HealthWatch Magazine - Summer 2011 by Brainerd Dispatch and Echo Journal

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Table of Contents 17 18 20 22 23 25

Editor’s Note by Sarah Nelson

HEALTH SERVICES RECOGNITION Essentia Health St. Joseph’s Medical Center receives award for establishing paternity

YOUTH AND SPORTS Recovering from sports injuries by Jennifer Stockinger

CANCER CONFERENCE Essentia Health contributes to patient care By Renee Richardson

HEALTHY EATING: 8 things you should buy organic by Sarah Nelson

DIAGNOSING FROM THE DEN Can surfing the internet make you sick? by Sheila Helmberger

LIVING WITH HUNTINGTON’S DISEASE One family’s struggle by Sarah Nelson

WEIGHT LOSS SURGERY CRMC offers bariatric surgery program

MINNESOTA PUBLIC HEALTH MDH launches Public Health database

Q&A Kari Johnson, Speech Pathologist

SKIN CANCER AWARENESS What Lies beneath the UV Rays by Jenny Holmes

THE YEAR FOR FISH Fish tops the list for new dietary guidelines Associated Press

On the cover Brainerd Dispatch/Kelly Humphrey

Stephanie Zappa (right), her brother, Joe Sullivan, and cousin, Melissa Gamello have all been diagnosed with Huntington’s disease and are sharing their story of hope and perseverance.

Who we are Publisher — Tim Bogenschutz Advertising — Sam Swanson Cover Design — Cindy Spilman Editor — Jodi Tweed June Editor — Sarah Nelson Healthwatch is a quartely publication of the Branierd Dispatch. Read HealthWatch online at www.upnorthhealthwatch.com

For advertisting opportunitues call Sam Swanson at (218) 855-5841. Email your comments to sarah.nelson@brainerddispatch.com or write to: Sarah Nelson Brainerd Dispatch P.O. Box 974 Brainerd, MN 56401

From the editor... I

’ve never known anyone with Huntington’s disease. Not until recently.

A few years ago I saw the movie “North Country” that documented the lives of the women working in the mines of Northern Minnesota, and I remember there was a character in the film that was diagnosed with HD. So when Minna Wallin called the Dispatch about her friend Stephanie, who has HD, that was the first thing I thought of. Stephanie Zappa is one of the bravest people I have ever met. Having been diagnosed with this degenerative and debilitating disease that has no cure, I think she kind of has to be. I wasn’t exactly sure what to expect upon meeting with Stephanie, along with her brother, Joe, and cousin Missy, all affected by this disease that has ravaged through their family. The three shared their experiences in coping not only with the disease, but with a society that has so little understanding about HD and its impact on those who suffer from it, that it tends to treat those suffering as if it’s their fault they are sick. They’ve been asked to leave public places. They’ve been accused of public drunkenness. They hear words like stupid. Drunk. Crazy. Even retarded. And for the people who aren’t audacious enough to say what they’re thinking out loud — there are still the looks. The passing judgment. It’s enough to make them not want to even be in public. It’s not fair. All three of them would echo those words because it’s true — it’s not fair. In Stephanie’s own words: “You judge me for something you know nothing about.” We are so quick to make assumptions about people whose stories we couldn’t possibly know. I’m guilty. We all are. Huntington’s disease changes the way a person walks, the way they move and the way they speak. A little bit at a time, it changes and limits their everyday life. They can’t help it. They are trapped in a body that slowly and completely revolts against them. No one deserves to be treated as if they are less than others. No one deserves to be abused or marginalized because of an illness or its symptoms, especially when they can’t do anything to prevent the way it affects them. After hearing the story of this family, that has been so deeply affected by HD, my hope is that readers will not only become more educated about the disease itself, but more importantly that it will challenge people to be more aware of how they treat others — no matter who they are. — Sarah Nelson, June HealthWatch Editor

Brainerd Dispatch/Kelly Humphrey

What is Huntington’s disease? ➤Huntington’s Disease is a degenerative brain disorder which results in the loss of mental capacity and physical control. HD is an inherited disorder with a 50/50 that a child will inherit it from an affected parent. ➤It is estimated that 1 in 10,000 people in the U.S. are affected by Huntington’s Disease; 1 in 1,000 directly affected. ➤Symptoms usually appear between the ages of 30 and 50, but can begin at any age. Symptoms include: ➤ involuntary movement ➤ slurred speech ➤ unsteady gait ➤ difficulty swallowing ➤ personality changes such as anti-social behavior, irritability, moodiness, restlessness, paranoia and psychosis. Information provided by Huntington’s Disease Society of America and the National Institutes of Health.

Essentia Health St. Joseph’s Medical Center receives DHS recognition for helping establish paternity BRAINERD— The Minnesota Department of Human Services recognized Essentia Health St. Joseph’s Medical Center among 21 Minnesota hospitals for their work in establishing children's paternity. The recognition was part of the Fourth Annual Excellence in Birth Registration Training and Conference, hosted by the Minnesota Department of Health, April 29 at the MDH Snelling Office Park, St. Paul, Minn. “Establishing paternity is a critical step toward establishing lifelong relationships between parents and children,” said DHS Commissioner Lucinda Jesson, who signed the awards for each of the hospitals. “We are very proud of what these hospitals have achieved, and recognize their contribution toward building healthy families.” Essentia Health St. Joseph’s Medical Center was among 14 hospitals recognized for establishing paternity for at least 80 percent of children born to unmarried parents who signed the Recognition of Parentage at the time of their children's birth. These hospitals will receive the Recognition of Parentage Excellence Award.

For young athletes, recovering from sports injuries means taking them seriously By JENNIFER STOCKINGER Staff Writer

could not serve the ball in tennis practice. Natalie Linn, athletic trainer and exercise specialist at Lakewood Health System, advised Longbella to see Dr. Arden Beachy of Lakewood. Beachy diagnosed Longbella with lateral epiThe then Staples-Motley High School junior condylitis and sent him to start his physical therahad to sit on the sidelines as he was diagnosed py on May 16. Longbella had to go to physical therwith lateral epicondylitis, also known as tennis apy two days a week and had to conduct daily exerelbow. cises/stretches to help his right arm and elbow, as Longbella dislocated his shoulder two years ago well as icing the injury. from basketball and then in early May his right Longbella worked hard to get his right arm in arm started feeling pain to the point where he shape as the tennis sections would begin a week later. Linn told Longbella that playing in the section meet would depend on his pain tolerance and if he could correctly functionally hit the ball with his right arm. Longbella missed two tennis meets from his injury, but said he was slowly making improvements. “I had a full day off and that felt good,” said Longbella while standing in the S-M tennis courts in May. “When I’d play (tennis) it hurt. One day I couldn’t even serve the ball. But Brainerd Dispatch/Steve Kohls now the muscles are loosening up and In May, Natalie Linn, athletic trainer at the Staples-Motley High School and feeling better. exercise specialist at Lakewood Health System in Staples, worked with Grant “Every athlete Longbella, with one of his exercises for his sports injury of lateral wants to play (the

TAPLES — In May, Grant Longbella was getting ready to prep his game for the upcoming tennis sectionals, hoping to qualify for state.

epicondylitis he received from playing tennis.

Brainerd Dispatch/Steve Kohls

Natalie Linn, athletic trainer at the StaplesMotley High School and exercise specialist at Lakewood Health System in Staples, in May worked with then junior Grant Longbella with his lateral epicondylitis injury.

game). They fear going to the athletic trainer because they worry that they won’t be able to play. But if they don’t go in right away their injury usually won’t go away and will continue to bother them. If they wait to long before they see an athletic trainer it may be too late and they won’t be able to play or they’ll be out of more games.” Linn, who began at Lakewood 18-months ago, said she is working on her relationship with the athletes so they’re not afraid to come see her if they are feeling pain. “I want the athletes to know that if they come to me right away when they’re feeling pain, I will not necessarily stop their activity, but I can give them exercises and stretches before their injury becomes debilitating where they can not perform at their highest level any more,” said Linn. “I work hard to get them back into the game to be the best they can be. Linn watches the S-M athletes during practices and games. When she sees an athlete struggle she works with them to see what’s going on. She makes sure they stretch properly before and after practice and games. She also will tape up any ankle sprain or other body part that is needed to help the student. “This school year (2010-11) we didn’t have a lot of sport injuries,” said Linn. “We had two season endings because of an ACL (anterior cruciate ligament), a few concussions and some minor ankle sprains. “I stress to the coaches that we want them (the teams) to be successful, but my first priority is the safety of the athletes,” said Linn. “It’s obvious that we did something right as we haven’t had a lot of injuries this school year.” Dr. Beachy said the most common sports injuries in athletes in grades seven through 12, who he sees, are ankle sprains, lacerations in the face and the extremities, meniscus tears in knees and shoulders, ligament injuries in the knees and ankles and concussions.

Beachy said that lacerations are common injuries in football, wrestling and basketball. Ankle sprains are common in basketball, football and can occur in soccer. Meniscus tears in knees often occur in swimming, volleyball and football. Dancers and gymnasts have a lot of leg and knee injuries and runners, volleyball and soccer athletes can get more shin splints. Beachy said he saw five students this past school year regarding concussions, but he said there most likely were more athletes who had concussions, but they didn’t come forward because they wanted to stay in the game. “There could have been a kid who could’ve had four or five concussions and they think they’ll be all right, but that is not always the case,” said Beachy. Beachy said he mainly sees athletes from Staples, Pillager, Verndale, Browerville and some from Wadena and Brainerd. He said a third of his clients are students through age 18. He averages about 20 patients a day. Beachy said in today’s world sports are faster and the youth athletes are working harder, which means there is a bigger potential for injuries. Beachy said another reason why more sports injuries are occurring is because there is no rest time for the athletes to rest their bodies and give their injuries time to heal. Athletes need time to recover from an injury and they need proper strength training. Another aspect that’s causing more injuries, Beachy said is that more young athletes today are just in one sport. Beachy said when an athlete is involved in just one sport they’re working the same muscles and tissues over and over again. When an

athlete is in two or more sports, the athlete is work- the youth comes first and the faster the injury is ing different muscles in the body, which is healthi- healed, the faster the athlete can get back to the er. Beachy said if an athlete is in just one sport, they game. should try to focus on more circuit and strength training to help exercise other parts of the body. Beachy highly recommends youths have a bal- JENNIFER STOCKINGER may be reached at anced diet, which will help the athlete perform jennifer.stockinger@brainerddispatch.com or 855-5851. well, as well as getting a good night’s rest. The doctor said once he diagnoses the problem with the athlete, the treatment to a sports injury is physical therapy about three times a week, a lot of rest and a range of motion exercises. Beachy said one of the biggest things he tells his patients is that just because they feel better does not mean they are injury-free. Beachy said the athletes still have to continue to work that muscle that was injured to make it stronger. The faster the athlete becomes aware of their pain/injury and seeks help, the faster the injury will be healed, said Beachy. The longer they wait, the more pain they will have. “I’d say about 10 percent of my patients have to have surgery,” said Beachy. “The most serious injuries that require surgery could have the athlete out of the game for a month or two.” Beachy understands that athletes want to be in the game, as he is the Brainerd Dispatch/Steve Kohls coach for the Staples-Motley girls’ basStretching the wrist at a 90-degree angle is one of many ketball team. But Beachy said the most stretches a person with lateral epicondylitis, also known as important thing for the athlete and the tennis elbow, can do. coach to remember is that the safety for

8 things you should buy organic By SARAH NELSON Staff Writer

uying organic is good for your health, but it can be tough on your wallet.

Everything organic can be a bit overwhelming. For most, the reason people don’t go the natural route is because they don’t know where to start. Crow Wing Co-op manager Steve McKnight said these glossy-eyed firsttimers make their way into the co-op all

Brainerd Dispatch/Kelly Humphrey

It’s a good idea to buy organic when it comes to any fruit with a soft skin. Whether you eat the skin or not, pesticides used to treat fruit can be hard to wash off, particularly in “bumpy” fruits likes berries.

the time. “Most people are interested in grocery items,” McKnight said. “They want to buy the organic version of what they are already eating.” McKnight said part of changing people’s minds about buying organic is helping them understand how it benefits them. “Most of our customers walk in a fog,” he said. “Education is half the battle.” McKnight said most people are surprised to find that buying organic items isn’t actually as expensive as the might

Brainerd Dispatch/Kelly Humphrey

Crow Wing Co-op manager Steve McKnight said that it is not as important to buy organic when it comes to fruit with tough skin, however, organic produce does have a noticeable difference in taste.

anticipate. “Probably the biggest myth we have to fight is cost,” he said. “Often times, the organic often ends up cheaper than most items because of packaging.” Before you take the plunge into buying all things organic, know the facts. There are some things you might want to buy organic, some things you could buy organic, and then there are the things you absolutely should buy organic. Here are eight: 1 - Strawberries are a super-food and that means they are packed with Vitamins A, C and cancer-fighting antioxidants. Plus they are super low in calories. The problem with strawberries is all of those tiny seeds make it tough to wash off pesticides. Since you eat strawberries with the skin on that means you ingest more chemicals. A good rule of thumb is to go organic when it comes to any soft-skinned fruit including berries, cherries, apples, peaches and pears. When it comes to the thickskinned variety, like oranges, bananas and avocados it is pretty safe to take the standard route. 2 - Water bottles are obviously not a super-food, but they are a super source of hydration. Reusable plastic water bottles are better than the disposable kind for the environment, but they can do some lasting damage to your body because. Reusable plastic is of BPA or bisphenol A, an organic compound made of polycarbonate and epoxy resin. Canada has gone as far as to ban the use of BPA in baby bottles and has declared the compound a toxic substance. Switch out your BPA plastic bottle for one made BPA-free or go for an unlined stainless steel one instead. 3 - Beef is what’s for dinner and it comes with some unexpected side dishes. Hormones. Lots of hormones. Standard beef production includes a healthy dose of

hormone injections to help cows grow big and strong, but those hormones are also linked to cancer in humans. McKnight said that buying USDA certified is optimal, but not completely necessary because there are plenty of local farmers who aren’t USDA certified but still produce organic beef. “It’s not as simple as organic — it’s about the source,” McKnight said. “We interact with the producers and trust that it’s organic.” 4 - Got milk? Then just like beef, this cow dairy product is packed with hormones. Milk contains natural hormones from cows that account for more than half of our estrogen intake. Nearly 20 percent of cows are also treated with rBGH or rBST hormones to stimulate milk production by increasing the circulation of another hormone called IFG-1. And that, for humans, might be too much estrogen. Stick to milk without the artificial hormones. 5 - Popcorn, particularly the microwavable kind, can take on the toxic chemical, perfluorooctanoic acid, used to keep it from sticking to the paper bag it is packaged in. PFOA is also used in pre-treated carpet, wax remover, dental floss and cookware. Not the kind of stuff you want touching your popcorn. Use an air-popper or make your popcorn in a pan. For a lighter snack, try it with coconut oil instead of butter. McKnight said it’s not just popcorn you should by organic. All corn products, including corn on the cob are a good item to buy organic. Pesticides tend to get lots in the kernels and are very hard to remove — even after rinsing. Corn produced pesticidefree prevents the unnecessary consumption of harmful chemicals.

Brainerd Dispatch/Kelly Humphrey

Reusable plastic water bottles can contain BPA, a material used in hard plastics that can seep into the water and lead to negative health effects. Stainless-steel unlined water bottles like these are often recommended.

See EIGHT Page 10

Brainerd Dispatch/Kelly Humphrey

Dairy cows are often pumped with artificial hormones to help stimulate milk production and those hormones end up in your dairy products. Many consumers buy milk that is “rBGH-free” or produced without artificial hormones.

“Certified isn’t as important as just knowing what’s in it.” 6 - Cleaning products are often made with all kinds of harmful chemicals that can irritate your eyes, skin and lungs. McKnight said it’s important to know that household products list the ingredients differently that food products. “They don’t have to label their ingredients like you do for groceries,” he said. “It’s a lot easier to skew a product’s contents.” McKnight said that many “organic” home products aren’t actually organic, and in other cases, products that are not USDA certified can actually be made of 100 percent natural ingredients. “Certified isn’t as important as just knowing what’s in it,” he said, noting that companies, including farms have to pay to have the USDA certify their products. 7 - Cookware of the non-stick variety is convenient when it comes to making a perfect omelet, but that non-stick coating can become toxic when overheated. You can prevent the toxic release by keeping your non-stick cookware at heated with low-medium temperature and keeping metal kitchen utensils away from the Teflon. Whenever possible, use stainless steel or cast iron for your culinary needs, and if you’re worried about your ability to prevent sticking without the non-stick — try olive oil. It’s good for your heart. 8 - Celery is among the dirtiest of foods. According to the Environmental Working Group (www.ewg.org), celery is the absolute worst when it comes to absorbing chemicals. Celery stalks are extremely porous and absorb pesticides that are hard to wash off.

Ben’s Story Ben Maihot is serious

about going organic. The 23 year old Brainerd resident said 95 percent of the products he buys are made from all natural ingredients. In April 2010, Maihot reached the end of his rope. He had chronic digestive issues that he just couldn’t seem to shake. “I tried everything,” he said. “Food was the only thing that had any consistency.” Maihot took drastic measures and decided to completely overhaul his lifestyle abstaining from fast food, soda pop, “I haven’t even used deodorant in a year,” he said. For Maihot the transition to organic was foreign at best. “It was like learning an entirely new language,” he said. “I had no idea was I was doing.”

Maihot said he started by purchasing the ingredients to make an organic soup that was supposed to help his health issues and educated himself through the buying process. A year later, Maihot said his life is completely changed. His change in diet worked and he has never looked back. He’s not only committed to eating only natural foods, but also using natural hygiene products. Maihot now works part-time for Crow Wing Co-Op, helping others understand organic living and is studying to be a holistic health counselor. “I want to educate people on food and the things they are putting in their bodies,” Maihot said. “My dreams have changed completely.

Brainerd Dispatch/Kelly Humphrey

Ben Maihot, 23, abandoned his unhealthy lifestyle in April 2010 for an organic one. Maihot now works for the Crow Wing Co-op and is studying to be a holistic heath counselor.

Organic continued... Like fruit, it’s a good idea to go organic when it comes to soft skinned veggies — like bell peppers, spinach and even potatoes. McKnight said that organic goes beyond buying natural groceries, it is also awareness of where products comes from and how their production affects that community. “There’s an extreme amount of waste,” McKnight said. “Knowing the land used to produce is still going to be usable in 50 years — that’s truly sustainable farming. “That’s organic.” SARAH NELSON may be reached at sarah.nelson@brainerddispatch.com or 855-5879.

Brainerd Dispatch/Kelly Humphrey Additional information provided by United States Department of Food and Agriculure, Working Environmental Group, Mayo Clinic and www.nutrition.gov.

Standard cleaning products are packed with chemicals and undisclosed ingredients that can cause skin and eye irritation as well as respiratory issues.

Living With Huntington’s disease — one family’s struggle

By SARAH NELSON | GUEST EDITOR

tephanie Zappa just wants people to understand one thing — she didn’t choose this.

“(People) judge me for something they know nothing about,” Stephanie said. “They just don’t get it.” Stephanie has been accused of being drunk in public. She has had her mental aptitude questioned time and again. People call her names to her face and whisper them behind her back. On one particular occasion she was assaulted with a shopping cart in an area store by individuals who thought she was intoxicated. Stephanie is not a drunk. She’s not a drug addict. And she is not crazy. At the age of 19, Stephanie was diagnosed with Huntington’s disease, a degenerative illness that affects the way she walks and talks and thinks and has in many ways taken away her independence. “It’s hard to deal with the concept of giving up so many things,” she said. “If you tell me I can’t do something, it makes me want to do it more. I hate being told no.” Huntington’s is a hereditary disease that affects one in 10,000 people. There are 30,000 people in the U.S. with HD and up to 200,000 are at risk. HD symptoms appear gradually and often

do not show up until mid-life, between the ages of 30 and 50, and can progress for up to 25 years. Sometimes longer. Stephanie said her HD symptoms started showing up when she was about 32 — more than a decade after she was diagnosed. “You have to live knowing you have it,” she said. Stephanie is not alone; not even in her own family. Her mother, Connie, was diagnosed with HD when Stephanie was a teenager. “It happened early for her,” Stephanie recalled. Now in her 60s, Stephanie’s mother is unable to communicate and requires around the clock care. Stephanie’s brother, Joe Sullivan, and her first cousin, Melissa Gammello, also have HD. Melissa “Missy” was diagnosed with HD at the age of 32. “I started dropping things at work and didn’t know why,” said Missy, who wasn’t aware of her risk for HD until she met her father later in life. “It was a big shock.” Missy’s father also had HD. “We were raised with it,” Stephanie added. “Missy was never really exposed to it.” Every child born to a parent affected by HD has a 50percent chance of being born with the gene that causes the disease. It shows

Brainerd Dispatch/Kelly Humphrey

Stephanie Zappa (front) led the way for her cousin Melissa and brother Joe. All three have been diagnosed with Huntington’s Disease and struggle with maintaining their balance among other symptoms caused by the degenerative disease.

“I wish we had a T-shirts that said, ‘I have Huntington’s. Ask me about it,’ ... That would be beautiful.” — Melissa Gammello

Brainerd Dispatch/Kelly Humphrey

Joe Sullivan (left), joined his cousin Melissa Gammello and sister Stephanie to discuss their shared struggle with Huntington’s disease. The three said that while everyone experiences HD differently, their shared diagnosis provides a great deal of support.

up equally in men and women, and does not “skip” a generation. While HD presents differently in every case, some of the more common symptoms include involuntary movement, called chorea, changes in coordination, difficulty thinking through a problem, changes to mood and deteriorating motor skills. Missy said the progression of her HD forced her to quit working 10 years ago. “I miss the independence and being around people,” she said. Missy worked as a medical secretary for Essentia Health St. Joseph’s-Brainerd Clinic. At home, Missy said she had constant issues with maintaining her balance and would often trip and fall over her furniture. “(My) mom got me a round coffee table,” she laughed. “You gotta laugh — you got no choice.” As symptoms progress, those with HD require more care and often have a hard time finding it. “Places won’t take people with Huntington’s,” Joe Sullivan said. Joe, a former delivery truck driver, said his HD led to the end of his career and the dissolution of his marriage. Stephanie and her husband, Allen, have conservatorship over Joe and plan to add onto their house so Joe can eventually live with them. Stephanie said assisted care facilities are not typically

set up to handle patients with HD and often won’t accept them because of the danger their symptoms can present to other patients. As chorea, and mood changes worsen, movement can become violent. Medication for chorea can help relieve involuntary movement and physical therapy is often needed to help patients maintain control of voluntary movements. In the most progressed stages of HD, patients become totally dependent on care from others. As symptoms tend to vary in each case, chorea may become worse or it may end completely. Patients often lose their ability to walk and speak completely. Minna Wallin, a longtime family friend of the Sullivans, said she has spent the last two decades watching the family deteriorate. When Joe’s and Stephanie’s mother reached the stage in her HD where she could no longer care for herself, she asked Minna to be her conservator. “Connie said, ‘If I have to have a guardian I want it to be Minna,’” Minna recalled of the role she has served in since Stephanie was in high school. “It’s just so hard to watch them go through this,” she said. “Some people don’t get it until they’re closer to 50. Their family seemed to get it really

young.” Learning to live with Huntington’s disease means different adjustments for different people. Stephanie said one of her greatest struggles in dealing with HD is taking care of her family. “It’s very hard to be a mother and not be able to function as a mother,” she said. “My kid has to take on my role. “I’m trying to not let it affect her, but she has to do a lot more work because of me.” Stephanie said she received her share of criticism for having a child knowing she could potentially pass on HD, but she sees it differently. “There could be a cure for this generation,” she said. “You have to experience life.” Stephanie’s daughter, Kayla, is 18, and now eligible for testing to determine if she will develop HD symptoms later in life. Like her mom, Kayla has a 50/50 chance of carrying the gene that causes HD. Dr. Martha Nance, medical director of the Huntington’s Disease Center of Excellence at Hennepin County Medical Center in Minneapolis, said the number of potential HD carriers that get the genetic test to find out if they carry the gene is 10 percent or fewer. “The vast majority of those at risk are

Brainerd Dispatch/Kelly Humphrey

Stephanie Zappa (right) has found support from family and friends as her Huntington’s disease symptoms have progressed. Among those who have provided a great deal of support is longtime family friend, Minna Wallin.

not getting tested,” Nance said. “Each person has to make that decision individually. Siblings in the same family may make different decisions on whether to be tested or not.” Nance has specialized in the treatment and research of Huntington’s disease for more than 20 years. Nance said there are somewhere between 500 and 1,000 families in Minnesota, South Dakota and North Dakota that are directly affected by HD. Treatment of Huntington’s disease can be broken down into four general areas — movement, cognitive changes, emotional behavior and weight loss. Nance said medication is used to treat the involuntary movement involved with HD, however, as symptoms progress medication seems to make less impact. Patients’ voluntary movement can change making it impossible for them to do the things they want to.

“There are no pills to treat that,” Nance said. Huntington’s disease may cause patients to develop a form of dementia that differs from the kind seen in Alzheimer’s patients. While Alzheimer’s dementia tends to diminish existing memory, the dementia that affects HD patients contributes to the inability to learn new information. Some doctors do prescribe medication used to treat Alzheimer’s dementia, and other HD symptoms like depression, anxiety and paranoia, however Nance said there is no definitive research that those medications work in HD cases. Weight loss is an issue most HD patients face because of the constant movement and dementia that can contribute to patients forgetting to eat. Nance said her clinic works directly with other medical focuses, like speech therapy, to better address HD on a holistic level. Nance said: “It truly is a disease that lends itself to a team management approach.” Nance said clinics specialized in treating HD are growing fewer. Most clinics tend to treat other neurological disorders like Alzheimer’s or Parkinson’s disease. “To have a clinic that is specifically devoted to HD is pretty rare,” she said. Nance said she is proud of the network of support that surrounds those affected by HD in the state of Minnesota. “If you give people a firm base to stand on they’ll use their creativity to educate others,” Nance said. “It really a remarkable community surrounding HD. “There’s a lot of beauty that comes out of such great sorrow.” For Stephanie, Missy and Joe, the hardest part of living with Huntington’s disease is the lack of understanding they get from a general public they said remains grossly uneducated about the disease and its symptoms. “I wish we had T-shirts that said, ‘I have Huntington’s. Ask me about it,’” Missy said. “That would be beautiful.” Missy said she was once at an area high school baseball game with her daughter and heard other parents talking about her and making fun of her movements and the way she spoke. When she went to leave, one person went as far as to approach Missy’s vehicle and asked her not to come back. “I don’t like to be in public by myself,” she said. “You try not to let it get to you, but it does.” Stephanie said the Brainerd area lacks a support system for those affected by Huntington’s. “People are not aware of it,” she said. “That hurts me.” Dianna Nelson, Stephanie’s mother-in-law, said that before she knew Stephanie, she may have been among those who judged based on assumption. “You make fun of them because you don’t understand,” she said. “Stephanie has to be one of the strongest people I know.” Missy said even with the need for education about HD, she is optimistic about the life she has lived thus far. “You start feeling sorry for yourself and then you have to say, no, I’ve had a pretty good life.” Stephanie, Joe and Missy share the hope that as people learn more about HD and how it changes the lives of those affected by it, they will be more accepting and slower to make an assumption about what they think is “wrong” with them. “My belief is we all have something, ours is just Huntington’s,” Stephanie said. “Just have some compassion.” SARAH NELSON may be reached at sarah.nelson@brainerddispatch.com or 855-5879.

MDH Launches Minnesota Public Health Data Access: A Gateway to Minnesota Health and Environment Data The Minnesota Department of Health announced the launch of Minnesota Public Health Data Access, an electronic gateway to Minnesota health and environment data. MNPH Data Access is part of a national initiative led by the Centers for Disease Control and Prevention to close the information gap in what is known about the impact of environmental hazards on public health. This Web-based information system provides a â&#x20AC;&#x153;one stop shopâ&#x20AC;? for data about health, the environment, and other risk factors that may affect public health in Minnesota. Local public health professionals, the public and others may use MNPH Data Access to gather information about health and environment trends over time, and to conduct queries of state and county-level data in Minnesota about diseases and conditions, such as asthma, cancer and heart attacks. This information will help improve efficiency through better data access, and will help Minnesotans make healthy, informed decisions. MNPH Data Access currently includes data on ten topic areas: air quality, asthma, heart attacks, childhood lead poisoning, carbon monoxide poisoning, reproductive outcomes, cancer, birth defects, drinking water quality, and chronic obstructive pulmonary disease. This summer, MNPH Data Access will add new data and tools, including GIS maps. Minnesota, along with 22 states and New York City, receives funding from CDC to help improve what is known about the environment's impact on public health by building state tracking networks. With Minnesota's participation, CDC's environmental public health tracking efforts are informing public health policies and actions. MNPH Data Access is updated and maintained by the Minnesota Environmental Public Health Tracking Program, a program within MDH, through a cooperative agreement with CDC's National Environmental Public Health Tracking Program. Data is collected in collaboration with several MDH programs and other agencies, including the Minnesota Pollution Control Agency. MNPH Data Access is available at: https://apps.health.state.mn.us/mndata/. For information about the Minnesota Environmental Public Health Tracking Program, see: http://www.health.state.mn.us/tracking. For more information about the CDC Tracking Program, see http://www.cdc.gov/nceh/tracking/. The CDC Tracking Network is a nationwide network that integrates health and environmental data from a variety of national, state and city sources; it is located at www.cdc.gov/ephtracking <http://ephtracking.cdc.gov/showHome.action> .

What lies beneath the UV rays By JENNY HOLMES HealthWatchCorrespondent

t isn’t an uncommon story — overzealous indoor tanning exposure as a teen leads to skin cancer as an adult. Now, as a 42-year-old mother of two, Gayle Wood looks back on her experience over 14 years ago and thanks her lucky stars that her story ended on a positive note. Wood, a 1987 graduate of Brainerd High School and now stylist at the Sharp Edge Salon in Brainerd, was 28 years old when she first noticed an unusual and unfamiliar spot under her left breast. “I’m typically a very moley person,” Wood noted, “but this was never there before.” The suspicious spot in question was no bigger than an eraser head, dark brown in its center. While the “C word” crossed her mind, Wood said neither she nor her family practice physician were overly concerned. The mole was removed and sent in for biopsy. “I really didn't think much of it,” she said. “I was young and you weren't seeing skin cancer on young people at that point. But it came back as melanoma.” Wood underwent a process that removed 30 percent of the skin and tissue around the original spot to determine if additional cancer cells were present. Fortunately, it had been contained to the immediate area and was caught well in advance of spreading to nearby tissues. She was put on a preventative schedule for blood work and chest X-rays every few months until she was considered out-of-thewoods, so to speak. “That would be called high

school tanning beds,” Wood said of her believed source of cancer. “That’s what that was: the dangers of being in a tanning bed. You know in high school, you looked better and felt better when you were tan. Skin cancer was unrealistic.” Over the years, Wood has had approximately 10 separate spots removed as a precaution, none of which have been declared melanoma. But in an ironic twist of fate, skin cancer revisited Wood’s family a little over one year ago. Husband, Brian, had a mole on his back that Wood said had been there “forever.” But this particular spot began growing darker in color, raising her suspicions. “Brian’s skin fits more in profiling someone who would be more apt to get skin cancer,” Wood said. “He’s light complected, has red hair, burns easily.” Brian walked the same road his wife had several years earlier, undergoing the ‘punch’ process, removing the area in question. And, once again, results were positive for melanoma. However, this time when 30 percent of the surrounding area was removed and tested, additional abnormal cells were detected. Brian's cancer was more substantial than that of his wife’s. A much larger area of skin was removed by a surgeon to remove additional cancer cells. Fortunately, Brian was then cleared without need for radiation or additional invasive treatment. Because of her bout with skin cancer, Wood said her children were put at a high risk. Now with the addition of her spouse’s cancer incidence, that risk is even higher. And for Wood, her concern is somewhat lessened in having two sons.

Brainerd Dispatch/Kelly Humphrey

Gayle Wood, 42, was diagnosed with melanoma skin cancer 14 years ago. Wood won her battle against skin cancer, but has changed the way she views the sun and the damage it can do to her skin.

“We still do all of our summer activities, play out on the beach. You're just more careful, all of us. I use sunscreen a lot....”

“Fortunately, they won’t be using tanning beds.” According to the American Cancer Society, skin cancer is the most common of all cancer types, with more than 2 million skin cancers diagnosed each year in the United States. It goes without saying, the real rays of the sun can be as dangerous, if not more so, than the UVA and UVB rays emitted in an indoor tanning bed. Ultraviolet (UV) radiation is believed to be the major risk factor for most skin cancers, and sunlight is the main source of UV rays, which can damage the genes in skin cells. Becky White is a certified nurse practitioner with Dermatology Professionals, PA in Baxter and said rates of all forms of skin cancer are certainly on the rise. “The increased rates may be due to increased awareness,” White said. “People may be more apt to seek medical attention for suspicious lesions resulting in better diagnosis. Ultraviolet rays, including rays from the sun and tanning beds, are the leading cause of skin cancer. Skin cancer, however, can occur in areas that have never been exposed to ultraviolet rays.” White said there are many ways to keep yourself, and loved ones, safe while enjoying the summer sun. “Wearing sunscreen with protection factor of 30 or greater that contains at least one of the follow-

ing active ingredients will provide the best protection from both UVB and UVA rays: zinc oxide, titanium dioxide, avobenzone or mexoryl (ecamusol). Wear a wide brimmed hat and clothing with ultraviolet protection when exposed to sun. Choose to be in the shade as much as possible. And avoid the peak hours of sun, generally between 10 a.m. and 2 p.m.” White urges individuals to see their doctor if they have a spot that won’t heal, a scaly spot that won’t go away or if they have a mole that is irregular in color, irregular in shape, changes shape, becomes irritated, or bleeds. Protection from skin cancer doesn’t necessarily mean avoiding the great outdoors through the summer months. It just means stepping up your skin safety smarts, Wood noted. “We still do all of our summer activities, play out on the beach. You’re just more careful, all of us. I use sunscreen a lot. I’m good about applying sunscreen when I’m out and I think you become more aware of it. And I make sure it's not just myself, but also my kids. I’m really trying to get them into the habit of using it. You can still get color even though you're using sunscreen. Everybody loves a tan or to get color, but you don't have to get as dark as you can.”

Essentia Health St. Joseph’s Medical Center receives DHS recognition for helping establish paternity The Minnesota Department of Human Services recognized Essentia Health St. Joseph’s Medical Center among 21 Minnesota hospitals for their work in establishing children’s paternity. The recognition was part of the Fourth Annual Excellence in Birth Registration Training and Conference, hosted by the Minnesota Department of Health, April 29 at the MDH Snelling Office Park, St. Paul, Minn. “Establishing paternity is a critical step toward establishing lifelong relationships between parents and children,” said DHS Commissioner Lucinda Jesson, who signed the awards for each of the hospitals. “We are very proud of what these hospitals have achieved, and recognize their contribution toward building healthy families.” Essentia Health St. Joseph’s Medical Center was among 14 hospitals recognized for establishing paternity for at least 80 percent of children born to unmarried parents who signed the Recognition of Parentage at the time of their children’s birth. These hospitals will receive the Recognition of Parentage Excellence Award.

Brainerd Dispatch/Renee Richardson

Weekly cancer conference brings together a multitude of specialties aimed at providing better care for cancer patients, with an ultimate goal of increasing cancer survivors. A recent conference included Dr. James Dehen (left), Dr. Laura Joque, Karen DuBord, Kathy Bjerke, Dr. Jonathan deHart, Barbara Morris, Amanda Hlad and Marian Foehrenbacher.

Essentia Health cancer conference contributes to patient care By RENEE RICHARDSON |Senior Reporter

ancer. It’s a word anyone waiting for biopsy results dreads to hear. And that diagnosis is often just the beginning of the questions. What type of medical option is best? Does it mean surgery? Is there a clinical trial that may provide a new treatment option? Faced with economic struggles, how can a family handle this diagnosis and treatments on top of a broken vehicle or a financial crunch? Early Tuesday morning, a group with experienced specialists — from surgeons to social services — meets at Essentia Health St. Joseph’s Medical Center for the weekly cancer conference. A patient’s case is presented — with biopsy results, risk factors, overall health. The presentation includes images such as X-rays and CT scans along with test results. A radiologist attends to help review the images such as a mammogram. A pathologist provides biopsy results. Patient care is reviewed, options discussed and a plan for patient care developed based on the evidence — utilizing the specialized knowledge of each participant. They look at the individual patient’s situation and what the best course of action may be. Beyond the tumor, the group considers the entire patient and needs both social and spiritual. The ultimate goal is to improve quality of care. The group tries to review all new breast cancer diagnosis perhaps even before surgery, along with other cancer cases. Each member of the care team may ask for a patient’s care plan, or a particular part of it, be presented to the group. It’s not revolutionary. Medical staff at the Brainerd hospital have been collaborating for many years. But when the medical center sought national accreditation, a monthly conference was turned into a weekly event with a broad range of specialties included. In March, Essentia Health achieved National Accreditation for Breast Cancers. Its cancer program was nominated for an outstanding achievement award. Essentia Health St. Joseph’s Medical Center reports it was the fourth hospital in Minnesota to achieve national accreditation. Essentia Health, which includes St. Joseph’s Medical Center and St. Mary’s Medical Center in Duluth, reported it makes up 50 percent of NAPBC accredited hospitals in Minnesota. The group typically gathers each week at 7 a.m. to discuss cancer cases. At least one representative from each specialty attends. Radiologist. Pathologist. Surgeon. Medical oncologist. Radiation oncologist. Clinical nurse navigator. Clinical research nurse. Lymphedema

Pastoral care representative. Cancer center manager. Cancer registrar. Dr. James Dehen, surgeon, said the cancer conference is really a formalization of what has always been done. “Cancer treatment is never a single physician disease,” Dehen said. Now with cancer clinical trials available to patients, Dehen said the medical center needs to have a way to help people through the process from diagnosis to the right arms of treatment. “We’ve been doing this all along, now we are doing it better, more efficiently and the patient has a contact person to work directly with in the form of a navigator.” The ultimate goal of bringing the specialists together is to increase the number of breast cancer survivors. “Patients feel like their care can be very fragmented, so especially with cancer patients where they are seeing multiple specialists,” said Dr. Laura Joque, medical oncologist. “I think they can feel confident that all of their care team doctors and nurses have spoken together and are on the same page as far as their treatment plan and goals. It’s all these people coming together so it’s nice to have that in a coordinated way. That to me is a big benefit of this formalized weekly meeting of the group.”

See CANCER Page 21

Brainerd Dispatch/Renee Richardson

With buttons linked to the Essentia Health St. Joseph’s Medical Center’s National Accreditation Program for Breast Centers in the foreground, Marian Foehrenbacher (left), cancer center manager, and Amanda Hlad, cancer registrar, close out one of the weekly cancer conferences.

Diagnosing from the den Can surfing the Internet make you sick? By SHEILA HELMBERGER HealthWatch Correspondent

ave you ever had a cough, a pain, a tinge or an ache and logged on to the Internet to figure out for yourself what the problem might be? There’s no denying the value in a trip around the web to connect with a long lost relative or as a tool to scan the deals for a new car and look for garage sales but is it the place to make decisions about our health? It can be helpful. But I fear a bit dangerous also. People use the Internet to diagnose medical ailments for the same reason they use it for most anything else. To save on cost, sometimes embarrassment, for its convenience and to save time. If you were ever prone to becoming a hypochondriac it only gets easier thanks to the Internet. In fact they’ve already given it a title — Cyberchondria: The unfounded escalation of concerns about common symptomology based on review of search results and literature online. There are many good sites that offer solid, informative help on when and when not to go to the doctor and there are a multitude of tips on how to treat almost any ailment. Knowing when to log off can be important. I took a stumble down the steps of my parent’s deck recently and landed on my left hand. It’s a little swollen and I’m sure I probably have a light sprain but I went to the Internet to diagnose my ailment. Since I already knew what happened I wanted to see what my friends online had to say based on my symptoms. There were some serious contenders for what my ailment might be. The problem about the Internet is that it’s easy to start wondering if you don’t actually have something. Anything. In fact — everything. I see where this could be a problem. Some of the sites are merely discussion boards where you access other exchanges regarding similar symptoms and anyone, including an everyday Joe like myself, can dispel medical information and help determine a believable diagnosis. Some of them thought maybe it was from too much salt (well… there actually was this whole bag of sunflower seeds at the campfire the night before ... but I needed to remember my fall). I also started to get worried when terms like rheumatoid arthritis and fibromyalgia started coming up frequently. A search for ‘why is my left hand swollen’ resulted in suggestions of a potassium deficiency, anxiety disorder and actually, pregnancy came up more than once. One person was concerned that the pain might move from my hand down my wrist and I swear ... when I started rubbing, it I really started to think they could be right.

“Googling” your symptoms can lead to unfounded concern about existing conditions and create a whole new onset of issues — including hypochondria.

I already know I’m just the sort of person that shouldn’t use these websites. The hand wasn’t enough to worry about because when I decided to be even more honest my online friends started to question why I tumbled down the stairs in the first place and it became a topic of great concern. Even though I knew the culprit was really a flip-flop that flipped when it should have flopped, others were worried that I may have gotten a dizzy spell, which led to an early determination of dementia, cerebral tumor, stroke or just poor eyesight. Hypoglycemia was suggested, as was anemia. Pretty soon my fingers were flying and I was second guessing the whole slip-on-the stairs incident myself. Was I noticing I was more clutzy these days? Tough one. But I did spill a cup of coffee in the morning. Actually, that happens pretty often but I’ve never done it the ... same ... day I’ve fallen before. Coincidence? Some thought not. That led to suggestions of nerve damage, more votes for arthritis, and also lupus, gout, Lyme’s disease or some sort of severe infection. If I had something really scary I’m not sure this would be the place for me to go. I’m way too easily convinced about things. But I have to admit I’ve used things like WebMD and MayoClinic.com and some other sites as a source to gather information before taking my mother to the doctor or going myself. Only so we can go armed with some good, necessary questions to ask a real physician. The truth is the good doctors at Mayo Clnic .com actually suggested a sprain or break when I entered information on my swollen hand. Since a search for information on a headache can run the gamut from caffeine withdrawal to a brain tumor it might be a good idea to let the experts do the real diagnosing. While I was pretty close to rushing to the nearest hospital and admitting myself for a full battery of tests I stopped before I got too much information. My hand is already feeling better and I’m pretty sure I’m just your average klutz. It really does seem that surfing the Internet for medical advice can make you sick.

SHEILA HELMBERGER lives in Baxter and contribures to several publications. She has been married for 24 years to her husband, Kirk. They have three children and almost as many cats.

Inside a Cancer Conference At Essentia Health St. Joseph’s Medical Center in Brainerd, each week a cancer conference pulls together a blend of specialities to discuss cancer cases. All new breast cancer cases go before the group, along with other cases. Each group includes a specific skill set aimed at the overall patient. They include: Radiologists — present any imaging on each case being presented. Radiologists read diagnostic imaging, such as X-rays, and perform biopsies that lead to a cancer diagnosis Pathologists — present any pathologic findings on each case being presented. Pathologists look at tissue that is removed from the body either by biopsy or surgery and look at the cellular structure under a microscope to determine if the cells are cancerous. Surgeons — treat cancer by removing cancerous organs and tissue through surgical procedures. Medical oncologists — medical oncology is the specialty that treats patients with systemic therapy such as chemotherapy and supports patients through diagnosis and treatment and continues to follow patients after they have completed treatment. Radiation oncologists — plan and deliver high energy radiation to cancer cells to treat and kill the cancer cells. Clinical nurse navigator — acts as a contact person for breast cancer patients to help navigate through the health system during their diagnosis and treatment. The nurse navigator answers questions and gives patients education on their cancer and treatment options. Clinical research nurse — screens cases for clinical trial eligibility and then enrolls willing eligible patients into available clinical trials, which give patients access to treatments not widely available. Lymphedema therapist — prevents and treats conditions caused by the damage or removal of lymph nodes. Lymphedema is tissue swelling caused by a buildup of protein fluid. Social services — provide support services to patients in need and links patients to hospital and community resources, such as transportation to and from medical appointments. Pastoral care — provides spiritual and grievance counseling to patients. Cancer Center manager — oversees day-to-day functions of oncology services and the infusion center to ensure patients are receiving the best care. The manager also processes changes that arise through discussion at the cancer conference. Cancer registrar — tracks cancer care data and provides conference participants with data on cancer incidence and treatment when necessary and keeps documentation of cancer conference discussions and attendance.

CANCER/ C o n f e r e n c e s a i m a t improving health care Patients are told their cases will be discussed at the cancer conference. Joque said the discussion, which can be lively, also provides a second opinion. “I think that’s all for the patient’s benefit,” Joque said. Dehen and Joque said in their experience, patients appreciate the group’s feedback, whether it’s an affirmation of the care they are receiving or a variation. “Cancer is a disease that scares people and the more you can do to just make them feel the path they are on is the right one is a plus,” Dehen said. Barbara Morris, clinical research nurse, said attending the weekly conferences to talk about the plan of care allows her to have input on the clinical trials that are available in Brainerd. By networking, the hospital in Brainerd is able to connect patients with existing clinical trials at other facilities such as the Mayo Clinic. Dr. Jonathan deHart said the discussions aren’t solely focused on treatment, but go into diagnosis as well and the format allows the group to challenge each other.

Beyond the obvious medical aspects and gathering input from specialists in those fields, the conferences look at the whole patient. Participants in the conference, from social services and pastoral care, are there to see if other patient needs are being met — be they spiritual or financial, or even as basic as whether a patient has transportation to get to appointments. Each of those areas impact how a patient does in treatment and thus is incorporated into the overall care plan. “I think it helps me give better care,” Joque said of the conferences and the relationships developed there between staff. Joque said she thinks the group sessions have helped in her daily work and not just in the specific cases discussed at the cancer conference. RENEE RICHARDSON may be reached at renee.richardson@brainerddispatch.com or 8555852.

Source: Essentia Health St. Joseph’s Medical Center.

Bariatric surgery program offered at CRMC has assisted more than 1,000 people in their weight loss journey

ROSBY — Losing weight and keeping it off usually warrants more than a fad diet or miracleworking piece of exercise equipment — it requires a lifestyle change.

Committed to helping patients battle obesity

People struggling with obesity, the No. 1 health problem in the United States, often have a hard time making those lifestyle changes on their own, or, no matter how hard they try, can't seem to lose weight. That’s when they turn to bariatric, or weight loss, surgery. Within an 80-mile radius of Brainerd, bariatric surgery is only offered at Cuyuna Regional Medical Center's Minnesota Institute for Minimally Invasive Surgery in Crosby. The bariatric program is amoung the oldest, most comprehensive in the state. MIMIS has a team of four experienced surgeons — Dr. Howard McCollister, Dr. Paul Severson, Dr. Timothy LeMieur and Dr. Shawn Roberts — along with a dietician, psychologist and nurse coordinators dedicated solely to bariatric patients. McCollister said he often hears stories from his patients about not being able to fly on an airplane, drive a car or actively participate in the lives of their children or grandchildren. It's those stories that led him and Severson to create MIMIS's program 12 years ago. “I've been a surgeon for a long time, and when someone gives you hug and says ‘you gave me my life back,’ I can’t even describe how gratifying that is,” said McCollister, codirector of MIMIS’s bariatric surgery program. After being overweight for most of her life, Lani Hatrick decided to have bariatric surgery at MIMIS after being diagnosed with diabetes and high blood pressure at age 35. “I'd failed every diet,” she said. “I was sick of it.” Although she had an active lifestyle even before the surgery, she now works out four See CROSBY Page 24

Dr. Timothy LeMieur (left), surgeon at Cuyuna Regional Medical Center's Minnesota Institute for Minimally Invasive Surgery, chatted with Lani Hatrick following her Lap-Band procedure.

Q & A with...

Speech Therapist Kari Johnson Can you share a little bit about yourself? I moved from North Dakota to Minnesota after high school to attend college at the University of Minnesota-Duluth. I got married the weekend after I graduated from graduate school to my husband, Jeremy. We’ve now been married for six years and have an almost 2 year old son, Carter. Besides spending time with my family and friends, I also love to cook and to travel. How long have you been a speech pathologist with Essentia Health St. Joseph’s Medical Center? I have worked at Essentia Health St. Joseph’s Medical Center for six years now. I can't believe how time flies. What kind of educational background and training was required before entering your field? To become a speech language pathologist, a master’s degree is required and you must pass a national exam. The title of the degree will vary depending on the university, but my master's degree is in Communication Sciences and Disorders. I studied at the University of Minnesota-Duluth.

Brainerd Dispatch/Steve Kohls

Kari Johnson works as a speech pathologist with Essentia Health St. Joseph’s Medical Center and Brainerd Medical Clinic.

What kind of treatments do your therapies provide? It really depends whether you’re working with children or adults. I work primarily with adults, so common treatments I provide are for swallowing, voice, cognitive-communication disorders, speech and language. What is the most common need for speech therapy? For me, in the hospital inpatient setting, swallowing evaluation and treatment is definitely the most common need. It’s crucial to identify what foods and liquids a patient can safely swallow and to provide therapy when disorders are present. What do you like most about your job? There’s a lot to like about my job. I love the variety each day and I have great co-workers, but what I love most is the great patients and families I get to work with on a daily basis. They are definitely the highlight for me.

— Health Watch Editor, Sarah Nelson

“I feel (Dr. LeMieur) saved my life.” days a week, inline skating and taking aerobics classes. “My stamina is much better … and I’m not thinking about food the whole time I'm doing it anymore,” Hatrick said. Her diabetes and high blood pressure is gone too. “I feel (Dr. LeMieur) saved my life,” she said of the MIMIS doctor who performed her surgery. MIMIS surgeons have performed more than 1,000 bariatric surgeries through the years, using Roux-en-y gastric bypass, lap band and sleeve gastrectomy techniques to help patients feel full soon after they eat. Statistics show people who have completed MIMIS’s bariatric program exceed the national average for being able to keep most of the weight off for at least two years following surgery. Jill Wehseler, a registered nurse who works with MIMIS's bariatric patients, said the high success rate is a testament to their comprehensive program. “We put a lot of emphasis on preparing patients for how their lives will change after the surgery,” Wehseler said. “I believe this has helped our patients succeed when it comes to keeping the weight off.” The thorough program takes anywhere from four months to a year to complete, and features psychological counseling and preparation, dietary education, exercise plans and a variety of health tests before and after the surgery. “We teach people to use the surgery as a tool to lose weight,” said McCollister. “You can’t have a successful bariatric program that revolves around just the surgery.” The dramatic amount of weight loss that usually follows bariatric surgery often leads to better overall health. In most cases, like Hatrick’s, health problems including diabetes, high blood pressure and cholesterol, sleep apnea and joint pain can be eliminated after returning to a healthy weight. “We’ve committed ourselves to answer the call to try to help people with obesity,” said Severson. “After a decade of laproendoscopic bariatric work, we're the most reliable bariatric program in the state.” So reliable, in fact, MIMIS is accredited by The Fellowship Council to teach other surgeons to preform bariatric surgeries. “The pinnacle in bariatric education is available here, not anywhere else in Minnesota,” said Severson. “Surgeons are coming from across the country to be trained here.” MIMIS has the only accredited bariatric fellowship training program in Minnesota. There are only about 130 programs in the United States and Canada that are accredited by the Fellowship Council to teach minimally invasive surgery. MIMIS is accredited by the American Society of Metabolic and Bariatric Surgery as a Bariatric Center of Excellence. They are also a Level 1a Center of Excellence through the American College of Surgeons, as well as a designated Blue Distinction Center for Bariatric Surgery by Blue Cross and Blue Shield. For more information on the bariatric program on the Medical Campus at Crosby, call 888-546-4343.

Lani Hatrick had weight loss surgery at Cuyuna Regional Medical Center's Minnesota Institute for Minimally Invasive Surgery after being diagnosed with diabetes and high blood pressure at age 35. Since having the surgery and losing weight, her diabetes and hypertension are both gone.

The year of the fish New dietary guidelines place fish at the top of the list for health benefits By Jennifer LaRue Huget Special to The Washington Post

There’s something, er, fishy about the new Dietary Guidelines for Americans 2010. Unlike the 2005 version, the newly updated edition of the federal government’s official guide to healthful eating lists increasing seafood intake among its key recommendations. By “fishy,” I don’t mean suspicious. Besides being delicious, fish and shellfish, which together constitute “seafood,” can confer lasting health benefits. The benefits Like red meat and poultry, fish provides the protein essential for maintaining healthy muscles and other tissues. Most of us get more than enough protein. What really makes fish worth eating are its omega-3 fatty acids. New research shows that these healthful fats may help prevent age-related macular degeneration, a disease that impairs vision. But their benefits extend far beyond that. ➤Heart health. Omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), help prevent cardiovascular disease and sudden cardiac death. Penny KrisEtherton, professor of nutrition at Penn State, says these healthful fats can reduce heart arrhythmia, the leading cause of sudden cardiac death. The effect can take hold mere weeks after a person adds more fish to his diet, she says. Omega-3s may also lower triglycerides and blood pressure and prevent blood clots that can cause stroke. ➤Child development. Omega-3 fatty acids contribute to fetal growth and brain development in early infancy, says Bethany Thayer, a spokeswoman for the American Dietetic Association. When women consume omega-3s -

especially DHA - from at least eight ounces of seafood per week, the dietary guidelines say, their babies may have heightened visual and cognitive development. Kris-Etherton adds that research shows kids who eat more fish may have slightly higher IQs than those who eat less. “A couple of IQ points, you question whether that can make a big difference,” she says. “But it might have some bearing on test-score results.” A diet rich in seafood provides lasting health benefits heart-health How to eat more: ➤Can it. For convenience, you can’t beat canned tuna and salmon (which also are good sources of Vitamin D and, if you buy the bone-in kind, calcium, Kris-Etherton says). Keep in mind, though, that if you limit yourself to these you’ll be getting more sodium than you need and missing out on the wide range of options in the fresh-seafood case. ➤Try milder fish. Don’t like fishy taste? Try mild-flavored fish such as cod, flounder, sole and tilapia, which take well to baking, poaching or steaming, Thayer says, more so than grilling. But she notes that these don’t deliver as big a dose of omega-3s as fattier fish. ➤Go beyond the fillet or steak. You can add fish to soups or salads, Thayer suggests. Get kids to eat more fish with homemade fish strips or fish tacos. Or simply coat strips of cod or haddock in seasoned bread crumbs and bake them in the oven. Thayer herself is partial to salmon topped with fruit salsa. (You’ll notice that nobody suggests battering and frying, which adds unneeded calories and often unhealthful fat.) Consumer concerns

boosting omega-3 fatty acids. Omega 3 also benefits eye health that may prevent age-related macular degeneration.

➤Best for omega-3s. Some seafoods have more of these than others. The best are: salmon (wild and farmed) Pacific oysters, anchovies, herring, sardines, trout, and Atlantic and Pacific mackerel. ➤Mercury. Some people avoid fish for fear of consuming methyl mercury, which may harm the developing nervous system of an unborn baby or young child. Some fish contain more mercury than others, including large fish such as albacore tuna that “are great big and hang around the ocean a long time, eating smaller fish,” says Kris-Etherton. Pregnant women in particular should steer clear of the top four mercury-containing fish: tilefish, shark, swordfish and king mackerel (also known as golden bass). As for tuna, the dietary guidelines say women who are pregnant or breast-feeding can eat any kind of tuna they like but should stick to no more than six ounces of white tuna per week because it contains more mercury.

➤Cholesterol. Shrimp is a “very lean source of protein,” Thayer says, but some people shy away because it is loaded with cholesterol. (It’s also lower in omega-3s than other seafood.) Thayer and Kris-Etherton agree that the science is fuzzy on how eating shrimp affects cholesterol levels in your body. American Heart Association guidelines call for consuming less than 300 mg per day of cholesterol; four ounces of shrimp deliver about 160 mg. ➤Safety and freshness. Cook fish until its internal temperature measures 145 degrees on a food thermometer, Thayer advises. Just checking to see if it’s flaky isn’t good enough. And the best way to tell whether fish is fresh is to give it a sniff. “If it smells fishy, it’s probably not fresh,” she says. “It should have just a faint smell of the sea.”

HEALTHWATCH