Holmes • Essentia Health-St. Joseph’s Medical Center • Pamela Knudson/Forum News Service • Christa Lawler/Forum News Service • Reuter’s Health Health Watch is a quarterly publication of the Brainerd Dispatch.

Read Health Watch online at www.brainerd dispatch.com For advertising opportunities call Susie Alters at 218-855-5836.

Email your comments to newstips@brainerddispatch.com or write to: Brainerd Dispatch P.O. Box 974 Brainerd, MN 56401

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CRMC Emergency improves patient experience . . . . . . By Sarah Nelson Katzenberger

Cassie Carey Energized . . . . . . . . . . . . . . . . . . . . . . . .

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Area woman advocates good health throughout Crow Wing County . . . By Jodie Tweed

Battling the undiagnosed enemy . . . . . . . . . . . . . . . . . .

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How one women’s illness led her to total health . . . . . . By Sarah Nelson Katzenberger

Giving the gift of life . . . . . . . . . . . . . . . . . . . . . . . . .

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Most people, or their family members need blood at some point. . . By Sheila Helmberger

Fitness Technologies . . . . . . . . . . . . . . . . . . . . . . . . .

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Using activity trackers to compete . . . . . . . . By Christa Lawler, Forum News Service

Care across continents . . . . . . . . . . . . . . . . . . . . . . . .

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Missionary calls on Brainerd clinic team . . By Essentia Health-St. Joseph’s Medical Center

Secondhand Smoke . . . . . . . . . . . . . . . . . . . . . . . . .

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What does it do to kids? . . . . . . . . . . . . . . . . . . . . . . . . By Reuters Health

Heart disease treatment improves . . . . . . . . . . . . . . . . .

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Advancement uses wrist artery for care . . . . . . . . . . . . . By Dr. Michael Thurmes

Genetics of deadly viruses . . . . . . . . . . . . . . . . . . . . . .

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Researchers team up on Ebola and MERS . . . . . . . . . . . . . . . By Reuters Health

Tiny Terrors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Deer tick bites can lead to Lyme disease. . . . By P Pamela Knudson, Forum News Service

Capturing Curiosity . . . . . . . . . . . . . . . . . . . . . . . . . .

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Children’s motivation—key to early learning . . By P Pamela Knudson, Forum News Service

By SARAH NELSON KATZENBERGER Editor

One bite is all it takes P ,

arents Physicians and educators work together to educate on food allergies

One bite.

That’s all it would take to cause any one of Kay Paulus’ three children to suddenly stop breathing or worse. Pau Paulus’ children all suffer from severe allergies. Between the three of them they are allergic to eggs, nuts, sunflower seeds, dairy, chickpeas, fish and apples — a mix of common and rare allergies.

“There are eight foods that represent 90 percent of all food allergies,” Paulus explained. “So we have five of the top eight.”

Paulus said sunflower seeds and chickpeas would be considered a rare allergy.

The discovery of her children’s allergies started when her oldest son was just 13-months-old. Paulus said her son ate some eggs and almost immediately developed a rash on his chest and back.

Paulus said a call to the pediatrician led her to meet with an allergist. “We were very naïve,” Paulus explained.

Paulus said the first allergist they saw didn’t clearly explain the severity of her son’s allergies. Her son was prescribed an Epi-Pen, a portable shot of epinephrine to be used in case of an allergic reaction.

Per her doctor’s instruction, Paulus stocked one EpiPen at home and one at her son’s daycare “There was never any explanation of needing to always have the Epi-Pen when you leave the house,” she Essentia Health Allergy and Asthma Specialist Dr. Minto Porter (right) demonstrates how to use an Epi-Pen to a mom Karlee Magnan and 15-month-old son Blake Magnan of Brainerd.

Steve Kohls • steve.kohls@ brainerddispatch.com

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said.

It wasn’t until the Paulus family moved to Minnesota that they really grasped how vital it was that the Epi-Pen be within reach at all times.

“We showed up to the (new allergist’s office) and he asked, ‘Where is this Epi-Pen,’ and I didn’t have it,” she said. “What would we do if he had a reaction?”

Paulus said until her second child was diagnosed with a severe peanut allergy she was in a state of denial about the gravity of the allergies her kids were living with.

“It’s a loss” she said. “We’ve lost all these favorite foods.”

Paulus said all of her kids now carry an Epi-Pen on them at all times. They have completely overhauled their diets and only buy safe foods. Still, despite all their planning and adjusting the chance of exposure still looms.

Just two weeks after meeting their new allergist, Paulus’ oldest son accidentally ingested eggs from a mislamisla beled product and had his worst reaction to date requir requiring the use of his Epi-Pen. “He just had welts all over his body and couldn’t stop coughing,” she said. “We’ve learned not to hesitate.”

Dr. Minto Porter, allergist with Essentia Health-St. Joseph’s Medical Clinic in Brainerd said hesitation is often what leads to tragedy in cases of severe allergic reaction.

In addition to external visible reaction, an allergic

reaction can cause an extreme drop in blood pressure, which can result in cardiac arrest.

“The longer the reaction progresses the harder it is to get it to reverse,” Porter explained. “A lot of people think, ‘I’ll give them Benedryl and watch them closely,’ but the reaction can continue to progress.”

Porter said at some point a single dose of epinephrine won’t do enough and may need to be given multiple times. “You’re going to need other interventions at that point,” she said.

Porter said anyone who has a true allergic reaction to any sort of food or sting should be prescribed an Epi-Pen. Porter added it was previously thought that an antihistamine, like Benedryl, could be used to block the spread of histamine. “Even allergists would have recommended giving Benedryl first,” she said “Really things have evolved over the last five years.”

Porter sited tragic situations where Benedryl was adad ministered at the first sign of an allergic reaction and children have died as a result.

“Benedryl covers up the hives and a lot of the symptoms, but it really does not stop anaphylaxis,” she said.

“The more severe symptoms are more subtle in their progression until it’s too late.”

Patients who come into the clinic in Brainerd are treated with epinephrine within five minutes. “It’s the first

■ Food Allergies 101

medication I give,” Porter said.

Jambor said her concern is for high strict avoidance is the only way to Paulus said because previous protoschool students who don’t carry their prevent an allergic reaction. col was antihistamine first, many par par● Food allergies affect approximately ● Managing a food allergy on a daily Epi-Pen with them at all times. “Someents are still hesitant to use a prescribed 15 million Americans, including 6 times they were just so young when basis involves constant vigilance.

Epi-Pen because it feels extreme. million children. they had a severe reaction and haven’t ● Trace amounts of an allergen can “I’m not sure why there’s this idea of ● A food allergy is an immune had one since, they assume they’ve outtrigger an allergic reaction in some using it as a last resort when it should system response to a food the body grown the allergy and that’s just not alindividuals. be the first line of defense,” she said. mistakenly believes is harmful. ways the case,” she said. ● Unfortunately, food allergy deaths “Once you see it work and watch your ● When a person with a food alPorter added that 80-90 percent of do occur, even among persons child get better before your eyes it’s oblergy eats the food, their immune children will outgrow an egg allergy with a history of mild reactions. vious that it was the right decision.” system releases massive amounts and 80-90 percent of children will not ● 9-1-1 must ALWAYS be called with Porter said she carries Epi-Pens with of chemicals, including histamine, outgrow a peanut allergy. Paulus’ oldest every anaphylactic reaction. her at all times. “There’s very little I can triggering a cascade of symptoms son’s peanut allergy is so severe it is not Eight foods account for 90 percent do without one,” she said. that can affect the respiratory likely he will outgrow it. “He will live of food allergies: The presence of severe allergies has system, the gastrointestinal tract, with this likely for the rest of his life,” launched a greater sense of awareness the skin, and/or the cardiovascular ● Peanuts ● Tree nuts (cashews, Paulus said. pecans, walnuts, etc.) ● Milk within the Brainerd School District. In system.

While schools do have Epi-Pens ● Egg ● Wheat ● Soy ● Fish addition to being a parent of kids with ● There is no cure for food allergies. stocked on campus, Jambor said she allergies, Paulus facilitates a local sup(halibut, salmon, etc.) ● Shellfish ● The prevalence of food allergies wants a clear message to be under underport group of parents with severe aller aller(crab, lobster, shrimp, etc.) appears to be increasing among stood that the idea is not that they be gies and also acts as a liaison, between However, almost any food can cause children under the age of 18, that dispensed like a pharmacy. parents of students with allergies and is two students in every classroom. a reaction.

“The Epi-Pens on campus are meant the school district, disseminating infor inforFor more information on severe food ● Although food allergy desensitifor emergency situations — like first mation from the district and acting as zations are being studied, these allergies visit www.foodallergyawaretime allergic reactions,” Jambor said. the voice to express parental concerns. are not yet proven treatments, so ness.org .

“The safest situation is for the child District nurse Aimee Jambor said to have their own pen,” Porter added. policy for administering medication “You have to prepare for the worst and “That’s essentially two in every classroom,” she exallows Epi-Pens to be kept in a child’s hope for the best.” classroom or with the school nurse, depending on the plained.

Paulus said it’s also important to stay updated on a Jambor said many parents in the district, particularly family’s preference. Other variables include the size of the school and the age of the child. “It’s family driven,” with older students will make their children self-suffi- child’s allergies and not assume that they have been outshe said. “We want to make medication available for cient in carrying their own Epi-Pen and those students grown. She said many parents just have a difficult time any child who has been diagnosed with allergies, but we are not reported to the school and not included in the coming to grips with how serious a reaction could be.

“They just don’t want to face the fact that their child is official district number. support the parents’ decision for their child.”

Porter said she believes some parents see allergies as literally one bite away from death,” she said. “It could Jambor said there are approximately 80 students with diagnosed severe allergies in the district. Porter said 1 in a stigma, something she discourages because of the con- be that they survive this game of Russian roulette. There’s fusion it causes when there is a reaction at school.

13 children will have a food allergy of some kind. only so many times you can chance it.” ■

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By JENNY HOLMES Contributing Writer

Ladies only— Baxter gynecologist works to change perception of women’s health care Ask any woman and she’ll likely tell you there’s nothing indulgent about an “annual visit.”

However, one Brainerd area gynecologist is working to change the way women view an exam and medical practice in general.

In June 2014, Dr. Jennifer Arnhold opened an indeinde pendent gynecology practice at the Cascade Women’s Wellness Centre and Medspa in Baxter. After practicing in the mainstream healthcare industry for 10 years, ArnArn hold had a yearning to be different and provide women a new level of care.

“I wanted to take real medicine and provide a differ different delivery concept,” Arnhold said. “I wanted to create an atmosphere that takes some of the dread and scariness out of it. Because we all know what that’s like and it’s nice to create a pleasing environment where you feel like you’re giving people quality care and a little something extra.”

Through a collaborative arrangement, Arnhold has two exam rooms within the Wellness Centre and MedMed spa and shares a procedure room with Kurt Waters, facial plastic and reconstructive surgeon at the Centre.

Arnhold offers full gynecology services including

gynecologic surgeries, with an emphasis on minimal minimally invasive procedures, to women of all ages through her private practice, meaning she isn’t employed by a specific health care system. However, her services are still insurance-based and you don’t need a referral to be seen. She also collaborates with Tri-County Health Care in Wadena.

“I think I just missed the autonomy and making my own decisions,” Arnhold noted. “I like having control over the quality of my own practice. Plus, it seemed like a challenge for myself.”

When contemplating a private practice, Arnhold met with Waters and the two talked about the concept of a women’s wellness center — creating a place for women to come for a variety of services under one wellness umbrella.

By having a medical practice housed in a spa atmosphere, patients are removed from the institutional feel of many clinics and greeted by aromatherapy, dim lights, gentle music and thoughtfully decorated rooms that feel more like you’re coming in for a facial than an exam. Thought was given to every last detail, including the plush robes.

Over the past year, Arnhold and staff have received positive feedback from clients who have reaffirmed the change in setting.

“It’s a more calming and inviting environment,” she said. “I think that’s what a lot of people don’t like about larger systems. Our office is just very cozy and inviting.

That really sets us apart.”

Clients can always make an appointment for a postexam indulgence, including a facial or massage.

“You really receive a full range of care but in a differ different setting and a bit more personalized,” Arnhold said of her practice. “We truly want women to feel special and cared for. That, to me, is what it’s all about.” ■ Kelly Humphrey • kelly.humphrey@brainerddispatch.com

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Concussion: the sprained ankle of the brain When you sprain an ankle you have some

tance of rest and consequences of not doing things right from the beginning. immediate pain and swelling. When you suf sufUnlike the ankle, which can swell outward without limits, when the brain swells it is in a confined space. The fer a concussion you have similar swelling, ankle often demands rest and elevation. But the brain nevwhich impacts performance. The swelling of er really switches off completely. Particularly in students who carry such huge demands from school and electronthe ankle is nature’s way of getting you to ics. rest the injury so it can recover and reduce In fact, we now know that too much mental stimulaDR. BRUCE tion or physical activity slows recovery from a concussion.

CUNNINGHAM the chance of reinjury or a worse injury.

A major challenge in care for the concussed individual With a concussion the swelling causes nausea, headis determining the severity of the problem and appropriately moniache, trouble with focus and problems with balance. Both injuries toring recovery. There is no way to predict who will recover quickly need rest to heal. and who will have lingering problems. Both women and the young Both ankle sprains and concussions occur most often in athletic are more susceptible to brain injury and need longer periods to fully settings, but they can both happen in other environments. Many of recover. us have stepped off a curb and twisted an ankle only to limp for the Current standards of care have changed dramatically. Our tools next several days. In the doctor’s office we often see people suffer suffer- for assessing levels of function are improving, both in the acute and ing from concussions that have slipped on ice or been involved in a convalescent phases. motor vehicle accident. A common misconception is that there has Working together the team trainers, coaches, physicians and par parto be a loss of consciousness to have a concussion, however, most ents can guide the concussed individual back to full function at an brain injuries are not associated with a loss of consciousness. appropriate pace. Besides mental stimulation we now know that After the injury a sprained ankle self-limits return to activity. The return to physical activity too soon can also slow the progress to full football running back that cannot run obviously sits on the sidelines recovery. until he is nearly 100 percent. A little extra tape or brace can get Frequent monitoring and patience are required for best outthem back a little sooner. But an injury to the brain is harder to rest. comes and to prevent a re-injury, which can be much worse than First the injury does not turn purple like the ankle and many athletes the original and lead to more severe post-concussion syndrome. think they can play through a headache and some confusion. It also There is a new focus on concussions and how best to prevent takes more training to evaluate a concussion both in the acute and and treat them. There will always be head injuries but a competent recovery phase. Unlike the injured ankle there is no tape or brace health care team with special training in caring for the concussed to protect the brain during recovery. Also, the consequences can be individual can help determine the best time to return to full activity much worse if a brain injury recurs compared to a re-injured ankle. and if and when athletics can be safely returned to a sport. ■ The analogy between the sprained ankle and a swollen brain is DR. BRUCE CUNNINGHAM is a family physician at Cuyuna Regional Medimore complex when we look at the severity of the injury, the impor impor- cal Center.

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LIVE WELL.

By SARAH NELSON KATZENBERGER Editor

Every second counts— CRMC Moves to iMpRove eMeRgenCy RooM expeRienCe foR patients Dr. Paul Allegra,

A visit to the emergency room can be scary and

CRMC director of criticriti

stressful. In many cases, it can also be an all day

cal care, Sheila Hoehn

event, adding a sense of helplessness to an already

and Dr. Clay Schulte discussed the expansion of CRMC’s Emergency department due for completion at the end of 2015.

8

tense situation.

When Dr. Paul Allegra took over as emergency room director at Cuyuna Regional Medical Center (CRMC) in Crosby, he set out to change those stereotypes. “We just don’t want patients waiting,” Allegra said.

After serving as a part-time physician with CRMC for six years, Allegra took over the role as director of CRMC’s emer emergency department in January. Allegra said he has made it his goal to improve patient experience in the emergency room by

upping the level of care provided.

“The emergency department has changed so much,” he said. ”It’s really evolving — we’re really trying to advance emergency care here.”

Since January, the hospital has hired 10 board-certified emergency room (ER) physicians. There are 12 total board cer certified emergency room physicians on staff. “Out of 79 critical care hospitals in the state, nobody has that,” Allegra said.

“They want to be part of our facility.”

Along with expanding the size of emergency room staff, Allegra said CRMC’s ER is able to do procedures not common in a critical access hospital ER — like a transesophageal echo, a test used to get a better picture of the heart by way of the throat. “Access to that kind of testing allows us to discharge

They’re not driving down to Minneapolis, incurring the expense of a hotel to be near family members.

“They’re right here and are going home at night.”

Sheila hoehn, CRMC diReCtoR of CRitiCal CaRe only have six beds,” he said. “We have to be really efficient.”

Allegra said plans to increase the number of beds in the ER from 6 to 14 should be complete by the end of 2015.

“We’re constantly looking at the metrics, constantly looking at staffing ratios,” he said, adding that the increase in the volume of patients seen was not anticipated when it increased two years ago. “We’re responding to that need.”

Allegra said the proximity of where patients are coming from the CRMC is expanding, some coming as far as from the Canadian border. “I really feel obligated to take good care of them — they’re driving so far,” he said.

Hoehn said she believes CRMC’s reputation speaks for itself when it comes to understanding why people would come from so far for their medical services.

Hoehn said she sees an immense amount of pride and dedication among the doctors. Hoehn said she previously worked at the Mayo Clinic in Rochester before relocating to the lakes area and joining the team at CRMC. “There’s just the sense of quality, patient-centered care,” she said.

Allegra said the teamwork at CRMC between the ER and family practice doctors plays a major role

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in the quality of care patients receive. “I’m able to call up a family practice doctor at 9 p.m. about their patients and they graciously answer my phone call,” he said. “That’s totally unheard of.”

Allegra said he believes the collaboration between the critical care departments — emergency room and intensive care — is so important to patients.

“Other hospitals don’t have the ability to contact a primary care doctor the way that we do here,” he said.

Allegra said CRMC is working to build collaborative relationships with surrounding facilities to help patients receive the treatments they need without having to drive to the metro. “Patients want to stay local,” Allegra said.

Allegra said the expansion of outreach and education has been critical in building collaborative relationships to better serve more patients. “I just think we reached a critical mass,” he said. “There’s just been a lot of growth in the last two years.” Allegra said the vision of the hospital’s leadership is focused on growing the facility and that has attracted new medical staff from all over who what to be apart.

“Doctors want to be part of something bigger than themselves,” he said. “We’re working on making (CRMC) the best it can be.” ■

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patients and send them home rather than transfer them (to a larger facility),” he said. “We take care of patients.”

CRMC’s ER also has an acute stroke designation allowing them to manage more strokes on-site.

Allegra said patients that come to the ER are ofof ten very sick and in most critical access hospitals’ emergency room would require a transfer to a larger, better-equipped facility.

“We’re transferring less than half the number of patients that facilities like ours are transferring,” he said. “We’re managing a lot sicker patients — our goal is to keep them here.”

Sheila Hoehn, director of critical care and cliniclini cal development at CRMC said the decrease in transtrans fers is key to patient satisfaction, particularly from the family perspective. “They’re not driving down to Minneapolis, incurring the expense of a hotel to be near family members,” she said. “They’re right here and are going home at night.”

Hoehn who oversees the hospital’s intensive care unit said acuity (the percentage of patients admitted to the hospital) has gone up with it increasing the severity of illness in ER and ICU patients “People are sicker when they come here,” she said.

Allegra said the volume of patients in the emer emergency room has grown by 22 percent over that last two years and acuity is more than twice the national average.

With the increase in patients visiting the ER, AlAl legra said strategies are in place to keep patients from spending hours waiting. He said from the time patients walk in the door until they see a physician is between 5-10 minutes. “Our biggest issue is that we

By JODIE TWEED Contributing Writer

Cassie Carey Energized Personal lifestyle changes drive area woman to advocate health throughout crow wing county Cassie Carey, coordinator of Crow

Motivation can come in many forms, even

Wing Energized, a grassroots

when you least expect or want it.

For Cassie Carey, it was Oct. 26, 2010, a day she de describes as “one of the worst days of my life.”

Carey’s father, Dick Evenson, a longtime Pequot Lakes school bus driver, was supposed to be at Eagle View Elementary School in Breezy Point to pick up stustu dents at the end of the school day, but he never arrived. He was found dead of a heart attack in his school bus in his field at his home.

He was 59.

Dick Evenson’s own father died at age 53 of a heart attack.

Carey, who at the time of her father’s death was morbidly obese, knew this would likely be the path her life would take if she didn’t make any lifestyle changes.

While her dad had lost weight and walked five to six miles each day in the years before his sudden death, a lifetime of unhealthy eating and inactivity had taken its toll.

health and wellness movement, is hoping to help people throughout the county, including those in her hometown of Pequot Lakes, reach their health and wellness goals like she did. Carey, a former college athlete who at one time was mor morbidly obese, is expecting her first child in July.

10

“It was devastating,” Carey explained, of her dad’s death. She and her husband, Alvin, were living in Valdez, Alaska, at the time. She was a high school physical education and health teacher and head boys’ basketball and head volleyball coach.

They decided it was time to move back home to be closer to family, particularly to be there for Carey’s mom, Leanne, and her sister Junell Wendt’s family.

The Careys, along with Ruger, their German wirehair dog, had moved to Alaska in 2008 on a whim, after she had accepted a teaching job there.

“It was an adventure. We were ready to tour the world,” Carey said, of her four years in Alaska.

They moved back to Breezy Point a year after her dad’s death, and Carey returned to nursing school to become a registered nurse after teaching for almost a decade. She already was a licensed practical nurse and she soon found a job at Essentia Health-Urgent Care in Baxter.

In the meantime, Carey started cooking differently.

She was eating healthier foods, using portion control, drinking more water and exercising.

Slowly she was able to chip away at the pounds that had been weighing her down since she suffered a basketball career-ending ankle injury while at the Univer University of Wisconsin, Superior. A 1999 Pequot Lakes High School graduate, Carey grew up involved in several sports, including volleyball, basketball, golf and softball. She played basketball and golf at Central Lakes College and went on to play at the University of Wisconsin, Superior.

While working at Urgent Care, Carey also worked as a lifestyle change coach for the National Diabetes Prevention Program at Essentia, a lifestyle change program geared for people who are pre-diabetic, or at risk for diabetes, and are overweight or obese. The goal of the class is to help participants make sustainable changes that improve their health and prevent them from havhav ing to go on medication and ultimately reduce the rates of chronic illness, including Type 2 diabetes.

Carey was thrilled to coach others on how to achieve their health goals, celebrating each milestone, big or small, alongside them. She often shared her own personal struggles and triumphs.

When she learned last December that Essentia Health was hiring a coordinator for Crow Wing Energized, a grassroots county-wide health and wellness movement that Essentia co-leads with Crow Wing County Community Services, along with funding from a state SHIP grant, she knew it was the position for her.

As a lifestyle coach for Essentia

This is a grassroots health and wellness movement. I believe in this to my core. It is awesome to be part of some really out-of-the box thinking by a great publicprivate partnership that we have in Crow Wing County C C , C w e and Essentia Health.� assie

Health’s National Diabetes Prevention Program, Carey was able to help about 15-20 participants per class. As coordinator for Crow Wing Energized, her efforts to help others become healthier suddenly grew to a potential 63,000 people, the county’s population. “I feel like I am the luckiest person in the world,�

Carey said with an enthusiastic smile. “This is my calling. That’s the way I feel.�

Carey is working with community leaders to create health and wellness initiatives that positively impact people in the workplace, at school, at home and throughout the community. So far the leadership committee and its volunteers, about 130 of them, are spearheading more than 50 health and wellness initiatives that are now getting off the ground. These initiatives will benefit people of all ages and all socioeconomic backgrounds, from children to seniors, in the county.

One of those initiatives involves the training of

23 volunteer lifestyle coaches who will be offering free National Diabetes Prevention Program lifestyle change classes at various locations throughout the county. This is the same curriculum that Carey taught at Essentia, a program that is evidence-based and has proven results for weight loss and increased exercise levels. It is close to her heart. “This is a grassroots health and wellness movement,� Carey said, of Crow Wing Energized. “I believe in this to my core. It is awesome to be part of some really out-of-the box thinking by a great public-private partnership that we have in Crow Wing County and Essentia Health.�

In addition to her work with Crow Wing Energized, Carey serves as head basketball coach at Central Lakes College. Her husband, Alvin, serves as assistant coach.

And in July, the Careys will be introducing a new player on their team. She is pregnant with their first

arey Coordinator of

row

ing

nergized

child.

Carey knows her dad is looking down and is proud of her efforts. She dramatically changed her lifestyle and now, she’s helping others doing the same. Her background in teaching, coaching, nursing and even her personal struggle with her own weight have formed who she is today, giving her the passion and drive to attempt to positively impact the lives of people in the community she grew up in. It is also holding her accountable to her own personal health goals. “I’m hoping to make an impact where people don’t lose their dads and spouses too early,� she said. “I have so much pride in what the community is doing.�

To learn more about Crow Wing Energized, visit www.crowwingenergized.org. â– JODIE TWEED, a former Brainerd Dispatch reporter, is a freelance writer who lives in Pequot Lakes.

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By SARAH NELSON KATZENBERGER Editor

Battling the undiagnosed enemy How one woman’s mystery illness led Her down a new road toward total HealtH Kelly and Mike

STAPLES — All Kelly Syrdal

Syrdal pose with

wanted was a baby.

Shortly after they married in 2003, Syrdal and her husband, Mike, started dreaming of building a family of their own. But years of disappointment led the Syrdals to believe they might never be able to have a baby.

Then their son Kyle was born.

“We kind of lost hope,” Syrdal re recalled. “We really felt like he was just a little miracle.”

For years, Syrdal struggled to get her weight under control and just assumed her extra pounds were the cause be behind her battle with infertility. “It didn’t matter what I tried, I couldn’t lose the weight,” she said.

While in the early months of her pregnancy with Kyle, Syrdal learned her weight was just a symptom of a much bigger problem.

A trip to the emergency room led to a diagnosis that would change her life — even if she didn’t know it at the time.

An emergency room doctor ran tests that confirmed suspicions that Syrdal was suffering from polycystic ovarian syndrome (PCOS) — a hormonal dis disorder that causes enlarged ovaries and cysts on the outer edge.

The diagnosis also helped shed some light on the mystery on Syrdral’s weight struggle. “It’s virtually impos impossible to lose weight (with PCOS),” she said. “It just all made sense.”

Besides facing her weight loss head on, Syrdal said her biggest concern about having PCOS was whether it would prevent her from having another child. “My doctor didn’t make it sound all that serious so I just kind of had it in the back of my mind,” she said. “My concern was whether we would be able to have another baby.”

Looking for answers, Syrdal and her husband attended an infertility seminar where they met Lakewood Health Sys System Nurse Practitioner Kelly Thomp Thompson. Thompson specializes in women’s health and infertility.

Syrdal said among the topics discussed was PCOS. “I looked at (my husband) and said, ‘I have that,’” she recalled. “I knew I needed to meet her.”

“Most people want to be pregnant,

their son Kyle during a recent trip to Disney World.

12

like, yesterday,” Kelly Thompson said from behind her desk at Lakewood Health System’s Pillager Clinic. And Thompson knows — she’s dealt with it first hand. Having faced her own battle with infertility, and eventually giving birth to five healthy babies, Thompson knows the joys and disappointments that come along with creating a family.

Her personal and professional experience makes her the ideal practitioner to help women like Kelly Syrdal facing an uphill battle with infertility. Thompson said unlike many patients — who aren’t particularly patient — Syrdal was committed to improving her own health before taking the steps to conceive another child.

“She just said, ‘I want to have another baby, but want to be healthy first — that was her main goal,” Thompson said. For many women, the getting healthy first is the hardest part, Thompson added For Syrdal, the objective of improving her health would start with getting her PCOS symptoms under control.

Syrdal said it wasn’t until she heard Thompson’s discussion of PCOS that she realized how serious complications could be. Common symptoms include irregular menstrual cycles, inability to lose weight, unwanted hair growth, hair loss and infertility. More serious complications could lead to cervical cancer, type II diabetes or even stroke.

“I just had no idea it was that serious,” Syrdal said. “I just wanted to know how I could prevent all that stuff.”

Thompson helped Syrdal begin a plan of attack that included medication to control her PCOS symptoms and a strategy to help Syrdal lose those unwanted pounds.

“She’s one of few that really took it to heart,” Thompson said. “She looks like a different person, and she’s done all of this on her own.”

Three years later Syrdal said she has lost nearly 80 pounds. “I have people ask me all the time, ‘What did you do?’” she said. “They assume I had some kind of surgery.”

The answer is as simple as portion control and steering clear of foods she knows are bad for her, including car carbonated beverages which she has cut

almost completely from her diet, plus the addition of better sleep, stress reduction and daily exercise.

Syrdal said she diligently walks every day on her lunch break with a group of colleagues.

Coming from a place of very little energy or ambition to do anything, Syrdal said she now spends a lot of time doing activities she never thought would be possible. Her favorite — riding her bike with her son Kyle, now 6.

“It’s just totally changed my life,” she said, adding that she really feels that Thompson and the Lakewood staff saved her life.

Thompson said the message she wants to give women struggling with the same issues as Syrdal is they don’t have to live with their symptoms.

“You can do this,” Thompson said. “It’s a lot of hard work, but it’s there. It’s doable.”

Thompson said it’s not just about the number on the scale — it’s about feeling better.

Thompson added that PCOS symptoms are a common complaint for many women. “We just want them to know they don’t have to live with this,” Thompson said. “We really can fix it.”

The Syrdals haven’t given up the idea of having another baby, but Kelly said that is no longer their focus — the health of her family takes precedence.

“If it happens it happens,” she said. “We just want it to happen naturally.”

Nurse Practitioner Kelly Thompson (standing) and Sandy Paskewitz pose for a photo in an exam room at Lakewood Health System.

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By SHEILA HELMBERGER Contributing Writer

Giving the gift of life You could save the life of someone today.

Actually, in less than the time it takes to watch a movie you could potentially save the lives of three people. One donation to a Red Cross blood drive can make it possible.

If you’ve never been to a site on blood-donation day, it’s worth a visit. A busy hub of activity, potential donors are being screened, cots hold those currently giving. Others sit in the makeshift canteen having finished their donations and are eating and visiting with one another.

Healthy donations ensure

14

a good supply of blood is on-hand for emergencies and none of us ever knows when we, or any of our friends or family, may need it.

Dee Severson has been working as a volunteer with the Red Cross for 25 years. She said her best blood drives have brought in over 1,000 donations.

Now the numbers are more than 2,000 donations but that number is the total for a year.

Severson said when she first started volunteering, the blood drives were held at the Moose Lodge in Brainerd. Back then the drives got bigger and bigger and grew from two days to three days to four days, then five. Now they are held several times a year at various locations including the National Guard Ar Armory and several local churches but the numbers have fallen off.

The regular donors come often, but getting first time donors is trickier.

“I don’t know what’s happening,” Sever Severson said. ”People aren’t turning out like they used to. It should be an easy decision, because, really, most people, or their family members, will need blood at some time in their lives.”

“I know people aren’t crazy about that needle,” she said. At times, though, the supplies can get crucru cially low. Rare types are always high in demand.

Blood types O, A negative and B negative are always in need because Sever Severson said those types are also valuable to cancer and burn patients.

Besides that initial dreaded poke the process is painpain less. The first step is to check in with volunteers and you will be required to read the information they have on hand about donating blood. It will answer some of the questions most people have. You

will be required to show either a blood donor card if you have one or your driver’s license or other form of identification. Bring a list of any medications you take.

Next you will be called on to answer questions privately about your personal health history and any places you have traveled recently. A short health screening will follow. It includes having your temperature taken, a blood pressure check and a hemoglobin check.

Some willing donors may be turned away temporarily during this step of the process. Some of the reasons include a low iron reading, an open sore, a cut, high fever, or blood pressure that is too low or too high.

Severson says there are a few steps you can take to make sure your donation goes smoothly. “Make sure you drink enough water the morning you come in,” she says. “It will make the blood flow more smoothly and quickly.” She also recommends eating a good meal two to three hours before you make your donation. Wear clothing that is loose and comfortable that has sleeves that can easily be pulled up.

When you know you are going to donate try to eat meat and vegetables that are rich in iron.

Most healthy people are able to donate every 56 days — about six times a year.

“A lot of people do,” said Severson, “And they wish they could give even more.”

After donating eight pints donors are awarded a pin. Severson said some people in the area have made donations totaling 15 to 20 gallons. And each donation really does have the potential to save up to three lives, she says.

The actual donation itself is safe and takes only about 10 minutes. Afterwards you will be asked to have a snack and drink something in the makeshift canteen. If you feel well enough after sitting for 1015 minutes you can leave and go about your normal daily activities.

Donors need to be 16 years of age with parental consent or 17 years old without. Severson said sometimes families come in together to donate and it’s amazing to think that each member could potentially save three other moms or dads or their chilchildren.

Some people choose to make an outing of a blood drive and schedule their time to coordinate with a friend who goes at the same time. A shopping date or lunch date is scheduled for after.

Blood drives are scheduled frequently in the lakes area. Upcoming drives include the first week in May at the First Lutheran Church in Brainerd and another beginning June 30 with root beer floats included for donors.

To make a date to donate blood at either of the upcoming drives call Dee at 838-5433. ■

By CHRISTA LAWLER Forum News Service

Fitness competition with activity trackers SUPERIOR, Wis. — Megan Wilson went to bed at the end of the week confident that the 3,000-step advantage she had on her coworkers at Re/Max here would be enough to win the inner-office challenge.

She was wrong. She didn’t bank on her co-worker noticing she had taken the lead.

Erin Hendry responded by taking her dog for a walk at 11:30 p.m. — and earned enough steps for the win.

What started as a few Re/Max employees wearing activity trackers and competing in head-to-head stepoffs has turned into almost half of the office tossing off taunts, posting step counts and water consumption on a white board and sharing fitness articles on a closed Facebook Group.

“It’s become an addiction,” said Hendry, who aver averages 17,000-20,000 steps per day and won a costume star necklace during the office’s March challenge.

An activity tracker is a wearable device that monitors the number of steps a user takes per day and, in some cases, sleep quality, heart rate, calories consumed and burned, caffeine intake and skin temperature. Popular brands include FitBit, JawBone and Garmin. The tracktrack ers have become a way to compete in fitness challenges with family, friends and coworkers.

At Re/Max, the FitBit wearers are parking farther from the front door, Hendry said. If someone prints a copy

of something, another employee might deliver it to deprive them of the steps. Hendry, the receptionist, doesn’t just transfer calls. She walks to the coworker’s office and tells them they have a call waiting.

Not to mention the laps around the adjacent KMart during lunch breaks.

“On an average day, after going home I’d sit on the couch,” Hendry said. “Now, you’re walking around, trying to get in extra steps.”

Hendry said she doesn’t consider herself a competitive person — but this is different. It’s easy, she said.

Plus: “I just feel better,” she said. “I sleep better, I don’t feel so lazy.”

Wilson, an exercise science major-turned-real estate agent, averages 16,000-17,000 steps per day. It is believed that she holds the office daily steps record at 32,000 — which she’s hit twice. Once was on the day of the Step Out: Walk to Stop Diabetes, which gave her so many steps she was inspired to walk everywhere she went for the rest of the day just to see the number grow.

The other was on Good Friday, when she got off work and ran to services and back and then added the final touches by doing laps in her home.

FAMILY COMPETITION Jessica Detko knows if her father doesn’t mention his

workout in his daily morning mes message, something is wrong. Likewise, if he hasn’t gotten a text from her by noon: “He’ll say, ‘What’s going on?’” she said. “He knows I work out at lunch.”

For Detko, who lives in Cottage Grove, Minn., and her father, Jim Ruprecht of Duluth, their activity trackers and compatible app My Fitness Pal have become a way of staying connected through a common area of interest: exercise.

“I’ve been kicking her a--,” said Ruprecht, 62. “I take great joy in that.”

Ruprecht has been working out since the 1980s, he said. These days, he does a cardio-resistance training combo beginning at about 4 a.m. Detko runs, takes a spin class, barre, and does Body Rock, a home workout plan. Not all of these contribute to her step count as much of her dad’s cardio, she said.

Still, she likes the text messages and the taunting.

“It’s awesome,” she said. “The thing I love is that we’re accountable.”

During a recent conversation, Ruprecht noted that his daughter had just burned 571 calories in a spin class earlier in the day.

“I’m still 1,200 steps ahead of her” for the week, he said. “And I’ll let that pass without notice.” ■

ESSENTIA HEALTHST. JOSEPH’S MEDICAL CENTER

Care across continents Missionary in nigeria turns to Brainerd clinic teaM

Lying in a Nigerian hospital, Dan Gibbs decided he needed a second opinion.

And he knew just who to call — Dr. Ross Bengtson and his nurses at the Essentia Health St. Joseph’s-Brainerd Clinic.

Gibbs had met the team three months earlier, when he was back home in Pine River. Painful varicose veins in his legs had brought him to their educational seminar. Now the condition had hobbled him. A growing skin ulcer on his badly swollen lower right leg had Nigerian doctors prescribing a month-long hospital stay and a skin graft.

The skin ulcer had begun as a simple scratch from a stick during a hike with his wife, Tina, near their Pine River cabin. Poor circulation in his legs had hindered healing and the large skin ulcer had developed because he had spent so much time traveling on planes to Nigeria and in vehicles once he arrived.

The couple serves as missionaries with Converge Worldwide and manages the Gembu Center for HIV/AIDS Advocacy Nigeria (GECHAAN), an HIV/ AIDS ministry in Gembu, Nigeria.

Although Tina wanted to head home for medical care, Dan believed they could stay another month, as planned, if they could better deal with the skin

■ Complimentary Seminars The Essentia Health St. Joseph’s-Brainerd Clinic offers comprehensive vein care from a team of three board-certified surgeons and a nurse practitioner. You can learn more about vein conditions and have an initial screening at one of these complimentary educational seminars: • 9-11 a.m. June 18: Ruttger’s Bay Lake Lodge, 25039 Tame Fish Lake Road, Deerwood • 9-11 a.m. July 16: AmericInn Lodge and Suites, 32912 Paul Bunyan Trail Drive, Pequot Lakes • 9-11 a.m. Aug. 20: City of Emily Building, 39811 Minnesota Highway 6, Emily • 9-11 a.m. Sept. 10: Arrowwood Lodge, 6967 Lake Forest Road, Baxter Space is limited, so please register at 218828-7583 or at www.EssentiaHealth.org/VeinServices. To schedule an appointment, call 218828-2880.

16

ulcer. Then he thought of Bengtson and his team.

Gibbs made a call on Nov. 3, 2014, and later sent an email to Jan Lambert, a licensed practical nurse (LPN) in the Brainerd Clinic’s General Surgery Department. An ultrasound screening done before Gibbs left for Nigeria had shown blood was flowing backwards in the main vein in both legs that drains the skin, Bengtson explained.

A series of calls and emails, including photos of the skin ulcer, led to a treatment plan that the Gibbs could follow in Nigeria. Sara Jacobs, another LPN, also worked to schedule a pre-op physical and an endovenous thermal ablation as soon as the couple returned to Pine River.

“I can only praise Jan and Sara,” Gibbs said. “We were trying to communicate halfway around the world and they truly went way above and beyond to take care of us. They made us feel so comfortable — that we could do this.

“My wife thinks my leg is going to fall off and they reassured us that we could manage it. They were such a comfort to both Tina and me.”

Lambert consulted with Bengtson and relied on her nursing experience to coach the couple. “Dan did everything we asked of him,” she was quick to point out. “They trusted us even when we were so far away — and they trusted themselves.”

“In a matter of a few days, we saw progress,”

Gibbs recalled. “When we flew out on Dec. 15, the wound was completely healed.”

“We help the patient and we help the doctor,” Lambert explained. “That’s why Sara and I are in nursing.”

On Dec. 18, Bengtson closed down the affected veins from Gibb’s groin to his knees using a small catheter heated by high-frequency radio waves. The minimally invasive procedure causes the body to reroute blood through deeper veins and improves circulation in the whole leg, the surgeon explained.

Gibbs felt no pain during the outpatient procedure and only needed to take over-the-counter ibuprofen during his short recovery. As his circulation improves, the swelling in his ankles has decreased along with the pain in his legs and feet. He expects the discoloration to improve as well.

Pain, swelling and discoloration led the couple to explore treatment options. They were visiting his father at St. Joseph’s Medical Center last July when they noticed a poster in the elevator advertising the vein treatment event in Pine River. “Tina said, ‘That looks like your legs. We should go,’ ”Gibbs recalled.

“We were at the right place at the right time last summer,” Gibbs said. “Everything fell into place.

God really works great things in an interesting way.

Now I can say, ‘Oh, I see what happened there.’” ■

REUTERS HEALTH

Does secondhand smoke affect kids?

In a Finnish study spanning 26 years, kids exposed to parental smoking were more likely to develop plaque in their carotid ar arteries as young adults than kids who were not exposed to secondhand smoke.

These findings and others suggest the health effects of passive smoking on children are not limited to respiratory or developmental health, but can have a long-term impact on cardiovascular health, said senior author Costan G. Magnussen of Menzies Research Institute Tasmania in Hobart, Australia.

Researchers used frozen blood samples from more than 1,000 kids ages three to 18 collected in 1980, along with parental reports of smoking status in 1980 and 1983 from a larger group of kids.

They also had ultrasounds of the adult children in 2001 and 2007.

They tested the blood samples for levels of cotinine, a byproduct of cigarette smoke exposure, and looked for a buildup of plaque in the carotid arter arteries, two large blood vessels of the neck, on the adult ultrasounds. Carotid plaque can cause narrowing of the arteries, increasing blood clot and stroke risk, according to the National Institutes of Health.

About two percent of the grown-up kids had a carotid plaque uncovered vered by ultrasound at an aver average age of 36.

More than 84 percent of kids of nonsmokers had

no cotinine in their blood, compared to 62 percent of those with one smoksmok ing parent and 43 percent cent when both parents smoked.

The he authors assumed that kids with a parent who admitted to smoking who ho did not have cotinine in their blood second had been exposed to less secondhand smoke, possibly because parents had been careful to keep their smoking away from the child.

Compared to kids of nonsmokers, these kids were about one and a half times as likely to have carotid artery plaque as adults. But kids of smokers with poorer “smoking hygiene” that exposed them to more smoke (and resulted in cotinine in their blood) were four times as likely to have carotid plaque as those with nonsmoking parents.

“What we were able to do that others have not, is show that parents who are unable or unwilling to quit smoking can still limit the impact of their smoking on their child’s future cardiovascular health by changing their smoking behavior to limit the amount of smoke their child is exposed to,” Magnussen told Reuters Health by email.

Many smoking parents did not smoke inside the home or car, or smoked well away from their children, to the point where there was no evidence for passive smoke exposure in their child’s blood, Magnussen said.

Plaque buildup, or “atherosclerosis,” can begin in childhood so the results are not surprising, according to Karin B. Michels, an epidemiologist and associate professor at Harvard Medical School in Boston.

But only 64 out of more than 2,000 grown subjects did develop plaque, which is a very small number, Michels told Reuters Health by phone.

Atherosclerotic plaque is more dangerous w when it develops at an early age.

This group of kids grew up in a time when smoking was much more ubiquitous, and they w would have been exposed to more secondhand smoke, said Melbourne Hovell of San Diego State University, who was not part of the new study.

Early smoke exposure may have several deleterious effects other than just plaque buildup in the arteries, including an increased risk of later breast cancer and a predisposition to nicotine addiction, Hovell said. Plus, children of smokers are more likely to become smokers themselves, triggering a cascade of other health risks.

“It’s pretty much a perfect storm,” Hovel said.

“The other message for the lay public is to not allow any smoking in your home or car,” as it will contaminate the environment indefinitely, he said.

“Parents with young children probably should avoid buying a used car that has been smoked in.” ■

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Heart disease treatment improves with the advancement of using a wrist artery for care Coronary artery disease (heart disease) re re-

Once blockage of these coronary arteries is identified by heart catheterization, a treatment plan is for formains the most common cause of death mulated. Treatment may include balloon angioplasty, in America today, in spite the fact that tre tre- placement of a stent, which is a small metal coil that fits into the artery and holds it open, open heart surgery mendous advances have been made in or medicines. The extent of blockage dictates which treatment and prevention of this common of these treatments might be best for a particular individual. but dangerous disease.

Traditionally, heart catheterization has been done through the groin vessel called the Over the last 20 to 30 years we have seen femoral artery. As equipment used for the proprogressively better and safer treatments, incedure has improved and become smaller, it cluding balloon angioplasty, stenting, new has become possible to use a smaller artery surgical techniques and even mechanisms for to advance the equipment to the heart. Startrepair of heart valves without surgically opening several years ago, some cardiologists being up a patient’s chest. gan using a smaller artery of the wrist, called All of these new procedures require a proDR. MICHAEL the radial artery, to advance equipment to the cedure called a cardiac catheterization. Car CarTHURMES heart. diac catheterization consists of puncturing an Use of the wrist artery is technically more artery, traditionally the femoral artery located at the crease of the groin and advancing a small tube challenging for the cardiologist.

Any time medical equipment is passed into the body called a catheter up to the heart using X-ray guidance.

The catheter is then used to inject contrast into the there is a small risk of bleeding or other complications, small vessels that supply critical blood flow to the heart but in many cases the risk to the patient is reduced if the muscle. The small arteries that supply this blood flow radial artery is used. are known as coronary arteries and blockage of these Overweight patients, in particular, may do better vessels can lead to heart pain (angina) or heart damage with the radial artery approach. (heart attack).

This is because the vessel is not as deep or as large

18

and it is much easier to visualize and monitor.

Most patients report less discomfort with use of the radial artery and after the procedure patients can sit up, eat and move about more freely.

If the groin artery is utilized, several hours of bedrest are often needed and this can be hard on some patients, especially those with back problems. Use of the wrist also generally results in a shorter period of time before full activities can be resumed.

Because of this increased patient safety and comfort, many cardiologists are beginning to use the wrist approach rather than the groin approach more frequently.

The cardiologists at Brainerd Lakes Heart & Vascular at Essentia Health-St Joseph’s Medical Center have embraced this new approach and are now doing nearly 90 percent of all cases through the wrist rather than the groin. Nationally, only about 10 percent of cases are done this way, but these numbers are rising as more car cardiologists gain experience and comfort with this new technique.

If you need to have an angiogram done, consider asking your cardiologist about the radial wrist approach.

For additional questions or to schedule an appointment call the Brainerd Lakes Heart & Vascular at 218828-7580. ■ DR. MICHAEL THURMES is a physician at Essentia Health-St. Joseph’s Medical Center

REUTERS HEALTH

Genetics of deadly viruses LONDON — Genetic sequence data on two of the deadliest yet most poorly understood viruses are to be made available to re researchers worldwide in real time as scientists seek to speed up un understanding of Ebola and MERS infections.

The project, led by British scientists with West African and Saudi Arabian collaboration, hopes to encourage laboratories around the world to use the live data — updated as new cases emerge — to find new ways to diagnose and treat the killer diseases, and ideally, ultimately, prevent them.

“The collective expertise of the world’s infectious disease experts is more powerful than any single lab, and the best way of tapping into this...is to make data freely available as soon as possible,” said Jeremy Farrar, director of the Wellcome Trust global health char charity which is funding the work.

The gene sequences, already available for MERS cases and soon to come in the case of Ebola, will be posted on the website virological.org for anyone to see, access and use.

Middle East Respiratory Syndrome (MERS) is a viral disease which first emerged in humans in 2012 and has been spreading in Saudi Arabia and neighboring countries since then. It is caused by a coronavirus and has already killed more than 430 people.

An unprecedented epidemic of Ebola virus in West Africa has killed more than 10,000 people in the past year and infected more than 25,000 mainly in Guinea, Sierra Leone and Liberia.

Despite the many deaths caused by Ebola and MERS, researchers still know relatively little about the viruses — including what animals might be acting as “viral reservoirs” — and scientists are battling to develop safe and effective

cures or vaccines against them.

GENETIC CHANGES

Paul Kellam, a professor at Britain’s Sanger Institute, said mapping the gene structure, or sequencing the genome, of a virus can tell scientists a lot about how it is spreading and changing, and help in the search for better ways to diagnose, treat and prevent infections.

“With more genetic surveillance we can spot things that are potential areas of concern — such as (genetic) changes that might mean our diagnostics might not work so well any more, or changes that suggest a virus is becoming able to transmit more easily,” he explained.

Yet while this kind of data is invaluable to researchers, it is rarely shared swiftly or freely enough among them.

Kellam said Saudi authorities are now committed to sharing viral data widely and immediately, keen to enlist the help of international scientists in controlling MERS. As part of the same gene sequencing project, Ian Goodfellow from the University of Cambridge is in Sierra Leone working with the government there to make similar data on the Ebola virus available on virological.org as soon as possible.

He plans to collect samples from Ebola patients, sequence them in a matter of hours and process the data to make the viral genome sequences in weeks — a process that could take months if samples were to be bought back to Britain for analysis. ■

19

By PAMELA KNUDSON Forum News Service

Tiny Terrors Deer tick bites can leaD to lyme Disease SALOL — Valerie Cran Dahl of Salol has been living with Lyme disease for nearly 30 years, she says.

In the summer of 1985, when she was 14, she distinctly remembers that she woke up to find “a dozen tiny poppy seed-sized ticks latched on to my right ankle, which was swollen and painful.”

“I was an outdoor girl” and had been bitten by ticks a few times, she said. But pulling off these ticks was “very painful — unlike the annoying dog ticks that had bitten me.”

She removed them all, but “that ankle remained swollen with a rash for several days.”

Her symptoms included achiness and a fever or flu, she said. She spent “a few miserable days in bed.”

Since then, Dahl has suffered failing health and has received “dozens of wrong diagnoses until I was finally diagnosed correctly in 2010,” she said. “I have been disabled ... fighting hard, but not getting well.”

Her symptoms “have lingered for a long time — on and off for the first few years.” she said.

Over time, she has also experienced “constant moderate to severe leg pain — knees to toes, but hips too.”

Migraine headaches and lingering symptoms of meningitis and encephalitis “got worse and worse as the years passed,” she said.

TICK BITES

Lyme disease, which is transferred to humans via a tick bite, is the most common tick-borne illness in North America and Europe, according to Mayo.com.

Black-legged ticks, more commonly known as deer ticks, which feed on the blood of animals and humans, can harbor the bacteria which causes Lyme disease and spread it when feeding.

The ticks are brown and when young, they’re often no bigger than the head of a pin, which can make them nearly impossible to spot.

People who engage in outdoor activities, especially in the spring and summer, are at increased risk of getting Lyme disease, said Dr. Chris Henderson, family

20

physician with Altru Health System in Grand Forks.

In most cases, in order to transmit Lyme disease, a deer tick must be attached for 36 to 48 hours, medical experts say. If you find an attached tick that looks swollen, it may have fed long enough to transmit bacteria.

Removing the tick as soon as possible may prevent infection.

SYMPTOMS Signs and symptoms of Lyme disease vary and usually affect more than one system of the body, according to MayoClinic.com. The skin, joints and nervous system are affected most often.

If left untreated, infection can spread to joints, the heart and the nervous system, the CDC says.

The most common sign of infection is an expanding area of redness that begins at the site of the bite about a week after it occurred. The rash usually feels warm to the touch but is typically not itchy or painful.

“You hear about the bull’s-eye rash, but 25 to 30 percent of people don’t have that kind of rash — or a rash at all,” Henderson said.

The disease “presents like a lot of other things — muscle soreness, headache, fever, stiff neck, sore joints,” he said. “A known history of tick bites” would also increase the possibility of Lyme disease.

With Lyme disease, long-term complications can arise but are less common, Henderson said.

“Arthritis is a common one which causes pain if not treated. Neurological symptoms, which are less common, include meningitis, numbness and a certain weakness in a particular muscle.”

In late stages of persistent Lyme disease, infection can cause damage to the nervous system, joints and brain, according to WebMD. Lyme disease, which has been termed “the great imitator,” may be misdiagnosed as multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, lupus, Crohn’s disease, HIV or other autoimmune and neurodegenerative diseases.

While the term “chronic Lyme disease” is controversial, a classification, called post-treatment Lyme disease syndrome, or PTLDS, has emerged and is de-

fined as continuing or relapsing non-specific symptoms — such as fatigue, musculoskeletal pain and cognitive complaints — in a patient previously treated for Lyme disease.

TREATMENT Doctors usually treat Lyme disease with antibiotics.

“Doxycycline is usually the first (drug) we use,” Henderson said. “It has benign side effects and is pretty well tolerated.” “(In the past) it was harder to isolate that bacteria (Borrelia burgdorferi)” which causes Lyme disease, he said. “Different types of blood or joint fluid serum tests are available now.”

Each of those tests “have their own limitations.”

Early diagnosis and treatment can be better for patients, he said, but “even if treated later, people are still likely to do very well.”

If you’re treated with appropriate antibiotics in the early stages of the disease, you’re likely to recover completely, Mayo doctors say. In later stages, response to treatment may be slower, but the majority of people with Lyme disease recover completely with appropriate treatment.

Left untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pain, severe headaches with neck stiffness or heart palpitations, among others.

PRECAUTIONS Last year in North Dakota, there were eight cases statewide that were reported to the North Dakota Department of Health.

In other years, reported cases in the state totaled 29 in 2013, 15 in 2012, 26 in 2011 and 33 in 2010.

According to the Minnesota Health Department, the number of Lyme disease cases has been increasing dramatically since the 1990s. In 2013, 1,431 confirmed cases and an additional 909 probable cases were reported.

A variety of factors, including increasing physician awareness, increasing infection rates in ticks and expanding tick distribution may have led to this

trend, the department said.

You’re more likely to get Lyme disease if you live or spend time in grassy or heavily wooded areas where ticks carrying the disease thrive, according to Mayo.com. It’s important to take precautions in ar areas where Lyme disease is prevalent.

“You should wear long pants and long-sleeved clothing and wear an insect repellant such as DEET,” said Javin Bedard, environmental health manager for the Grand Forks Public Health office.

“Public Health recommends that you check your yourself for ticks, especially if you’ve been in tall grass and rural areas.”

Recent studies by UND researchers have revealed that the deer tick is showing up in this area, he said.

“The potential is there (to acquire Lyme disease).”

Ticks depend on moisture, so homeowners are advised to keep their grass mowed, he said.

When conditions dry out, ticks “retreat to the under mass, or forest litter, to stay in moisture.”

The potential is there to pick up a deer tick at any time, Bedard said, but the ticks become more active as the summer progresses.

REMOVAL

When removing a tick, it’s most critical to be sure the mouth part is removed, Henderson said.

“If you don’t think you can get it out completely, come in (to Altru Clinic) and we’ll take it out. The mouth part can cause problems if it stays in there. It can be pretty irritating.”

Lyme disease “is endemic — meaning it’s present in the population,” he said. “It has been spreading further west with the migration of ticks. (But) people don’t need to worry.” “(They) should be aware that if they come in ... with symptoms of fever, aches, etc., it’s probably not going to be Lyme disease. Especially in December or January, I’m not going to suspect Lyme disease.” ■

■ Symptoms of Lyme disease

T

he signs and symptoms of Lyme disease vary and usually affect more than one system of the body. The skin, joints and nervous system are affected most often.

Early signs and symptoms may occur within a month after you’ve been infected: • Rash: A small, red bump may appear at the site of the tick bite. This small bump is normal after a tick bite and doesn’t indicate Lyme disease.

However, over the next few days, the redness may expand, forming a rash in a bull’s eye pattern, with a red outer ring surrounding a clear area. This rash is one of the hallmarks of Lyme disease.

• Flu-like symptoms: Fever, chills, fatigue, body aches and a headache may accompany the rash.

In some people, the rash may spread to other parts of the body and, several weeks to months after you’ve been infected, you may experience: • Joint pain: You may develop bouts of severe joint pain and swelling. Your knees are especially likely to be affected, but the pain can shift from one joint to another.

• Neurological problems. Weeks, months and even years after you were infected, you may experience inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell’s palsy), numbness or weakness in your limbs and impaired muscle movement.

Only a minority of deer tick bites lead to Lyme disease. The longer the tick remains attached to your skin, the greater your risk of getting the disease.

If you think you’ve been bitten by a deer tick and experience symptoms of Lyme disease--par disease--particularly if you live in an area where it is prevalent--contact your doctor immediately. Treatment for Lyme disease is most effective if begun early.

See your doctor even if symptoms disappear, because the absence of symptoms doesn’t mean the disease is gone.

Left untreated, Lyme disease can spread to other parts of the body from several months to years after infection, causing arthritis and nervous system problems.

Ticks can also transmit other illnesses, such as babesiosis and Colorado tick fever.

—Source: MayoClinic.com

By PAMELA KNUDSON Forum News Service

Capturing curiosity Capitalizing on Children’s motivation to disCover key in early eduCation GRAND FORKS, N.D. — It may look like children are just playing — as they giggle, babble and analyze items that have caught their eye and sparked their curiosity.

But they’re actually engrossed in the important work of building the foundation on which future learning depends, early childhood education specialists say.

In the earliest years of a child’s life, the brain is buzzing with activity, rapidly constructing the framework for learning.

It’s a critical time “because everything they’re experiencing is brand new,” said Dawnita Nilles, child-care licensor for Grand Forks County Social Services.

“Any experience a child has is creating a chemical reaction in the brain,” said Judy Milavetz, early childhood educator.

Both women are organizers of the Hands-on Learning Fair, set for Saturday at Purpur Arena in Grand Forks.

“A child is born with billions of neurons in the brain,” Milavetz said. “Some are already organized. For example, children can distinguish their parents’ voices from other voices ... and distinguish smells.”

The earliest years represent a prime time for parents — and other caregivers — to engage with children and to capitalize on the opportunity nature presents.

“Quality early childhood education is extremely imim portant,” said Nilles. “Every time a child experiences something, new connections are being made.”

Experience is the key to the synaptic connections that help organize information and knowledge in the brain.

“In this digital age, it’s easy to forget that the young child’s brain becomes organized through hands-on exploration, creating the capacity to acquire complex skills and knowledge,” Nilles and Milavetz wrote in a news release about the Hands-on Learning Fair.

They hope that, through this event, parents will gain a deeper appreciation of the importance of their role in providing quality early education for their children.

“Part of what we’re trying to do is build awareness that learning begins at birth,” Milavetz said. “We want to build on what the child comes into the world with.”

‘BORN LEARNING’

“Children are born learning,” she said. “They are primed for every type of learning skill.”

People generally think of early childhood education in terms of “academic learning” — things like numbers, letters or similar categories — or what’s called “content knowledge” in her field.

“Before you can learn content knowledge, you have to have real experience with that content,” she said.

Hands-on activities that demonstrate that it takes a certain number of cups to fill a pitcher, for example,

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give children the basis to understand mathematics.

Such an activity helps children begin to grasp the properties of water and the concepts behind words like “more” and “larger,” she said. It helps with development of fine motor skills — like how to tilt a pitcher when pouring.

In children who are too young to learn to read, for example, the foundation for reading is laid by “something as simple as lego blocks (to convey that) parts make up a whole, that words make up a sentence,” Milavetz said.

While content knowledge will come later, very young children “are trying to build a repertoire of skills” they can use to engage with their world — skills like problem-solving, information-gathering, memory and perseverance.

“We want to capitalize on what children have to begin with,” Milavetz said, by providing “appropriate play materials for children to explore and manipulate and to pique their curiosity, and the human element — meaning, what kind of engagement will make their interaction possible?”

PARENTAL INTERACTION

The quality of parents’ interaction with their children makes a “huge” difference in a child’s development, Nilles said.

It’s expressed by “responding to that little baby, reading to him, singing with her, having him help around the house — all the ways that parents, through inter interaction and purposeful intent, can and do impact that child’s readiness for school,” she said.

By being engaged with — and being excited by — what children are discovering, parents send a nonver nonverbal but unmistakable message that “they are valued for who they are and that they have a role,” Nilles said.

“In order for a child to feel safe and secure in their environment, they need to trust that you will be there to meet their needs,” Milavetz said.

“From those early relationships, children learn that they are valued as human beings, and they have a reason to be in the world and are competent to function in the world. They can engage with others, knowing, ‘I can go back to these people’ if need be.”

Neuroscientific research has shown that the brains of people who’ve had early loving, supportive relation relationships differ from those who haven’t, Milavetz said.

“If these nurturing relationships aren’t there in the first three years, you’ve missed an opportunity to devel develop that part of the brain in ways that are most optimal.”

DRAWBACKS OF TECHNOLOGY

Although technology can supplement a child’s learning in some ways, Milavetz said, “it cannot re replace traditional interactive play with real objects and people.”

“Children who spend a lot of time with TV or gaming devices, their attentional skills may suffer,” she said.

“They’re not able to focus on characteristics of objects, characteristics which they pick up visually and by hear hearing and kinesthetic means — like picking up and han handling an object.”

Also, use of electronic media creates the potential for literacy and social skill delays, obesity, problemsolving deficits and sleep problems in young children, she said.

The human element is powerful, Nilles agreed.

“Children learn through interaction,” she said. “They need communication, back and forth.

“The digital device will give a word or a color, but the device is not going to know if you named it right. It’s not giving the child feedback.”

The communication with these devices is “one way,” she said. “Devices pour information into a child.

But children don’t learn that way.

“They learn through doing, through practice and, once in a while, by having it not work out and trying it again. Learning depends on a loving relationship with an adult who is vested in wanting this child to learn.” ■

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