UpNorth HealthWatch Feb. 2005 by Brainerd Dispatch and Echo Journal

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Continued from Page 12 vate dormant problems. “You’re bent over and you’re moving in ways you shouldn’t, because you’re chasing someone around who’s 2 feet tall,” said the 51year-old father, whose children are ages 3 and 7. “You never do it with proper biomechanics.” The problems often start during pregnancy, when many women experience carpal tunnel syndrome and sciatica. Hormones weaken the joints and stretch ligaments. Weight gain throws the body off balance, stretches out the abdomen and weakens the back muscles. Prolonged bed rest, often prescribed by doctors concerned about complications of pregnancy, also can reduce muscle strength. “The pregnancy and all the missteps (women) can take during the pregnancy is all but inviting a problem in the lower back,” said Jerome McAndrews, a former president of the Association of Chiropractic Colleges and spokesman for the American Chiropractic Association. “The older the woman is — and we don’t have a study on this — I would say the more likely it is she’s going to have problems.” Angie Rafferty, who stays at home to care

for her 11-month-old daughter Madison, struggled with sciatica during pregnancy. Recently she’s had muscle spasms in her shoulders. One day, she twisted her back so badly trying to lift 23-pound Madison out of her car seat that she had to get help from a neighbor. “I just avoid picking her up as much as I can,” said Rafferty, 30, of Essex, Md. “I spend a lot of time trying to teach her how to climb.” Susannah Wolf, 35, a stay-at-home mother, noticed pain in both wrists starting when her son, Samuel, was 5 months old. She’s twice received cortisone shots to relieve the symptoms. Doctors told her she has De Quervain’s syndrome — also known as “washerwoman’s sprain” — and that it often strikes new mothers. Before she knew what was wrong, Wolf, of Cedarcroft, Md., said, “I was really scared that I wasn’t going to be able to care for him.” She has since tried to remember to support Samuel, now 14 months, from underneath to ease the stress on her wrists. But when it comes to responding to their children, even well-educated parents can ignore their better instincts.

Chiropractor McAndrews said that while a parent might think to lift from the legs when picking up a heavy box, he or she might not take the same care when comforting a crying toddler. “It’s instantaneous, the way they deal with the child,” he said. Robin Rose-Samuels, 42, knows the dilemma. She’s had longtime back problems that have flared up since her boys, now 4 and 6, were born. The brothers don’t need to be lifted much anymore, but they do have a beloved bedtime ritual — each is carried to his bunk by a parent. Recently, after Rose-Samuels had a physical therapy treatment, her 51-year-old husband tried to keep up the routine by hoisting both boys. He promptly threw out his back. “He thought he could be Super Dad,” she said. So how do you prevent the common injuries of child-rearing? And if you’re already feeling the pain, how do you find relief? Experts say that a regular, balanced exercise program often can prevent or improve minor aches and pains. For more serious problems, a visit to a professional may be required.

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Imsande places, and have even splurged on an Alaskan cruise and trip to Disney World for the family. “Those are the highlights of our blessings,” Imsande said. “How can you be mad about that?” Before being diagnosed, Imsande said he was faithful, but took things for granted. Today, his outlook on life is bright, and he counts his blessings every day. “We will all die someday and between now and then it’s up to us to enjoy what God has given us,” Imsande said. Imsande shares his story by publicly speaking about his faith and the blessings he’s received, in hopes of touching the life of someone else. He’s spoken about 10 times in churches and schools in central Minnesota, including Brainerd, Wadena and Long Prairie. “By sharing with others, maybe I can help them,” he said. Although Imsande is at peace with what the future holds for him, he does admit reality has been stressful on his wife, Becky, and other relatives. They continue to pray for a miracle every day.

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He's at New Folsom, a modern California state prison next to the 19th century stone fortress that inspired Johnny Cash's tune. He spoke while crouching on the cell floor, so that he could peer through a thigh-high tray slot in the steel door. Inmates at maximum-security New Folsom are released from their cells for exercise just two hours every other day, unless they have a prison job. ``Wishing is a dream,'' Jones said of his food fantasies. He shrugged in a gesture of futility. ``Steak? Lobster?'' In the kitchen, inmate laborers washed the remains of instant mashed potatoes from bathtub-size kettles. Pans of the potatoes were stocked in walk-in ``quick chill'' refrigerators. Quick chilling allows the prison to start meals two days in advance. The food is cooked, then ``blast cooled'' in the refrigerators to within a few degrees of freezing. On serving day, it is reheated. New Folsom places meal samples in a locker labeled the ``Dead Man's Tray.'' They are kept 72 hours for inspection in the event of an outbreak of food poisoning. ``We've never had an incidence of food poi-

soning,'' said Jeff Ridge, the prison's assistant food manager. ``You'll have three or four inmates say, `Oh, the food made me sick.' But then they'll go to the doctor, and he'll say, `I

``Two weeks ago, I fired two workers for putting 10 pounds of chicken, turkey, cheese and onions in a salad box. They were going to make burritos.'' — Frank Coleman, Prison cook supervisor

don't think so.' '' Ridge loped through the humid kitchen to a small office, where he and cook supervisor Frank Coleman discussed thievery. They told

of the ways inmate workers steal food to cook in their cells, sometimes with illicit candles crafted from purloined shortening. ``Two weeks ago, I fired two workers for putting 10 pounds of chicken, turkey, cheese and onions in a salad box,'' said Coleman. ``They were going to make burritos.'' The workers also steal from the trays of fellow prisoners, Ridge said. ``They'll pick out all the meat from the beef stew,'' he said. Prisoners caught stealing lose their jobs, which pay $20 to $50 a month. Inmates in disciplinary isolation are given paper trays, because the rigid plastic ones could be used as a weapon, Ridge said. For the same reason, they are not served baked chicken with bones, but get patties instead, he added. On this day the entree was Chili Colorado. The prisoner workers filled the trays in the kitchen and carried them to the two-man cells. ``It's basically slop,'' said Jonathan Hurth, 32, of Los Angeles, who is serving 25 years to life on a three-strikes burglary conviction. He grew wistful. ``It'd be nice to just order something.''

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Table of contents

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8 12 14 16 18

COVER STORY:

Binge drinking BACK PAIN:

Lifting tips for busy parents NUTRITION:

Hospital food DISEASE:

Living with Lou Gehrig’s disease

20 24 28 32

RELAX:

Massage therapy TECHNOLOGY:

Telemedicine

Who we are Publisher — Terry McCollough Advertising Director — Mary Panzer Editor — Heidi Lake Graphic Designer — Cindy Spilman HealthWatch is a quarterly publication of the Brainerd Dispatch.

Hospital addition

Read HealthWatch online at www.upnorthhealthwatch.com.

FOOD:

For advertising opportunities call Mary Panzer at (218) 855-5844.

MOVING ON UP:

Inmate’s nutrition

EXERCISE:

What works

THE ONLY WAY YOU’D HAVE MORE CONTROL IS IF YOU WERE THE ONE IN SCRUBS. NOW OPEN. Brainerd Lakes Surgery Center

E-mail your comments to heidi.lake@brainerddispatch.com or write to: Heidi Lake Brainerd Dispatch PO Box 974 Brainerd, MN 56401

From the editor Even in small Minnesota communities, the importance of healthy living is evident. Clinics, health clubs and massage therapists seem to be popping up in even the smallest towns. In HealthWatch, we try to cover stories from all around central Minnesota, and in this issue we ventured to New York Mills for a story about a man’s struggle with Lou Gehrig’s disease and to Wadena to see the technical side of small-town medicine. You may recognize the writers

behind the stories in this issue of HealthWatch. Dispatch staff writers Matt Erickson, Jodie Tweed and Jennifer Stockinger contributed a variety of stories, from binge drinking to the benefits of massaging infants. Please continue sending me your story ideas. Knowing what healthrelated stories you want to read is a great advantage when it comes to putting out a successful publication. Heidi Lake Editor

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prisons balk at accommodating the dietary needs of diabetic inmates or those with food allergies. `Ìt's ridiculous,'' he said. ``That's why there are riots.'' The nastiest of the nasty, Weinstein added, is the food in county jails. ``Notoriously horrible,'' he said. ``Lots of hot dogs and beans.'' Not true, said Scott, who runs meal service for 17,500 inmates in the county's lockups, the largest single feeding ground in American corrections. She insists meal time can be the best time of doing time. ``We're using Army-Navy recipe cards,'' Scott said, walking through the sprawling, clanging kitchen at the Twin Towers Jail. She said dietitians approve the low-fat and low-salt recipes, and the kitchen prepares 1,200 special meals on the average day for inmates with medical problems. But it also doles out a ``disciplinary loaf'' to unruly prisoners: An entire meal is molded into a baked log that is nutritious but unpleasant. ``We only do about 10 a day,'' said Scott. Her inmate crew stirred 100-gallon kettles of carrots and beans with paddles big enough to row a boat. Although it was late morning, the vegetables were for dinner, the jail's only hot meal. Cooking for thousands dictates an early start. Dinners are stored for hours in insulated containers before they are served. Scott said the food is kept free of illness-causing bacteria. As she toured the kitchen, steam from the kettles and pot washers rained puddles on the floor. The 50 or so workers, dressed in smeared white uniforms, had volunteered for the duty in exchange for double helpings of the jail food, plus leftovers from the officers' cafeteria, whose dishes are far more varied and appetizing. `Ì like the barbecued ribs,'' inmate Karen Hawkes, 43, said of the cafeteria's treats. Hawkes and her co-workers toiled under the wary eyes of a dozen staff cooks and sheriff's guards. Carving knives were tethered to cutting tables with padlocked cables, just in case. Years ago, Scott said, an inmate in another jail kitchen grabbed a loose knife and briefly took a cook hostage. She could recall no serious incidents of violence in the Twin Towers kitchen, or escapes from it. `Òur biggest security problem is pruno,'' she said, referring to an alcoholic drink prisoners make. They steal or hoard enough fruit to produce gallons of the potion each day, fermenting it in plastic bags. ``That's why we put holes in the bags,'' said Scott, displaying a plastic lunch sack. ``These have six holes, and I've asked for six more.'' The bag held two pieces of tired-looking processed turkey, two slices of wheat bread, two cookies, an apple and carrots. It is a typical lunch. Breakfast is mainly bran flakes and milk, hard-boiled eggs, a bun, jelly and fruit juice. The jail stopped serving hot oatmeal last year to trim $1.5 million from its annual food budget, which is $22.9 million -- or $2.25 per day per inmate, less than that of California's state prisons ($2.45) and federal penitentiaries ($2.78). Several women said they would starve if it weren't for the jail commissary, where inmates can buy noodles, soup, stew, chips, candy and the like -- if they have the money. Cleveland Jones isn't moving anywhere, and he's tortured by thoughts of food. Jones, 28, is doing 217 years to life for attempted murder and other crimes, leaving him eligible for parole in 2204.

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``It stinks,'' said Bobby Love, 46, jailed for a probation violation. Like his five cellmates, he spooned up the casserole, carrots and green beans while standing in the elbow-bumping space between metal bunks. ``The food's always cold and the milk is hot.'' Similar comments sounded up and down the cell tiers, the critics shirtless and tattooed, creating a boiler-room din: ``Garbage!'' ``Disgusting!'' ``Give us steak!'' Decent chow is considered as crucial as tall walls to the orderly management of jails and prisons. Churning it out is often an assemblyline, security-obsessed and penny-pinching task that depends on inmate workers who might prove better at stealing food than cooking it. And the quality and quantity of grub can mean the difference between peace and violence in the cellblocks, where prisoners long for the sirloins and sundaes that vanished with their freedom. But even food that isn't bad enough to trigger a revolt is routinely described as revolting. At Men's Central, the shouted protests covered the range of the jail's cuisine, although the chicken patties got a few thumbs up. ``The burritos are pretty good, too,'' said DeMarcus Smith, 19, of Los Angeles, another

probation offender. ``But I don't even know what it was, what we had yesterday.'' Scott said it was a tamale casserole. She appeared only slightly annoyed by the carping from the pens, her weary expression suggesting that it came with the territory. ``Typical,'' she said. It used to be worse, here and elsewhere. Over the decades, legal reforms have improved the nation's detention menus, doing away with daily rations of gruel-ish, artery-clogging concoctions. Many institutions, however, still spend less than $3 per inmate per day on meals. Complaints about food have fueled numerous disturbances behind bars, minor and major. Spaghetti sparked a nonfatal uprising at the historic federal prison on San Francisco Bay's Alcatraz Island, which closed in 1963 and is now a National Park Service attraction. Meals were also a factor in America's deadliest inmate riot, the 1971 rebellion that took 43 lives at New York's Attica prison. Today, inmates are guaranteed a healthy allotment of calories and nutrients, as well as clean kitchens. Diets low in salt and fat have gained favor. More and more prisons are eliminating pork in deference to the religious tenets of Muslim prisoners.

Some cling to an old tactic of pumping up the calories -- serving 3,500 to 3,800 a day, instead of the standard 2,500 to 3,000 -- to keep inmates full-bellied and calm, said Dan Jameson, a senior vice president of Aramark Corp., a food vendor that provides meals for 425 prisons and jails. ``It's using food to manage the prison,'' Jameson said. Inmate rights advocates condemn as dehumanizing what they say is the growing practice of requiring inmates to eat in their cells, a measure taken to prevent fights in dining halls. Cost-cutting is another sore subject for the advocates, who say leaner budgets have led to fewer hot meals, smaller portions and more palate-numbing packaged food. ``Most of us would find prison meals bland, unappealing and monotonous,'' said Steve Fama, an attorney for the San Rafael, Calif.based Prison Law Office, which represents inmates. ``Especially the bag lunch. . . . It has something that has similarities to what people would call lunch meat. I'm not sure it is lunch meat.'' Corey Weinstein, a physician and investigator for California Prison Focus, an inmate rights group in San Francisco, said jails and

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Young adults risk lives during ‘power hour’ crusade

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At midnight on Oct. 6, Andy Cutkay turned 21, but he doesn’t remember much of it. He had one hour to celebrate his birthday with several friends at downtown Brainerd bars. It was to be his “power hour,” the 60 minutes to take his first drink as a 21-year-old before the bars closed at 1 a.m. But the “power hour” is also associated with binge drinking, which is defined as consuming five or more alcoholic drinks in a row at one sitting. Cutkay met and exceeded that amount.

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For inmates, jail food is all sour grapes Story/Paul Pringle Photo/Rick Loomis Los Angeles Times

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LOS ANGELES -- In the sour innards of Men's Central Jail, Alice Scott watched with pride as trays of her chicken casserole dinner were delivered like mail through slots in the cell doors. Prisoners began devouring the fare as soon as they had it in their grasp. ``The inmates like the food, and that makes me happy,'' said Scott, a sheriff's lieutenant who oversees meal preparations for the jail. Then came the reviews. An inmate slid his food tray through the bars of his cell. Prisoners are guaranteed a healthful mix of calories and nutrients.

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He said he remembers taking about 10 shots in two bars he visited. He said his friends took him to two other bars, but he has no recollection of visiting them. His friends told him he began talking nonsense and wouldn’t pay attention. “That’s when they realized something was wrong,” Cutkay said. His friends tried to make him vomit, but couldn’t. “I was totally unresponsive so they took me to the hospital.” His blood alcohol level was 0.438, more than four times the legal limit in Minnesota. When excessive amounts of alcohol are consumed the brain is deprived of oxygen. The struggle to deal with an overdose of alcohol and lack of oxygen eventually will cause the brain to shut down the voluntary functions that regulate breathing and heart rate. “The brain is not working. There’s enough interference with the more primitive parts of the brain telling you to breathe,” said Dr. Nick Bernier, director of medical affairs at St. Joseph's Medical Center in Brainerd. “They black out, they’re comatose. It’s like a general anesthetic you’d get in surgery, but there we breathe for you.” Cutkay had his stomach pumped and was hooked to a ventilator to help him breathe. He was given fluids intravenously. When he woke up the next day in the hospital, Cutkay asked his parents why he was there, “and my dad told me I almost died last night,” Cutkay said. Binge drinking among young people is a concern, said Bernier. In national surveys, about a third of high school seniors and 42 percent of college students reported at least one occasion of binge drinking within the previous two weeks, the National Clearinghouse for Alcohol and Drug Information reported. “It can have serious long-term health effects and young brains are more susceptible,” Bernier said. St. Joseph’s Medical Center has had its fair share of people who’ve come through the emergency room unresponsive after excessive drinking and for other alcohol-related injuries. “It’s not unusual at all,” said Dr. Lynn Howard, who works in St. Joseph’s Medical Center’s emergency department. “And most people who drink themselves into an unre-

sponsive state tend to be young adults.” The biggest issue is health effects, Bernier said. While one or two alcoholic drinks actually can be healthy, binge drinking can damage the brain, the heart, the liver and other organs. It can have a social impact, affecting school and jobs, he said. Alcohol can lead to other drugs, such as methamphetamine, he said. In the emergency room, heavy drinking is a cause of other injuries, such as car accidents, Howard said, and doctors routinely check blood alcohol content when a person comes in with serious trauma. While national surveys have documented a significant decline in the use of other drugs by high school seniors and coll e g e - a g e youths, the N a t i o n a l Clearinghouse for Alcohol and D r u g Information reported there have been only modest declines in the numbers reporting binge drinking. Teenagers and young adults drink alcoholic beverages at about the same rates they did five years ago. According to the Centers for Disease Control and Prevention, the four leading injury-related causes of death among youths under age 20 are motor vehicle crashes, homicides, suicides and drowning. Alcohol is involved in many of these deaths, the NCADI reported. Brainerd Police Chief John Bolduc said there’s a dual responsibility for the drinker and the bar that serves the alcohol when it comes to binge drinking. “Both have the responsibility to not overdo it,” Bolduc said. If a bar is found to have served someone too much alcohol, it can be cited, he said. To cut back on “power hour” and binge

drinking, the North Dakota Legislature is considering a law that prohibits 21-year-olds from drinking until 8 a.m. of their birthday. Bolduc disagreed with that idea. “You can’t legislate good judgment and common sense,” he said. Cutkay has learned from his experience. He said he’s only been to bars a few times since he blacked out on his 21st birthday, and he’s only drank beer. He said he’s glad he’s surrounded himself with people who don’t look down on him for what happened, with people who cared enough to take care of him when it did happen. He said he has felt guilty and ashamed he put his friends and his family in a position where they were worrying about his life. “My dad told me to not get down on myself, that it’s a life lesson learned, a foolish mistake,” Cutkay said.

MATT ERICKSON can be reached at matt.erickson@brainerddispatch.com or 8555857.

Consequences of binge drinking ➤ Alcohol poisoning. A severe and potentially fatal physical reaction to an alcohol overdose, it is the most serious consequence of binge drinking. Symptoms include vomiting; unconsciousness; cold, clammy, pale or bluish skin; and slow or irregular breathing. ➤ Violence. In schools with high binge drinking rates, 34 percent of non-binge drinkers reported being insulted or humiliated by binge drinkers; 13 percent reported being pushed, hit or assaulted; 54 percent reported having to take care of a drunken student; 68 percent were interrupted while studying; and 26 percent of women experienced an unwanted sexual advance. ➤ Sexual encounters with their inherent risks of pregnancy, sexually transmitted diseases and HIV exposure, as well as date rape and other violence, can and do occur more frequently while students are consuming large amounts of alcohol by binge drinking.

(Source: The National Clearing House for Alcohol and Drug Information)

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Drinking misconceptions

➤ Binge drinking among youths ages 12 to 17 appears to occur most frequently in the north central region of the United States and in metropolitan areas. ➤ Binge drinking, often beginning around age 13, tends to increase during adolescence, peak in young adulthood (ages 18 to 22), then gradually decrease. ➤ Binge drinking during the past 30 days was reported by 8 percent of youths ages 12 to 17 and 30 percent of those ages 18 to 20. ➤ Among people under the legal drinking age (12 to 20), 15 percent were binge drinkers and 7 percent were heavy drinkers. ➤ Frequent binge drinkers were eight times more likely than non-binge drinkers to miss a class, fall behind in schoolwork, get hurt or injured, and damage property. ➤ Nearly one out of every five teenagers (16 percent) has experienced “blackout” spells where they could not remember what happened the previous evening because of heavy binge drinking. ➤ More than 60 percent of college men and almost 50 percent of college women who are frequent binge drinkers report that they drink and drive. ➤ In a national study, 91 percent of women and 78 percent of the men who were frequent binge drinkers considered themselves to be moderate or light drinkers.

These are the most common misconceptions that people have about drinking and the effects of alcohol, along with the actual facts.

(Source: The National Clearinghouse for Alcohol and Drug Information)

MYTH: Beer is less intoxicating than other types of alcoholic beverages. FACT: One 12-ounce can of beer, one 4-ounce glass of wine or one normal mixed drink or cocktail are all equally intoxicating. MYTH: Switching between beer, wine and liquor will make you drunker. FACT: Mixing types of drinks may make you sicker by upsetting your stomach, but not more intoxicated. Alcohol is alcohol. MYTH: Cold showers, fresh air or hot coffee help sober a person. FACT: Only time will remove alcohol from the system. It takes the body approximately one hour to eliminate the alcohol in one drink. MYTH: Eating a big meal before you drink will keep you sober. FACT: Drinking on a full stomach only will delay the absorption of alcohol into the bloodstream, not prevent it. Eating before you drink is not a defense against getting drunk. MYTH: Everyone reacts to alcohol in the same way. FACT: Many factors affect a person's reaction to alcohol — body weight, metabolism, gender, body chemistry and many others. (Source: Alcoholism.about.com)

er system will go online and allow all areas of the hospital to have instant access to patient records. Eventually the computer technology will allow for the scanning of medication bottles along with a patient’s wristband to catch any problems that could arise, such as if a patient were about to be given the wrong medication. This will make for greater patient safety, said Groneberg. The pediatrics and Family Birthplace areas will be moved to the fifth floor in mid-February so those areas can be completely remodeled. The temporary move is expected to take about three months, said Groneberg. The third floor is being renovated into a progressive care unit, increasing the number of beds from eight to 21. A new intensive care unit is also being developed on the third floor with an increase from eight to 10 beds. This construction likely will be finished by the end of January or early February, said Groneberg. Once the entire $26.5 million expansion project is completed next fall, the amount of expanded and renovated space at St. Joseph’s will exceed 120,000 square feet. “I am pleased with how it looks,” Groneberg said of the new patient floors. “I think we’ve created a healing environment. Our patients have more space and our nurses love it. We’re looking forward to seeing what our patients think and if we’ve met their needs.”

Visitors to the Nov. 17 open house at St. Joseph’s Medical Center’s sixth floor walked near the new nurses’ station.

JODIE TWEED can be reached at jodie.tweed@brainerddispatch.com or 855-5858.

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Binge drinking facts

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Jani Wiebolt (right), vice president of operations at St. Josephâ&#x20AC;&#x2122;s Medical Center in Brainerd, gave a tour of the sixth floor to visitors at the hospitalâ&#x20AC;&#x2122;s open house in November.

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The additional 27 patient rooms on each floor allow the hospital to operate at its licensed capacity of 162 beds. The two stories were constructed on the hospital’s north wing atop its existing four-story patient bed tower. When hospital administrators decided to build patient rooms, they did so with the intent of creating healthful, healing rooms that would appeal to the next generation of patients. Gone are the days of stark, cold tile floors with a roommate in the next bed. The 54 new patient rooms are all private rooms with large windows featuring indirect lighting and quality vinyl flooring with a wood appearance. The flooring is easier to clean and quickly quiets sounds. Wireless Internet service is available in every room for patients who wish to take their laptop computers to the hospital to remain connected to family and friends via e-mail or to keep up-to-date on world news or what’s

happening at the office. Radiant panels in the ceilings provide even heating and cooling so patients feel more comfortable in their rooms than in other types of heating and cooling systems. The patient bathrooms include easy, no-lift entry into the showers and a heat lamp for patients who feel chilled because of illness. Each room also features a sleep couch or chair for visiting family members. While the older hospital rooms in the 1953 hospital building are 107 square feet for private rooms and 180 square feet for two-patient rooms, the new floors feature 147- and 183square-foot private rooms. “It’s a softer, more healing environment,” Bonnie Groneberg, vice president of patient services, said of the new rooms. Each floor has a large waiting room and wider hallways. In the past family members had to wait in the hallways if they were gathering together when a loved one was ill,

Groneberg said. Stained glass designs in the fifth- and sixthfloor waiting areas were donated by an anonymous couple and feature a Benedictine cross in the design. The sixth-floor hallways incorporate a purple color scheme while the fifth floor has a sage color design. While St. Joseph’s continues to use its older hospital rooms, now 80 percent of the hospital rooms are private. The innovations in patient care aren’t merely aesthetic. New technology added to the fifth and sixth floors allows nurses to remain close to patients as they use a new electronic medical record system. Computer stations can be found in the entry space of every two neighboring rooms and mobile computer laptops can be brought into the patient rooms to document a patient’s medical history while the patient is resting comfortably on the hospital bed. Starting in mid-May, the integrated comput-

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Susannah Wolf, 35, held her 14-month old son, Samuel Guack, while working in the kitchen at their North Baltimore home. Lifting and chasing young children can lead to back strain or wrist problems for parents if they’re not careful.

Erin Brady thought it was no big deal to carry her then-13-month-old son Kyle across a parking lot so she could show him off to a friend. But the next morning, her back hurt so much that the 37-year-old stay-at-home mother made an emergency visit to a chiropractor. Her husband, a computer programmer, ended up taking two days off from work to care for Kyle while his wife recovered. “I know now not to push myself,” said Brady, of Owings Mills, Md., who is pregnant with the couple’s second child. Kyle is 21 months old now and fortunately needs less carrying. But Brady is wary of getting hurt again. “I have a feeling this is something that is going to be a problem for a while,” she said. It’s an unexpected problem for many parents — especially the growing number who are waiting longer to start their families.

Larger babies and the stress they cause to women’s bodies during birth also contribute, said Hollis Herman, a physical therapist and co-author of “How to Raise Children Without Breaking Your Back.” Wonder how a mom or dad can get hurt just taking care of children? Let us count the ways: Bending over to change diapers, putting kids in the car seat, in the stroller, in the high chair. Folding the stroller and hoisting it into the minivan. Twisting to separate tussling siblings. Giving piggyback rides. Stepping over the safety gate while carrying children and groceries. Nursing the baby on one side, day after day. Lifting the toddler out of his crib, carrying him on one hip while you twist to stir the spaghetti sauce. Hoisting the first-grader out of the car to keep from waking him up. Practicing baseball in the back yard with your Little Leaguer.

Statistics on the prevalence of parental injuries are hard to come by. But chiropractors, orthopedic surgeons and physical therapists say problems are common as the age of parents creeps up. “There are movements people make every day with a child, with an infant, that you don’t think about, but done over and over again can cause overuse injuries,” said Alan Sokoloff, a Glen Burnie, Md., chiropractor. Add to that the fact that parents are getting older. While the birth rate declined for women younger than 30 between 1990 and 2002, it rose during the same period for older women — from 80.8 to 91.5 births per 1,000 women age 30 to 34, and 31.7 to 41.4 births for those age 35 to 39, according to the National Center for Health Statistics. Dr. Nicholas DiNubile, a Philadelphia-area orthopedic surgeon, said that for many in their late 30s and 40s, parenthood can aggra-

The new sixth-floor waiting room at St. Joseph’s Medical Center features a stained glass design that incorporates the Benedictine cross. An anonymous couple donated the stained glass feature in the waiting areas on both the fifth and sixth floors.

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CROSBY — For some patients, chicken broth and JellO may be all they can stomach during their hospital stay. For others, a cheeseburger and baked potato will suit their needs. Taking everyone’s tastes into consideration, Cuyuna Regional Medical Center in Crosby offers patients room service. Heather Erickson, director of nutrition services at the hospital, said giving patients options as far as what and when they eat benefits everyone. “When patients can order something they can eat at home, they eat better,” she said. As an added benefit, the amount of food being thrown away has decreased considerably, keeping the hospital’s costs down. Erickson said under the traditional meal plan, where all patients were served a large breakfast, lunch and dinner at scheduled times, a lot of the food was going to waste. Erickson said some patients were in rehab or getting lab work done at meal times, so their food was thrown away and another meal was sent at a later time. “Our plate waste is a lot less,” she said. The room service program is more common in larger hospitals, Erickson said, but after researching other meal plans, she decided room service was the most patient-friendly program. “Patients love the freedom of choice it gives them,” she said. All able patients in the 42-bed hospital, excluding those in intensive care, can order room service meals free of charge. Each room is equipped with a menu with meal options. Erickson said the most popular menu items include the chicken Caesar wrap, shaved ham or turkey sandwiches and a hot roast turkey sandwich. Patients can call the room service phone number and place their orders between 7 a.m. and 6:30 p.m. daily. Dietary aides make each order fresh after it is requested. Trisha Tate (left) of Deerwood and Jamie Cutter of Crosby prepared sandwiches for patients at Cuyuna Regional Medical Center in Crosby. CRMC offers patients a room service nutrition program.

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Any hospital or clinic that has a telemedicine or video conference system can be connected to Wadena’s telemedicine system. The system in Wadena is frequently connected to physicians and specialists at Fairview-University Medical Center, Gillette Children’s Specialty Healthcare in St. Paul, Sister Kenny Institute in Minneapolis and Prairie St. John’s in Moorhead. Klemek said telemedicine has been at TriCounty Hospital since 1995. In the beginning, the hospital only used it for dermatology clinics. “There were very few dermatologists in rural areas so this was our first specialty clinic,” said Klemek. “Today this is one of our busiest clinics. We have four to five clinics a month.” Today the Wadena hospital has clinics in orthopedics for hands, wrists, shoulders and elbows; psychiatry for children and adults; neurology; cardiology; and wound medicine. Dr. Kimberly Bohjanen, a dermatologist at

Fairview; Dr. Peter Lee, a Mohs surgeon at Fairview; and Drs. Dan Buss and Mike Freehill, sports and orthopedic specialists from Edina, can be seen through telemedicine programs.

“There were very few dermatologists in rural areas so this was our first specialty clinic. Today this is one of our busiest clinics.” —Robin Klemek Outreach service manager, Tri-County Hospital Doctors at Tri-County Hospital see an average of 65-70 patients a month. Klemek said a majority of the patients live within a 45-mile radius of Wadena.

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Klemek said telemedicine at the hospital has been a success and has been beneficial to patients, especially senior citizens. “It’s hard for the elderly to go to a larger city like in the Twin Cities,” said Klemek. “Many elderly (people) don’t like to drive in the Twin Cities so they have their kids or a friend drive them.” Klemek said after being diagnosed with a condition, or after surgery, patients usually have to see a doctor more than once. She said patients usually have to see their dermatologist once or twice a year. Telemedicine saves these patients a lot of time and money, Klemek said. Hospitals in Wadena, Crosby and Aitkin, and the Ne-Ia-Shing clinic near Onamia are among other medical facilities using Fairview’s telemedicine program.

JENNIFER STOCKINGER can be reached at jennifer.stockinger@brainerddispatch.com or 855-5851.

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Trisha Tate (left) and Jamie Cutter, dietary aides at Cuyuna Regional Medical Center in Crosby, delivered meals to patients at the hospital.

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Dietary aides are aware of each person’s health condition and know the foods certain patients shouldn’t eat. “If a cardiac patient orders a three-egg omelet, we explain their diet to them and give them a better choice,” Erickson said. “Oftentimes they just don’t know what’s appropriate and what’s not.” Erickson said CRMC’s growing obstetric and minimally invasive surgery departments are bringing in a younger generation of patients, making the change in the hospital’s nutrition services inevitable. “New moms really like (room service),” Erickson said. “They didn’t grow up eating big breakfasts.” The room service team is made up of cooks, kitchen managers and dietary aides who deliver the food to patients in professional tuxedo garb. “It’s nice for the patients to see someone not in scrubs,” said Trisha Tate, dietary aide. “It’s a day brightener for some people,” Erickson said.

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with her occupational therapist and then went to the telemedicine room down the hall for her appointment with Bohn, who was in Minneapolis. Bohn asked Fischer routine questions about her hands and examined them with the help of a digital camera. Within 15 minutes Fischer was done and ready to go home. Robin Klemek, outreach service manager at Tri-County Hospital and a registered nurse, said the telemedicine system allows patients to see an out-of-town doctor just like they would in the doctor’s office. The only difference is the doctor cannot touch the patient. Telemedicine allows staff in Wadena to show X-rays, MRIs and CAT scans to doc-

tors at larger hospitals via television monitors, a view station and a dermoscope. Klemek said doctors also have a handheld camera that can freeze frames and polarize light on the subject. The polarized light allows staff to look through the top 12 skin layers. The dermoscope, which helps look at moles, can magnify the mole up to 50 times its size. A document camera is used for X-rays, MRIs and CAT scans. It also can reverse the negative for another look. Klemek said the technology, which takes the patient only 2 1/2 seconds to be connected to, allows the hospital to conduct education training sessions for physicians, staff, patients and the community.

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Fischer had surgery on her hands at Fairview-University Medical Center in Minneapolis. She saw Dr. Deb Bohn, a fellow at the university in orthopedic medicine, several times following her surgery. The six-hour round-trip drive to Fairview would have been difficult for Fischer, but Wadena’s Tri-County Hospital’s telemedicine system allowed her to drive just a few blocks from her home to see the doctor in Minneapolis. Telemedicine uses equipment, such as televisions and cameras, for patients at rural hospitals to interact with doctors at a different hospital. At a recent visit to the hospital in Wadena, Fischer first had an appointment

Rod Imsande, 40, was diagnosed with amyotrophic lateral sclerosis, or Lou Gehrig’s disease, in September 2003. Although Imsande can’t move his arms or legs, his faith keeps his spirits alive.

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NEW YORK MILLS — When a tragic illness threatened the life of a New York Mills man, his world was turned upside down. Suddenly, he had to live each day like it was his last, strengthening his faith along the way. Rod Imsande is a happily married father of three. He worked for years in child protection for Wadena and Ottertail County social services. He coached baseball and basketball and enjoyed hunting, fishing and camping. In August 2003, the Imsande family took a vacation to Yellowstone National Park where they could enjoy their favorite hobbies. While vacationing,

Imsande, then 38, felt the muscles in his left hand and arm twitching and feeling weak. When he returned home from vacation, Imsande went to the doctor, who told him he had tendinitis in his shoulder and recommended seeing a chiropractor. After visiting several doctors and getting a number of tests done, Imsande was staggered with news he never thought he’d hear. What started as an odd twitch in his hand ended with a bleak prognosis. He was dying. “That was a surreal day,”Imsande said.

A handheld camera is used in the telemedicine program at Tri-County Hospital in Wadena to help look at patients’ wounds and skin conditions. Here, a nurse in Wadena used the camera in a telemedicine followup visit to look at Leola Fischer’s hand so a doctor in Minneapolis could have a better picture of how the hand has healed. Fischer, of Wadena, had surgery on her hand.

Mary Houle (left), a registered nurse at Tri-County Hospital in Wadena, used a handheld camera to look at Leola Fischer’s hand during a doctor’s visit through the hospital’s telemedicine program.

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Imsande was diagnosed with amyotrophic lateral sclerosis, more commonly known as Lou Gehrig’s disease, in September 2003. ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. It attacks only motor neurons that control voluntary movements, so Imsande’s mind and senses are not affected, and internally his organs work normally. Symptoms usually start with muscle weakness in the hands and feet and eventually spread to the trunk of the body, affecting speech, swallowing, chewing and breathing. When the muscles used to breathe become affected, the patient needs constant respiratory support to stay alive. The progressive degeneration of the motor neurons in an ALS patient eventually leads to their death, usually two to five years from the time of diagnosis. Imsande was diagnosed just over a year ago and most of his body is now paralyzed. He cannot use his legs and has little use of his hands and arms. He said with help he can stand up long enough to move from chair to chair. He has a wheelchair he controls with his head and shoulder and is constantly under the watch of a home health aide, family member or friend. About 5,600 people in the United States are

diagnosed with ALS each year. There is no cure for the disease, just medicine to ease the pain and prevent complications. “As I realized I was dying in an in-your-face kind of way, I worried about (my wife), the children and my family,” Imsande said. As his condition increasingly worsened,

“My son asked if I was going to die. That was the hardest question I’ve ever faced.” — Rod Imsande, New York Mills quickly losing the ability to use his hands, arms and legs, Imsande worried most about how to tell his children, ages 11, 9 and 6, he was dying. “My son asked if I was going to die. That was the hardest question I’ve ever faced,” Imsande said. “I really began to deepen my faith by then and God became my support.”

Without giving a lot of details, Imsande broke the news to his children, who took the blow amazingly well. Imsande said children don’t think about the future the way adults do. At 6 years old, they don’t think about their graduation or wedding day, he said. “I was amazed at how well they handled it. Once that was over I was really relieved,” Imsande said. “God has a plan for them, for me, for all of us. He builds into each of us the ability to handle whatever comes to each of us.” Imsande turned 40 on Oct. 20, and although his life will most likely be cut short, he is not angry about his prognosis; he’s sad. While a massage therapist rubbed the muscles in Imsande’s hands, he thought about how long it had been since he walked handin-hand with his wife and children. He couldn’t help but cry. “My feelings have been hurt by losing the opportunity to do earthly activities,” he said. Imsande describes himself as “a glass half full kind of guy,” who relies on his faith to get him through tough times. “It hasn’t been hard not to be angry or crabby — every day there’s something new to help me get through.” Friends bring meals daily, offer to drive

Continued on Page 37

Leola Fischer (left) answered a question from her doctor, Deb Bohn (far right on the television), a fellow at FairviewUniversity Medical Center in Minneapolis, during a doctor’s appointment at Tri-County Hospital in Wadena. Also involved in the appointment were Fischer’s occupational therapist, Linda Trosdahl (second from left), and registered nurse, Mary Houle.

Story/Jennifer Stockinger Photos/Steve Kohls

WADENA — Arthritis got the best of 84-year-old Leola Fischer’s hands. Arthritis made the Wadena resident’s arms go numb and put a damper on Fischer’s lifestyle, especially her crocheting and knitting.

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Parents learn how to read their baby’s cues more easily and they learn how to relax. It also reduces stress and lowers their blood pressure and it improves their overall health. Once the baby gets older and is more active, a parent can incorporate play into the massage to help keep their child’s hands occupied. Peterson said singing nursery rhymes, reading stories or playing with small toys will help. A massage can last anywhere from five to 30 minutes and will depend on the baby’s or child’s desire on that particular day. Peterson said the person giving the massage has to take cues from the baby when to stop. “The baby will vocalize whether they like it or not,” said Peterson. “Your baby will tell you if they are enjoying the massage. Trust your intuition and enjoy your time with your baby.” Pain massage Nine years ago, Joyce Moran, Brainerd, hurt all over and could not function. She could not take the pain anymore. She picked up the telephone and called Debbie Endres, a massage therapist in Brainerd, on Christmas Eve to get an appointment. “She worked the pain out,” said Moran. Moran has seen Endres every two weeks since that day. “I’d come every day if I could,” said Moran. “She’ll hit an area where I’ll jump to the ceiling. I never knew I had pain there. I can just feel my muscles relax when I’m here.” Moran said until a person has had a foot massage they do not know what they are missing. She said all the tension a person has goes to his or her feet. She said a foot massage

Massage therapist Debbie Endres released her energy into her client’s body during a massage therapy session. (Photo/Nels Norquist)

gives a person a feeling they could never imagine. Barb Vandeputte, 64, Brainerd, has seen Endres for more than 10 years. Vandeputte, who had breast cancer, used massage therapy during her radiation treatments. She said after a radiation treatment she’d have a massage done as a treat and a way to relax. She said the massage made her whole body feel better. She started coming every two weeks. Now Vandeputte comes to relieve tension in her neck and lower back. She said massages are also emotional and spiritual for her. Vandeputte said her mother, who is 85, also sees Endres, as well as her daughter and granddaughter. Both Vandeputte and Moran said Endres has healing hands. They said they feel the effects from the massage for about two weeks. Moran calls her visits to Endres “preventive medicine.” Endres has been a certified massage therapist since 1990. She said she was one of three therapists in the Brainerd lakes area at that time. Now there are 30. Endres, who owns Life Care Center in Brainerd, works with clients to help them relieve pain and stress. “Stress is key to many human illnesses and disease,” said Endres. “A goal I have with my clients is to create an awareness regarding the impacts stress can have on the body and the physical manifestations that can result if one does not take the Darcy Renae Peterson gave her 2 1/2-year-old son, time to take care of themselves. I encour- Cameron Walkowiak, a massage. Peterson began masage my clients to listen to their bodies saging her son at birth. (Photo/Steve Kohls) and take steps to address the reasons why there is pain. feels more alert and less fatigued, Endres said. “Massage is good for the body, mind and it A person will feel much better and have a is spiritual.” healthier lifestyle when they incorporate Endres said one hour of massage is like good nutrition and physical activity along with three hours of sleep for those who come in on regular massage sessions, said Endres. a regular basis and are able to go into a deep Massage stimulates the circulation, nervstate of rest. ous, muscular and lymphatic systems. She said massage is beneficial and offers Massage can provide pain relief for a pinched peace and quiet, which is needed in people’s nerve, low back pain, neck and shoulder pain, busy lives. migraines and arthritis. Massage improves blood flow and stimuEndres suggests people should have a maslates the lymphatic system. It also stretches sage every four to six weeks. and loosens muscles, lowers blood pressure She added that if massage is not the soluand increases the flow of oxygen and nutrition to a person’s physical or medical needs ents to cells and tissue. she recommends the client go to the appro“During a massage a person takes deep priate health professional. breaths of oxygen, which allows the muscles to relax,” said Endres. “Throughout the massage session, the body produces endorphins, which are the body’s natural pain killers or JENNIFER STOCKINGER can be reached at happy hormones.” jennifer.stockinger@brainerddispatch.com or When oxygen reaches the brain the person 855-5851.

The results, we’ll wager, will motivate, not intimidate. We summarize them here; for more, see the January issue of Consumer Reports or visit its pay-per-view Web site at www.consumerreports.org. Thirty-eight percent of the survey respondents qualified as “successful exercisers,” meaning they perform moderate or vigorous exercise for at least 30 minutes three or more days per week, and had been doing so for a year or more. About a third of those in the successful group were “hard core:” They exercised five times a week and had kept it up for five years. (This self-selected group of responding readers is considerably more active than the U.S. population, as tracked in federal studies.) “Bah,” you scoff. “Out of my league.” Buck up, grumpy: Many of the successes emerged after years of sedentary behavior and/or severe obesity. Here’s how many of these folks pulled it off: • Stir it up — Fifty-eight percent of the successful cohort participated in three or more activities per week. Walking was by far the

most popular — among all respondents, even those who work out infrequently. But the fit folks also lifted weights, cycled or played racquetball — anything to break up the monotony of a singular pursuit. • Feel the joy — More than half of the successful exercisers reported feeling “joy or exhilaration” from their workouts. It’s not surprising that those who worked out more often experienced this more than the occasional movers. • Hit the bar(bell) — In what Consumer Reports called “one of the most striking differences between successful and unsuccessful exercisers,” 31 percent of successful folks lifted weights, compared with 3 percent of those in the equally large “unsuccessful exerciser” group. Aside from boosting strength, weight training helps prevent injury now and later by slowing the natural decline of muscle mass. • Move more — Thriving exercisers were more likely than their indolent counterparts to walk or bike on daily errands. Many cycled to work, commuting up to 40 minutes each way, or walked to buy groceries. “Impossible

for me,” you mutter, especially if you’re miles from the nearest store. But think about it: Is the nearest store really more than a mile or two away? And couldn’t you find time once a week to ride or walk there, knowing you’re “doubling up” by accomplishing exercise and errands in one swoop? • Schedule it — Not surprisingly, more than half of those who were not successful exercisers blamed their stasis on lack of time. The successful group cited the same challenge, but said they overcome it by working out at the same time every day. Consumer Reports called this the “top strategy” for sticking with an exercise plan. What’s that you say, you really really don’t have time? “At least one-fourth of respondents found time for regular exercise (even though) they had a full-time job, young children at home, or both,” the report said. The busy-but-active group’s second most popular strategy, after making an “appointment?” Exercising near home or work, so a workout doesn’t require a separate trip.

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room, dimming the lights and playing soft music. Peterson said the person giving the massage should provide the baby with cues that it is massage time and ask if they can give them a massage. In the first six weeks, Peterson said parents start to massage their baby by holding their hand still on the baby’s skin and asking them to soften and relax. She said this helps teach the baby how to relax the nervous system. After this time frame, the parent can use natural massage oil, such as an almond or apricot oil, and incorporate massage strokes. Peterson said once the parent puts the warm oil in their hands and rubs their hands together, babies get excited because they know they are going to get a massage. “Start with the feet and move up the front of the body,” said Peterson. “Finish with the back.” Peterson said there are many benefits to infant massage, the biggest being the bond a parent creates with their baby. Other benefits include reducing stress in the baby and the parent, reducing pain from teething and helping infants with gas, constipation, diarrhea or

colic. Peterson said parents need to massage the baby before the colic or stimulation period begins to be most effective in calming the baby. To help relieve these stomach pains, stroke from just below the rib cage down to the baby’s lower left belly and use a clockwise motion for the circular strokes. Peterson said by doing this routine you are bringing the gas and intestinal matter toward the bowel and this in return makes the baby feel better. Massage also increases blood circulation and muscle tone, strengthens the digestive, circulatory and gastrointestinal systems and boosts their self esteem. It also helps establish better sleeping patterns. Later on in the baby’s life, Peterson said the child most likely will return the favor and give you a massage. Peterson said another benefit is the communication between the child and parent. “During a massage your child will sometimes tell you things they normally wouldn’t tell you,” she said. “They will feel so relaxed during their time with you that they open up.”

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Infant massage Darcy Renae Peterson, a massage therapist in Baxter since 1997, works with people of all ages but specializes in infant massage. She also likes to focus on pregnant women and she does birth and postpartum doula work with them. When a client has an appointment with Peterson for infant massage, she demonstrates how to do a massage on an infant with a demonstration doll. She said the parent is the one who does the actual massage on their baby. “They are the ones who want to bond with their babies,” said Peterson. “I help them learn how to do it.” Peterson said giving a baby a massage is like giving them food for nourishment. She said the gift of touch is essential to the baby as it is their way to communicate and is the first sense they have. Massage also is a way for parents to show love and respect toward their child. Before giving an infant or child a massage, Peterson suggests setting up a relaxing atmosphere. This includes turning up the heat in the

Debbie Endres, a massage therapist at the Life Care Center in Brainerd, rubbed Barb Vandeputte’s neck during a massage therapy session. (Photo/Nels Norquist)

Massage benefits young and old

Story/Jennifer Stockinger

BAXTER — Sounds of running water accent the soft music being played. A fireplace adds warmth to the small, cozy room. The low-lit atmosphere created here will help ease anyone’s tension, make them relax or even make them want to go to sleep. Whether you are a colicky baby, a mom who wants to bond more with the life you just created or a person

who has lower back pain or a migraine, the touch of massage is therapeutic and relaxing, massage therapists in the Brainerd lakes area say. Two massage therapists shared information on infant massage and massage for pain. They said massage benefits people in many ways and if everyone could be touched by massage every day it would be a great world to live in.

Cameron Walkowiak’s feet were massaged during an intimate massage by his mother. (Photo/Steve Kohls)

Cameron Walkowiak’s face was massaged. Massaging an infant’s face helps release tension from sucking, teething and crying. (Photo/Steve Kohls)

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Debbie Endres, a massage therapist at the Life Care Center in Brainerd, rubbed Barb Vandeputte’s neck during a massage therapy session. (Photo/Nels Norquist)

Massage benefits young and old

Story/Jennifer Stockinger

Cameron Walkowiak’s feet were massaged during an intimate massage by his mother. (Photo/Steve Kohls)

Cameron Walkowiak’s face was massaged. Massaging an infant’s face helps release tension from sucking, teething and crying. (Photo/Steve Kohls)

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Massage therapist Debbie Endres released her energy into her client’s body during a massage therapy session. (Photo/Nels Norquist)

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8 12 14 16 18

COVER STORY:

Binge drinking BACK PAIN:

Lifting tips for busy parents NUTRITION:

Hospital food DISEASE:

Living with Lou Gehrig’s disease

20 24 28 32

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