UpNorth HealthWatch October 2005 by Brainerd Dispatch and Echo Journal

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“My labor experience was wonderful. ”

I know that sounds funny, but it really was.

— Deb, with Paige, 3 months

“J

erry and I had tried for several years to have a family, and when we learned we were pregnant, we were ecstatic. We were fairly new to the Brainerd Lakes area and were impressed by the caliber of care at St. Joseph’s. My nurse, Julie, and my doctor, Dr. Uhlman, were something else. It was so clear that they were experts! They told me exactly what was happening every step of the way, which really helped me get through it—and kept Jerry calm. When Paige arrived, it was the most amazing moment of our lives. I can’t describe to you how it felt when we finally got to hold her. As I recovered, the wonderful nurses made sure I was comfortable and didn’t want for anything.

The rooms were fantastic, and the hospitality was even better. Everything the staff did for Paige and me demonstrated the depth of their care. I got to order room service, relax in the Jacuzzi ... I thought I was at a hotel! They treated me like a queen, and treated Paige like the miracle she is. I’m so grateful to everyone at St. Joseph’s. I’m ready to have another one!” For experienced prenatal care, see any of these physicians at the Brainerd Medical Center: James W. DeLong, M.D. Hal M. Leland, M.D. Lyle C. MacIver, M.D. Carol L. Uhlman, M.D.

InfantSEE

Local optometrists give babies free eye exams Where patients come first. 523 NORTH 3RD ST., BRAINERD, MN • (218) 829-2861 • www.sjmcmn.org

All in the family

A family’s struggle with Cystic Fibrosis

October 2005

We are really SMART PEOPLE! We have the answers to all these problems:

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• • • • • • • • • •

Headaches Irritable Bowel Syndrome Depression Unexplained Anemia Infertility Joint Pain / Arthritis Fatigue / Weakness Painful Skin Rash Inability to Concentrate Abdominal Distension

• Muscle Cramps • Irritability, Especially in Kids • Delayed Growth • Seizures • Osteoporosis • Tingling and Numbness in the legs • Mouth Sores • Elevated Liver Enzyme Levels • Epilepsy

Answer: Get tested for CELIAC DISEASE Most people with Celiac Disease are unaware of it. Even though 1 in every 133 Americans has it, only 1 in 4,700 sufferers knows it! If you are taking medication for the above problems and still don’t feel well, maybe you have been MISDIAGNOSED. Maybe your real problem is Celiac Disease, an autoimmune disorder in which your body cannot tolerate gluten - a protein found in wheat, rye, barley, and sometimes oats - and begins to attack itself. Think the answer is too simple? So did we. Then we went on a gluten-free diet and got our health back. Brainerd Lakes Area Celiac Group meets 2nd Thursday of every month St. Francis Church basement @ 7:00 PM. For a meeting schedule or additional information about meetings, please contact: Jennifer Chock • 825-9525 • chock@charter.net or Sena @ 829-1290 • Karel @ 829-5946 • Sharon @ 546-5469

Craving that tan

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Vanity or addiction? Story/William Hathaway The Hartford Courant Researchers in Texas are trying to shed light on what they say is a previously undiscovered addiction — the tan. A large percentage of sunbathers at Galveston beaches responded to questions about sunbathing or tanning salons the way alcoholics or addicts answer diagnostic questionnaires about drugs or booze, according to a study published last week in the online edition of the Archives of Dermatology. They seem to crave the rays even if they know their harmful effects, said Dr. Richard Wagner, a professor of dermatology at the University of Texas Medical Branch in Galveston and senior author of the study. “Even people with severely damaged skin say they can’t stop,” Wagner said. “The behavior observed was similar to that of smokers.” There is no nicotine gum or Betty Ford Clinic for sunbathers, but Wagner suggests that a substantial number of sun worshippers could use help. Despite widespread educational warnings about the role of ultraviolet rays in causing skin cancer, some people aren’t willing to give up sunbathing or tanning booths, he said. Wagner said he began to suspect addictive properties of tanning in a previous survey when he and his colleagues asked sunbathers what they would do if they could not go to the beach. “Quite a few said they would sit out in the

back yard or go to a pool in order to maintain their tan,” Wagner said. The researchers modified a substance dependence survey adopted by the American Psychiatric Association and a second alcoholscreening questionnaire to see if they could identify problem tanners. The 145 sunbathers in the study were asked questions such as “Do you try to cut down on the time you spend in the sun but still find yourself sunbathing?”and “Do you think you need more and more time in the sun to maintain your perfect tan?” Using criteria adopted by the psychiatric association, 53 percent of the participants were labeled “ultraviolet light tanning dependent.” Under the alcohol screening criteria, 26 percent were identified as tanning addicts. Wagner theorizes that tanning produces endorphins, or neurotransmitters with properties similar to morphine, that produce the so-called “runner’s high.” “That may help explain why educational efforts don’t seem to work” in keeping people out of the sun and tanning booths, he said. Wagner conceded that causes of excessive tanning were “multi-factoral” and simple vanity may drive many people to seek the perfect tan. One study, for instance, showed that half of all women had used an indoor tanning facility in their lifetime. Wagner would like to use brain scans to test

his theories on tanning addiction. Although he has treated many “tanning crazies,” Dr. Edward Benjamin, a dermatologist at St. Francis Hospital and Medical Center in Hartford, Conn., said most are able to give up tanning without much trouble when confronted with the damage the practice causes. “People swear off the sun more easily than they turn away from smoking or alcohol,” Benjamin said. But too many people ignore the perils of the sun, he said. Those who get melanoma, the deadliest form of skin cancer, tend to have a history of sun exposure or a family history of moles, he said. “And in any given individual, melanoma tends to develop in areas that have been exposed to the sun,” Benjamin said. Dermatologists recommend that people take steps to reduce their exposure to the sun’s most harmful rays. The American Academy of Dermatology’s Web site recommends staying out of the sun between 10 a.m. and 4 p.m. when rays are the strongest, applying a sunscreen that offers UVA and UVB protection with a SPF (sun protection factor) of at least 15 year-round to all exposed skin and wearing protective clothing such as widebrimmed hats and sunglasses.

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Table of contents 6 8 10 12 16

COVER STORY: Eye exams for babies EXPANSION: St. Gabriel’s Hospital

MIND MATTERS: Hospital for brain injury patients DISEASE: Area family suffers from Cystic Fibrosis IN TRAINING: CLC’s dental program

19 20 22 24 26

EXERCISE: Stay hydrated DIET: Slow down

Who we are

WORK OUT: Deep water running

ADDICTION: Tanning

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HealthWatch is a quarterly publication of the Brainerd Dispatch. Read HealthWatch online www.upnorthhealthwatch.com.

PREVENTION: Lower back pain

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From the editor The plaque that now graces the wall of my cubicle at the Dispatch serves as a constant reminder of the quality content HealthWatch provides. I recently had the honor of receiving the plaque from the Minnesota Medical Association for “Excellence in Medical Journalism.”The award-winning article, “Sunseekers beware,” was about skin cancer prevention and awareness, and appeared in the July 2004 issue of HealthWatch. This issue also is full of compelling healthrelated news from Brainerd and the surrounding areas. The cover story, InfantSEE, is about the importance of eye exams for children under 1 and a public health program that provides free exams to children 6-12 months old. Health care in the lakes area is continuing

to grow at a rapid pace. St. Joseph’s Medical Center is completing a huge addition, Lakewood Health System in Staples is building an entirely new facility, and now plans are in the works for an overhaul of St. Gabriel’s Hospital in Little Falls. (See Page 8 for the story.) These are signs of the times. Central Minnesota communities are thriving so area hospitals are stepping up, supplying what their patients are demanding — larger, more high tech facilities. Drop me a line if you have a story idea for an upcoming issue of HealthWatch. Who knows, maybe your idea will help me get another plaque to hang on my cubicle wall. Heidi Lake, Editor

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A better run at exercise

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Katie Honaker, left, leads a deepwater running class at the Maryland Athletic Club in Timonium, Md.

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â&#x20AC;&#x153;Take it into a jog! Itâ&#x20AC;&#x2122;s a hard two-minute jog,â&#x20AC;? barks Katie Honaker. â&#x20AC;&#x153;Every 15 seconds reverse direction. You want to make these reversals as fast as possible. Knees high! ... At the end of this 15 seconds, run it hard to the wall.â&#x20AC;? Sounds like a track coach putting her team through a tough practice. Only thereâ&#x20AC;&#x2122;s not much solid ground in sight, let alone a track. Honaker, a group instructor at the Maryland Athletic Club in Timonium, Md., is pacing the side of a pool, exhorting 18 members to keep themselves moving and their hearts pumping. This isnâ&#x20AC;&#x2122;t your basic laid-back aqua aerobics class. Itâ&#x20AC;&#x2122;s called â&#x20AC;&#x153;Deep Water Running.â&#x20AC;? Think of it, in the lexicon of water sports, as synchronized sweating. These â&#x20AC;&#x153;runnersâ&#x20AC;? may be reminiscent of cartoon characters trying to negotiate a mudslide â&#x20AC;&#x201D; legs spin furiously, forward progress is incremental â&#x20AC;&#x201D; but thereâ&#x20AC;&#x2122;s nothing funny about this hourlong workout. Ask former Johns Hopkins lacrosse player Brian Kelly. He has not-so-fond memories of his first few classes. â&#x20AC;&#x153;There were times I was ready to throw up,â&#x20AC;?

he says. Kelly, a 33-year-old real estate salesman from Lutherville, Md., has had seven arthroscopic procedures on his knees, which are almost devoid of cartilage. Road running and pickup basketball games are now so painful theyâ&#x20AC;&#x2122;ve become distant memories of his college days. Deprived of his two favorite forms of exercise, Kelly found himself creeping toward obesity. He came to the Maryland Athletic Club last December intending to take up swimming. Someone suggested he instead try deep-water running. â&#x20AC;&#x153;I got in the pool and it was an unbelievable workout,â&#x20AC;? Kelly said. â&#x20AC;&#x153;Thirty-five pounds later, Iâ&#x20AC;&#x2122;m still at it. Thereâ&#x20AC;&#x2122;s no impact. Thereâ&#x20AC;&#x2122;s no stress on the joints. Itâ&#x20AC;&#x2122;s a total-resistance, fullbody workout.â&#x20AC;? Thatâ&#x20AC;&#x2122;s the beauty of deep-water running: Put on a flotation belt or foam ankle cuffs, jump into the pool, and itâ&#x20AC;&#x2122;s â&#x20AC;&#x153;Look, Ma, no gravity.â&#x20AC;? You can replicate the mechanics of running without suffering any residual wear and tear on the body. Whatâ&#x20AC;&#x2122;s more, since water provides 12 times

the resistance of air, the rewards of expended energy are geometric: The faster you move, the harder your muscles work. Imagine jogging in chest-deep molasses, then sprinting through it. One study by exercise researchers at the University of New Mexico found that deepwater running burns 11.5 calories a minute, about the same rate as a 9-minute-per-mile road run. Unfortunately, switching mediums doesnâ&#x20AC;&#x2122;t come naturally. Count on experiencing moments of spasticity during those initial deep-water runs. This is one instance where being out of shape has its advantages. â&#x20AC;&#x153;The more fat you have, the more buoyant you are,â&#x20AC;? explains Kay Carney, a MAC aquatic personal trainer. â&#x20AC;&#x153;For people who are leaner, it can be very difficult.â&#x20AC;? Doug Stern, who teaches deep-water running classes in Manhattan in conjunction with the New York Road Runners Club, guarantees racing success to his clients: â&#x20AC;&#x153;This is an intense workout. Every single person who runs in my class and then runs on the road improves (his or her) time.â&#x20AC;?

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InfantSEE

Your Trusted Source for Non-Medical Care

Area optometrists provide free eye exams to babies

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Story/Heidi Lake Photos/Nels Norquist

Madison Avery, 11 months, got her first eye exam from Dr. Kerry Beebe at Brainerd Eyecare Center. Beebe participates in InfantSEE, a public health program that provides free eye exams to children under 1.

In their first six months of life, babies grow and develop fast. They frequently get well-baby check-ups from pediatricians to make sure they are progressing at a rate comparable to other children their age. However, parents often overlook a critical part of their growing child’s body — their eyes. Visual development is most dramatic in the first year of a child’s life. The American Optometric Association recommends children ages 6-12 months see an optometrist to reduce the threat of serious vision impairments, including amblyopia (lazy eye) and retinoblastoma (eye cancer), not always detected by base-level infant eye screenings. To reflect the importance of infant eye care nationwide, some optometrists have joined forces with InfantSEE, a public health program that provides one free eye exam to children ages 6-12 months. “This program has raised so much awareness, it’s amazing,” said Dr. Kerry Beebe, optometrist at Brainerd Eyecare Center. “We hope five years from now getting an eye exam will be like getting a wellbaby check-up. It’s complementary to their pediatrician visits.” InfantSEE was launched in June by the AOA, in partnership with The Vision Care Institute of Johnson & Johnson Vision Care, Inc. The program is supported by former President Jimmy Carter, who has two grandchildren with lazy eyes. Beebe said parents usually don’t notice symptoms of things like lazy eye, a condition that affects one in 30 children, but it can be treated if it’s detected early enough. Beebe recommends children get eye exams at 6 months old, 3 years old and just before entering school. Mallory Avery of Brainerd took her 11-month-old daughter, Madison, to get an eye exam from Beebe even though she didn’t know children under 12

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Promoting Health, Wellness and Recreation For All

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Keeping lower back pain at bay The person who coined the phrase “an ounce of prevention is worth a pound of cure” probably had lower back pain. Experience lower back pain just once, as about eight of 10 Americans will at some point in their lifetime, and “you are always predisposed to future pain,” said John Crosson, a physical therapist at the University of Connecticut Health Center. “It’s much cheaper to prevent injury in the first place.” One of the most common maladies of the developed world, lower back pain is also one of the trickiest to treat. The good news is that, in most cases, back pain goes away regardless of treatment. The bad news is that, if the pain doesn’t go away, fixing a chronically bad lower back can be a nightmare. The problem is not a lack of treatments. There are dozens. There are many pain drugs, ranging in strength from aspirin to narcotics. There are implantable pain pumps, nerve blocks, acupuncture, chiropractic, physical therapy or massage therapy, a variety of mechanical devices to stretch the back and isolate parts of the back, radio waves that can melt damaged tissue, several types of back surgeries, even procedures designed to repair

damage from outdated back surgeries. There are also anti-depressants that block pain pathways, and psychological counseling to relieve the depression that often accompanies chronic pain. Many chronic back-pain sufferers go through many of these treatments and still fail to find relief. “It is a well-established axiom that if you have 50 or a 100 treatments for something, nothing really works well,” said Dr. Jesse Eisler, a Connecticut orthopedic spine surgeon. “There is a lot of frustration among patients, and some people get desperate” and turn to drugs or alcohol for pain relief, said Dr. Sam Kishawi, a professor of anesthesiology at the University of Connecticut Health Center. A careful analysis by experts in back pain can lead to customized treatments for individual sufferers, Eisler and Kishawi say. But both doctors also agree that the best strategy is to prevent back pain in the first place. Some causes of back pain, such as trauma caused in accidents, can’t be prevented. And the elaborate structure of muscles, nerves and spinal column inevitably deteriorate with age. But there are plenty of ways to forestall the

Story/ William Hathaway The Hartford Courant process, experts say. Whether you are young or old, you need to pay attention to what you are doing when you pick something up, Crosson said. “We have young guys who work on loading docks all their life and blow their back out picking up a Lego.” Learn proper lifting techniques, such as bending knees when lifting, and avoid twisting the torso when picking things up, Crosson said. Stretching, particularly hamstrings, is important, but so is building up abdominal strength, he said. “What good is all that flexibility if you don’t have good stability and core strength in midsection,” Crosson said. “(Muscles in) the deep back should have the same tone as your arms and legs.” But the key to long-term back health is exercise. “Use your spine, and don’t abuse it. Walk, and do gentle activity frequently.” said Dr. Scott Fishman, president of the American Academy of Pain Medicine and author of the 2001 book, “War on Pain.”

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Dr. Kerry Beebe, optometrist at Brainerd Eyecare Center, explained to Mallory Avery and her daughter, Madison, the importance of examining a child’s eyes between the ages of 6-12 months old. A common misconception is children can’t get an eye exam until they are able to read the eye chart.

months old should have their eyes examined. “I’ve had eye problems, so I thought I’d try to catch it early,” Avery said. Because babies can’t verbally respond, Beebe said he has taken his regular eye exam and modified it to cater to children. Using toys and finger puppets, Beebe watches a child’s eyes as he moves a toy in front of them, testing how they track movement. “Their hands are the perfect answer,” he said. “If there’s a toy in front of them they’ll try to grab for it.” To test vision sharpness, Beebe holds up cards with stripes of varying widths. Beebe

also uses lights and lenses to see how light reflects off the baby’s eye, telling what their prescription is. Since the InfantSEE program started in June, Beebe said he has performed about four free infant eye exams per week. “Many parents think their children can’t get exams until they can read the letters,” Beebe said. “We had to do something to tell parents you have to bring your kids in.” Young children are usually cooperative, Beebe said, and sit on their parent’s lap during the 20-minute exam. Beebe, a 29-year veteran in his field, and his

associate at Brainerd Eyecare Center, Dr. Corey Tabbert, participate in the InfantSEE program. Nationwide, 7,000 optometrists perform free infant exams, including many in the Brainerd area. To find participating optometrists, go to the doctor locator at www.infantsee.org. “Not everybody does (baby exams) or is comfortable doing it,” Beebe said.

HEIDI LAKE can be reached at 855-5879 or heidi.lake@brainerddispatch.com.

FAMILY MEDICINE • INTERNAL MEDICINE • GENERAL SURGERY• OB/GYN • PEDIATRICS

Little Falls hospital plans $22 million expansion Story and Photos/Jennifer Stockinger

Facts on St. Gabriel’s Hospital

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➤ Hospital is currently 150,000 squarefeet. ➤ Addition is proposed to be 60,000 square-feet and three-stories high. ➤ The hospital was able to give X-rays in 1916. ➤ There was an operating room in 1891. ➤ The hospital blood bank was installed in 1950 . ➤ The hospital became part of the Red Cross Network in 1988. ➤ St. Gabriel’s School of Nursing was held on campus from 1916-1934 and from 1942-1970. ➤ Maj. Ashley Morrill donated the first five acres for the hospital. St. Gabriel’s Hospital in Little Falls is planning a $22 million expansion project to accommodate its growing patient population in several areas of care.

LITTLE FALLS — A $22 million expansion project is scheduled for St. Gabriel’s Hospital in Little Falls and is expected to be completed in 2008. Carl Vaagenes, chief executive officer at the hospital, said the expansion project is needed so the hospital can accommodate a growing patient population in several areas of care, including surgery and rehabilitation. St. Gabriel’s received approval to proceed with the project from Catholic Health Initiatives, its parent corporation that owns 69 hospitals and 43 long-term care, assisted living and residential facilities in the nation. The Little Falls hospital proposes to build a three-story, 60,000 square-foot addition. The existing hospital is 150,000 square-feet. The addition will affect the hospital and the clinic which are located on the 26-acre medical campus on the southeastern part of town. The addition to the hospital will be built where the business office is currently. The 7,500 square-foot business office will be demolished. Vaagenes said construction will begin in May or June and the project is expected to take 18 months. The addition will include patient care space for surgery and outpatient services and more private rooms for inpatient care. The hospital also will include space for radiology, physical and occupational rehabili-

tation, speech therapy, respiratory care, cardiac rehabilitation and a lab. Surgery volumes grew 15 percent from last year and more space is needed for surgeries. Vaagenes said orthopedic surgeries represent 70 percent of the total surgeries. Vaagenes said the hospital decided an addition would be a better long-term solution after determining that the remodeling costs were too expensive. He said it would have cost $2 million to update the mechanical system alone. Vaagenes said he was pleased that St. Gabriel’s has room on the campus for the expansion. “We’re so integrated on this campus that to move would have been more complicated,” he said. Besides the hospital and medical clinic, St. Otto’s Care Center, a 150-bed nursing home; St. Camillus Place, a 13-bed home for people with developmental disabilities; and the Alverna Apartments, a 60-unit low-income housing apartment for seniors are on the campus. Vaagenes said a community survey was conducted two years ago and St. Gabriel’s scored low on its facilities. “Our physicians have also expressed the need to update,” said Vaagenes. “We need to redesign the facility to improve patient privacy

and confidentiality by creating better traffic flow for outpatients and visitors. “Our vision is to create the best health care experience for our patients and this project will help us achieve our vision.” Vaagenes said with the constant change in health care and technology the hospital needs to keep up with the changes to satisfy the patients. Vaagenes said the hospital was recently approved for critical access status by the Center for Medicare and Medicaid Services, which will provide additional reimbursement to help fund the $22 million addition. The original hospital was founded in December of 1891 by the Franciscan Sisters in Little Falls. The first patient was seen in 1892. The original hospital was a shared facility housing the convent, hospital and the orphanage. The hospital itself opened in 1916, with two major additions, one in 1940 and the second in 1960. Once construction begins, Vaagenes said patients and staff will see minimal disruption to the existing facility operations. JENNIFER STOCKINGER can be reached at jennifer.stockinger@brainerddispatch.com or 855-5851.

Peter Max-Muller is a perfect example. The 25-year-old is constantly on the run in his job as a Los Angeles clothing stylist. Breakfast is either a bagel and orange juice grabbed from the refrigerator or a doughnut and orange juice grabbed from 7-Eleven. Lunch is from a fast-food restaurant, a nearby sandwich shop or provided on the set if he’s lucky. Dinner is at a restaurant with friends or a Trader Joe’s frozen entree cooked at home. Max-Muller says he wouldn’t trade his lifestyle for anything, but sometimes ponders his food choices. “When I’m feeling tired or lethargic, I think it’s probably because of what I’m eating,” he says. “But I can’t see myself preparing foods at night, especially because it’s just for me.” With work hours and commutes getting longer, there are no indications that our society is going to slow down and adopt the European model of lengthy, relaxing meals. If anything, Europeans are becoming more like us. Americans, says University of Texas at El Paso psychologist John de Castro, “take the lowest amount of vacation of any soci-

ety and we feel guilty when we do, so we bring our cellphones and laptops. It’s just epidemic how work has become a focal point of people’s lives. These are very strong forces and they’re not about to change.” But health experts say it is possible to change our eating habits, with some guidance. Our mothers will be thrilled to know that some of what they drilled into us as kids was right: slow down, and cut food into smaller bites. That admonishment to chew each bite 20 times, however, is pointless, Bowerman says: “If you’re busy counting how many times you’re chewing, you can’t talk,” she says. “You certainly don’t want to swallow things whole, but if you’re aware that you’re trying to chew longer, OK.” Although we’re tempted by things such as fattening mall foods, “We have to think in advance — what is my plan for today?” says Netty Levine, a registered dietitian with Cedars-Sinai Medical Center in Los Angeles. “Set meal times. Take a lunch break — put it into your calendar. Think, ‘I’m not going to eat so quickly.’ ”

Other tips include setting the fork down and taking sips of water between bites. Waiting until you’re starving to eat will have you reaching for fatty, highsugar foods, so have healthy alternatives available such as fresh fruits and vegetables. Eating slowly gives the brain time to register fullness; wolf down a meal and you may end up overeating. Keeping healthy, nonperishable food items in your car is a good idea, especially for long commutes. There are some trade-offs when developing healthier eating habits. You may get less done and perhaps spend more money for high-quality, healthy foods — fast foods are notoriously inexpensive. In one of de Castro’s studies he found that having social interaction while eating — i.e., the family dinner — actually made people eat significantly more. But, he points out, “The function of a family meal is more complex than just getting calories. The social aspects of it are very important. If we understand the consequences, we can counterbalance them.”

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CMYK

The typical diet overhaul involves the ceremonial throwing out of the bad (chips, ice cream) and the installation of the good (fresh vegetables, skinless chicken breasts). But swearing off terrible food doesn’t complete the healthy lifestyle renovation. It’s not just what we eat that affects our bodies, it’s how we eat it: in our cars, while watching TV or on the computer, at our desks, always gobbling down meals while doing many other things at the same time. All of this can cause us to eat more without realizing it. That should be reason for concern, say nutrition experts, who add that eating behavior is regularly ignored in most diet books, which typically concentrate on calories and fat, carbs and protein. It’s even given short shrift on the Web site for the newly redesigned USDA food pyramid, which offers up a scant tip or two. Dietitians say many people don’t understand that the where and how of eating is as important as the food itself. “It’s much easier

to say that if I cut my carbs down to 20 a day I can lose weight,” says Susan Bowerman, assistant director of the University of California, Los Angeles’ Center for Human Nutrition. “It’s very tangible. But if I use smaller plates or stretch my meals out to 30 minutes, the promise isn’t really there.” “It’s diet, diet, diet,” says Gail Frank, a spokeswoman for the American Dietetic Association. “I don’t think people stop and think of patterns and plans when it comes to meals. They think of restriction — what I’m not going to do.” These patterns include eating while doing something else (driving, watching TV), eating under stress and eating too quickly, barely taking time to chew the food. Frank says other meal patterns include switching from a weekend eating culture (bingeing on rich, fatty foods) to a weekday eating culture (chowing down quickly at a desk). “People have a lifestyle,” she says, “and their style of eating is related to that.”

2005 Award for Excellence in Medical Journalism (print category), a contest by the Minnesota Medical Association

The winning story, “Sun-seekers beware,” is about skin cancer awareness and prevention. It can be found in the July 2004 issue of HealthWatch. The contest was judged by a panel of physicians on the basis of accuracy, significance, quality, public interest and impact. JoAnn Mellor (left), Little Falls, and Norma Nelson, Randall, work out weekly in the cardiac rehabilitation room at St. Gabriel’s Hospital in Little Falls. This is one of several areas that will be expanded.

New edition of HealthWatch coming Tuesday, Oct. 4

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Story/Heidi Lake Photos/Steve Kohls

The Minnesota Neurorehabilitation Services hospital, located on the campus of Brainerd Regional Human Services Center, is celebrating its 10th anniversary. The 15-bed inpatient facility is for people suffering from the effects of acquired brain injuries. Acquired brain injuries occur after birth from things like strokes, near drowning or from blunt force trauma, often occurring in car accident victims. “We treat survivors of brain injuries,” said Floyd Hale, MNS program director and certified behavior analyst. Hale said following brain injuries people often have behavioral issues or a form of emotional disorder. The MNS hospital serves as a transitional facility for patients who are dysfunctional in the community, and aren’t ready to enter a group home. “We serve as a stepping stone into the community,” Hale said. The MNS hospital is the only neurorehabilitation hospital of its kind in the state.

Dr. Don Starzinski, neurologist and MNS clinical director, is one of the founding members of the hospital. “(Brain injury) patients’ needs were not being met within state hospitals,” Starzinski said. “That’s how things got started here. We developed the program from the ground up.” Forty-five people staff the neurorehabilitation hospital, including physicians, psychologists, physical and occupational therapists, nurses and behavior analysts. While talk of the possibility of closing Minnesota’s regional treatment centers in 2007 surrounds BRHSC, Starzinski said the hospital is not expected to be affected. “We’re a self-sufficient network,” he said. “The state looks to us to treat and maintain these people (with brain injuries). They want us to succeed.” The MNS hospital, or Building 21 on the BRHSC campus, is a locked-down facility with a hospital-like feel. While specialists treat the physical and mental aspects of brain injuries, most cases involve behavioral prob-

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Susan Wallin, registered nurse, posed with Simba, a canine companion golden retriever that roams the halls at the Minnesota Neurorehabilitation Hospital providing a calming influence to patients.

Chiropractic care can never start too early. The Minnesota Neurorehabilitation Hospital celebrated 10 years of service with an open house. About 150 patients with acquired brain injuries have graduated from MNS programs and now live in group homes.

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lems or chemical dependency issues. Starzinski said following brain injuries, many people become impulsive, disinhibited or behaviorally dysfunctional. “Many of our clients have one foot in jail, one foot in some sort of psychiatric hospital,” Hale said. Brain injuries are complex cases to treat. The average length of stay at the MNS hospital is about 40 weeks, but some patients have stayed as long as two years. Treatments at the MNS hospital include medical, physical, cognitive and behavioral therapies with a goal of helping patients recognize and control the triggers that proceed socially unacceptable behavior. Positive reinforcement is used when a patient displays positive social behaviors. As a patient advances through their individualized treatment program, they are granted freedoms, some eventually leaving the hospital alone for a small length of time. Life inside the hospital is extremely structured. A patient’s day is filled with appointments with specialists, exercise routines and outings where they are taken into public — a sort of test to see how the patient adjusts to life outside the hospital. “They have to establish a routine or they’ll end up here again,” Hale said. “It’s all part of

she likes the hands-on experience and she likes to do X-rays. She also said she likes to make models of teeth with plaster because it is like a craft project. Kim Panek, Bowlus, said being a dental assistant has always been something she was interested in. She said when she was in the ninth grade her teeth were bad and she had to wear braces. She said she wore the braces for three years and the experience at the dental office was a good one. Panek said she chose to go to Brainerd instead of St. Cloud Technical College because she heard good things about the Brainerd campus and the program was 11 months, verses two years at St. Cloud.

CMYK

JENNIFER STOCKINGER can be reached at jennifer.stockinger@brainerddispatch.com or 855-5851. Billy Bigler of Brainerd played the role as a dentist as Jessica Jones of Onamia portrayed his assistant in a recent dental assisting program lab at Central Lakes College in Brainerd.

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the program. They’re always being assessed.” The hospital even has an apartment to test patients’ independence before leaving the hospital for good. “Our goal is for our patients to learn to live independently over time,” Hale said.

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Programs geared toward the hobbies of each patient are used to channel energy, Hale said. A greenhouse is set up in a courtyard at the hospital, with individual plots cared for by patients. Hale said the gardening program develops skills and provides a calming connection between the patient and the environment. “We do it all. We try to address the whole person, that’s what rehab should be,” Starzinski said. Simba, a canine companion golden retriever, can often be found roaming the halls at the MNS hospital. Simba is used as another calming influence for patients who groom him and take him for walks. “We’ve never had a patient that didn’t connect with Simba,” Hale said. “Pet therapy is a fantastic tool.” One of the hospital’s goals is to become more community-oriented, providing training to group home providers on how to deal with people with brain injuries. “We want to do what we can in the outpatient community before resorting to inpatient programs,” Starzinski said. HEIDI LAKE can be reached at 855-5879 or heidi.lake@brainerddispatch.com.

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CMYK

All in the family Cystic fibrosis not only affects three of Norm and Barb Powell’s children, but two of their grandchildren as well. Several other family members carry the gene for the disease. The family recently gathered in rural Pequot Lakes. They include David (left) and Sarah Hanson and their two children, Brianna and Brady; Jennifer Grams and her three children, Benjamin, Abigail and MacKenzie; Melanie and Kaleb Olson and their two children, Ethan and Kaitlyn; Stephanie Lee, holding daughter Isabella; and Jeremy Powell, holding nephew Brandon, who is Stephanie’s son; and Jeremy’s wife, Jera. Maxie, David and Sarah Hanson’s dog, is also pictured. The back row includes Barb (left) and Norm Powell; Carlton Powell, holding Stephanie’s daughter, Aaliyah, and his wife, Mary; and Gertrude Collins.

Family struggles with Cystic Fibrosis

Story/Jodie Tweed Photos/Steve Kohls

PEQUOT LAKES — When Norm and Barb Powell’s youngest daughter, Melanie, was 7 months old, she was diagnosed with cystic fibrosis. The family soon learned that not only did Melanie have the genetic disorder but so did two of their other five children. That was 1984, a time when a diagnosis of cystic fibrosis meant the child may not live beyond his or her teen or young adult years. But with advanced medications and aggressive preventative treatments, people are living with cystic fibrosis into their 30s, 40s and beyond. The defective gene that causes cystic fibrosis was discovered in 1989 and researchers are learning more about the lifethreatening disease each day. The entire Powell family has helped the

medical community in the fight against cystic fibrosis, by participating in long-term genetic research studies that lead to the identification of the cystic fibrosis gene. It is rare for a family to have three daughters with cystic fibrosis and Barb Powell recalls when they were living in Brainerd they had a room that resembled a medical clinic with mist tents and equipment to try to keep their three daughters healthy. Norm had worked at the Potlatch Mill for 21 years before the mill was sold and shut down in 2002. When he got a job working at the Cloquet paper mill, he and Barb moved to Esko, where they live today. Most of their family remains in the Brainerd lakes area. Now their family has more than doubled in size as the Powell children are raising children

Students then will offer dental care to the public at a reduced rate two days a week. Students will polish teeth and do fluoride treatments, X-rays and sealants. They cannot do fillings or braces. LeAnn Schoenle, CLC dental program director, said the students will see about 50 patients a week. The CLC dental program has six dental rooms and three radiology rooms for X-rays available for students. The students also give free dental care to children in February as part of Give Kids a Smile Day, a national program led by the American Dental Association. The program offers children ages 18 and younger a free checkup, sealants, fluoride treatments, fillings and more treatment if needed. Schoenle said normally they have about 24 students enrolled in the program. In the past three years, there have been around 28-30 students enrolled. This year there are 30 full-time students and six part-time students. Schoenle said there are about 12 dental assisting programs in the state and all the programs are seeing an increase in enrollment. The dental assisting program consists of nine months of classroom time and nine weeks where a student interns at a dental office. CLC works with about 60 dental offices within 120 miles of the Brainerd lakes area. Schoenle said they have a 90-100 percent placement rate with students in the program. She said a majority of the students find work where they intern. “There is a need for dental assistants, but it fluctuates throughout the state,” said Schoenle. Schoenle said dental assistants are paid between $13-$18 an hour. There are about 65-80 dental assistants in the Brainerd lakes area and many of them graduated from CLC, said Schoenle. She said there are not a lot of openings in Brainerd at this time. Cassandra Spitzley, a dentist at Lakes Dental Care in Baxter and Pequot Lakes, said they currently have no openings in their offices, but there is a demand for dental assistants in the state, such as in Duluth. Spitzley said they have hired many CLC graduates who were interns at one of their offices. She said this is one of the benefits of the relationship between the dental community and the college. April Banick, a 2005 Pillager High School graduate, said when she was a junior CLC representatives went to the high school for career day and she learned about the dental assisting program. Banick decided then that she wanted to be

LeAnn Schoenle, dental program director at Central Lakes College in Brainerd, helped Sheri Schaefer of Brainerd work with the dental tools in a dental assisting lab recently.

a dental assistant. She said she likes working with her hands and the work hours and the job outlook for a dental assistant looked good. Brandy Rasmussen, 26, Little Falls, was forced to change careers because of a car accident she was involved in January. She said she

can no longer do physical labor. She was a powder coat painter at Falls Fabricating in Little Falls. Rasmussen said the dental assisting program interested her because of all the aspects that go into being a dental assistant. She said

CMYK

Something to smile about

Sheri Schaefer (left) of Brainerd and Tracey Foss (right) of Foley worked on a skeleton’s mouth while Central Lakes College dental instructor Julie Benett supervised in a recent dental assisting lab.

of their own. Jennifer Grams, 28, Brainerd, who has cystic fibrosis, is married and has three children who do not have cystic fibrosis. Stephanie Lee, 27, International Falls, is married and also has three children. Her youngest, Isabella, is 5 months old and has been diagnosed with cystic fibrosis. Jeremy Powell, 25, is married and lives in Brainerd and doesn’t have cystic fibrosis. Sarah Hanson, 23, rural Pequot Lakes, is a carrier for cystic fibrosis but doesn’t have the disease. She is married and has two children with a third child

due in December. Melanie Olson, 22, Brainerd, has cystic fibrosis, is married and has two children. While Melanie’s 4-year-old daughter does not have cystic fibrosis, her 1year-old son Ethan has struggled with serious complications from the disease. Though the Powell daughters have a less severe form of cystic fibrosis, managing the disease remains costly. They must take numerous medications to remain healthy. Throughout her childhood and teen years Melanie has had a tougher struggle with the disease than her two sisters. But even harder on Melanie is that her 1-year-old son, Ethan, has suffered greater complications. He was hospitalized throughout the summer. He suffers from acid reflux, has supplemental feedings through a feeding tube and has had difficulty gaining weight. During surgery in June, Ethan’s intestine was perforated twice, said his mom. “He’s a fighter,” Barb Powell said of her grandson. On the Fourth of July both Ethan and Melanie were hospitalized in Brainerd because of dehydration. Cystic fibrosis

JODIE TWEED can be reached at jodie.tweed@brainerddispatch.com or 8555858.

What is cystic fibrosis? Cystic fibrosis is a genetic and life-

Job placement for CLC’s dental students is nearly 100 percent

Story/Jennifer Stockinger Photos/Steve Kohls

can make them feel worn out and they can get sick easily. The three sisters said they sometimes have shooting pains emanating from their lungs from the disease. Humidity can pose a major health concern. “It’s an unpredictable disease,” said Barb Powell. “(Their health) can change on a dime. You never know what can happen.” Stephanie’s daughter Isabella has suffered from pneumonia twice since she was born five months ago. She has undergone genetic studies and appears to have an unusual combination of three cystic fibrosis genetic mutations. Barb Powell said she and her family have become their own support system and they remain close. While it was hard for her to raise three daughters with cystic fibrosis, it is worse to watch her children worry about whether or not to have children and also deal with having a child of their own battling cystic fibrosis. “It’s much harder to watch my kids go through it than when I went though it,” said Powell. Powell is in the process of writing a book about how cystic fibrosis has affected her family.

Billy Bigler of Brainerd may play the role as a dentist in his classes at Central Lakes College in Brainerd. However, Bigler is not going to school to become a dentist. He is enrolled in the dental assisting program, a program dominated by women for the past 30 years. Bigler, a 2005 Brainerd High School graduate, is the fifth male student in the program. “I get a lot of criticism in class,” said Bigler because of his gender. “But I can dish it out as well. I don’t let it get to me.” Bigler said the first few days of class were tough, but after he got to know the female students he said they were nice. “I just hope to get through the program,” said Bigler, whose mother, Kris Bigler, is a dental assistant at The Smile Center in Deerwood. His mother graduated from CLC in the dental

assisting program in 1997. Bigler said he wanted to have a career in the medical field as a doctor or a dentist. However, after doing research, he changed his mind. “I thought it was a better fit to be a dental assistant,” said Bigler. “Being a doctor I would always be on call and a dental assistant normally works from 9 to 5, which is a better fit to have a family.” Bigler will earn his dental assisting certificate in Brainerd and then he will continue his schooling to study hygiene at either Duluth or St. Cloud. School started in September and Bigler and the other students have already had hands-on experience. They will see even more work during the second semester which begins in January.

Kaleb and Melanie Olson, Brainerd, held their 1-year-old son, Ethan. While their 4-year-old daughter Kaitlyn does not have cystic fibrosis, Ethan has been greatly affected by the disease. The 1-yearold was hospitalized most of the summer and continues to suffer from medical complications. Melanie was diagnosed with cystic fibrosis when she was 7 months old.

ease, the child must inherit a defective gene from each of his or her parents. When both parents carry a defective gene, there is a 25 percent chance their child will have cystic fibrosis, a 50 percent chance the child will be a carrier of the cystic fibrosis gene and a 25 percent chance the child will not have the disease and will not be a carrier. One in every 31 Americans, or an estimated 10 million people, may be carriers of cystic fibrosis and do not know it. The primary goal of treatment of the disease is to prevent infections and reduce the amount and thickness of secretions in the lungs while improving airflow. Treatments include antibiotics, mucus-thinning drugs, bronchodialators, bronchial airway drainage procedures and oral enzymes. A lung transplant may be required.

threatening disorder that causes severe lung damage and nutritional deficiencies. Cystic fibrosis affects the cells that produce mucus, sweat, saliva and digestive juices. Normally these secretions are thin and slippery but a defective gene causes these secretions to become thick and sticky. Respiratory failure is the most dangerous consequence of cystic fibrosis. Each year about 3,200 white babies are born in the United States with the disease. Cystic fibrosis is less common among minority populations. While most children are diagnosed with cystic fibrosis before 3, mild forms of the disease may not be detected until later in life. About 30,000 people in the United States Information provided by suffer from the disease. MayoClinic.com and Cystic Fibrosis In order for a child to have the dis- Foundation.

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Barb Powell sat at her daughter Sarah Hansonâ&#x20AC;&#x2122;s kitchen table in rural Pequot Lakes and discussed the challenges of having raised three of her five children with cystic fibrosis. Powell said it has been harder for her to watch two of her daughters having to go through raising two children suffering from the disease. (See story on Page 12.)

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Something to smile about

JODIE TWEED can be reached at jodie.tweed@brainerddispatch.com or 8555858.

What is cystic fibrosis? Cystic fibrosis is a genetic and life-

Job placement for CLC’s dental students is nearly 100 percent

Story/Jennifer Stockinger Photos/Steve Kohls

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Family struggles with Cystic Fibrosis

Story/Jodie Tweed Photos/Steve Kohls

LeAnn Schoenle, dental program director at Central Lakes College in Brainerd, helped Sheri Schaefer of Brainerd work with the dental tools in a dental assisting lab recently.

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413 South 6th Street Brainerd, MN 56401 Phone (218) 828-4418

Susan Wallin, registered nurse, posed with Simba, a canine companion golden retriever that roams the halls at the Minnesota Neurorehabilitation Hospital providing a calming influence to patients.

Specializing in the Care of Chrildren and Pregnant Women

Putting the brakes on a to-go life

Congratulations to Brainerd Dispatch staff writer Heidi Lake for winning the

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2005 Award for Excellence in Medical Journalism (print category), a contest by the Minnesota Medical Association

New edition of HealthWatch coming Tuesday, Oct. 4

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Little Falls hospital plans $22 million expansion Story and Photos/Jennifer Stockinger

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Your Trusted Source for Non-Medical Care

Area optometrists provide free eye exams to babies

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Story/Heidi Lake Photos/Nels Norquist

Enjoy upnorth HealthWatch?

Watch for our next edition in February. For advertising opportunities contact us at 218-829-4705 or 800-432-3703

Companionship Meal Preparation Light Housekeeping Medication Reminders Shopping & Errands Respite Care

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Katie Honaker, left, leads a deepwater running class at the Maryland Athletic Club in Timonium, Md.

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Table of contents 6 8 10 12 16

COVER STORY: Eye exams for babies EXPANSION: St. Gabriel’s Hospital

MIND MATTERS: Hospital for brain injury patients DISEASE: Area family suffers from Cystic Fibrosis IN TRAINING: CLC’s dental program

19 20 22 24 26

EXERCISE: Stay hydrated DIET: Slow down

Who we are

WORK OUT: Deep water running

ADDICTION: Tanning

Assisted Living

Publisher — Terry McCollough Advertising — Tim Bogenschutz Editor — Heidi Lake Copy Editor — Roy Miller

Offering A Christian Continuum Of Care To Meet Your Health Care Needs Now... And In The Future!

HealthWatch is a quarterly publication of the Brainerd Dispatch. Read HealthWatch online www.upnorthhealthwatch.com.

PREVENTION: Lower back pain

Lakes Country

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

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829-9433 to schedule a tour.

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Smile Design Orthodontics

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Headaches Irritable Bowel Syndrome Depression Unexplained Anemia Infertility Joint Pain / Arthritis Fatigue / Weakness Painful Skin Rash Inability to Concentrate Abdominal Distension

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“My labor experience was wonderful. ”

I know that sounds funny, but it really was.

— Deb, with Paige, 3 months

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InfantSEE

Local optometrists give babies free eye exams Where patients come first. 523 NORTH 3RD ST., BRAINERD, MN • (218) 829-2861 • www.sjmcmn.org

All in the family

A family’s struggle with Cystic Fibrosis

October 2005