Think Wellness

Page 1

With happy feet,

Beckie Swanson pursued her passion

Your Non-Diet

PEP Talk: New Year’s Resolution

Do you need help managing

your diabetes?

y h t l a e H ! r a e Y New

Brought to you by the

The Free Press MEDIA

Winter 2021 Issue - FREE



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Think Wellness

CONTENTS

Winter 2021 • Volume 2, Issue 1 Page Designer

Advertising Sales

Contributing Writers

Christina Sankey

Danny Creel Jordan Greer-Friesz Josh Zimmerman Theresa Haefner

Marie Wood Erin Gonzalez Danette Peterson

The Free Press MEDIA

This magazine is published by The Free Press Media in partnership with Mankato Clinic. The Free Press Media 418 South Second Street, Mankato MN 56001. For all editorial inquiries, call Marie Wood at 507-389-8716 For advertising, call 344-6364, or e-mail advertising@mankatofreepress.com.

4 • Think Wellness • Winter 2021

5

Thank you to our Healthcare Heroes!

8

Top 5 Tips to Take On Winter

9

COVID-19 vaccine: What you need to know

10

From refugee to American citizen: Maryan Mohamed

12

With happy feet, Beckie Swanson pursued her passion

16

Are you living in pain? There are solutions

18

PEP Talk: Your Non-Diet New Year’s Resolution

20

Do you need help managing your diabetes?

22

Are Your Beliefs Keeping You From Losing Weight


Jeff Haala, RN, and Galen Hilgendorf, PA-C, work at the Mankato Clinic Respiratory Clinic to treat people with COVID-19.

Thank you to our

Healthcare Heroes! By Marie Wood

Since March of 2020, Galen Hilgendorf, PA-C, and Jeff Haala, RN, have worked on the front lines of the COVID-19 pandemic. They pull 12 hour shifts in the Mankato Clinic Respiratory Clinic. On their feet all day, they follow strict guidelines and procedures to care for

people who may have COVID-19. The work is physically, mentally and emotionally demanding. They have made great sacrifices to respond to the needs of our community and will continue until the pandemic is behind us. Winter 2021• Think Wellness • 5


Q: What is a 12-hour day like in the Respiratory Clinic?

A: Busy! First things first, you have to get dressed for the day! Paper scrubs, shoe covers, 1 pair of gloves, N95 mask, goggles or shield, and hair net or scrub cap. Galen Hilgendorf, PA-C You wear this for the entire 12-hour shift. For each patient, prior to entering the room, you place a yellow gown over your scrubs and a second pair of gloves over the initial gloves. Our nursing team helps with the gowning and placing gloves as well as contacting the patient, obtaining vitals, and placing them in the correct exam room. While in each exam room, I check blood pressures, examine our patient and swab for COVID-19 if needed. I knock on the door for nursing help if I need supplies or swabs, a call to lab or diagnostic imaging, a work note for the patient

and to discharge the patient. Then the nurse helps me get out of the gown upon exit from each room. The nurses are on the ball the whole shift, at times running down the hall to get to a door to help! Then the process starts all over again. I see anywhere from 20-30-plus patients in a day. During surges of cases and exposures in November and December, and the increasing complexity that comes along with the virus, we are extremely busy.

Q: How did COVID-19 change your life in 2020?

A: COVID-19 changed everyone’s lives! Like everyone,

I have missed seeing friends and family. Experienced cancelled trips, sporting events, concerts, and developed a new/worsening online shopping problem. One change that I didn’t anticipate was the fear that I have seen in some once they hear that I work in the respiratory clinic. Six feet apart turns in to 10 feet fairly quickly! On a serious note, I also now fill a very different role and appreciate a new version of “tired.” It is not only the physicality of the job, treating some very sick patients, working our hardest to keep patients out of an ER that is already overflowing, keeping up with the current guidelines as well as the status of a vaccination that seems to change every day, but also trying to

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combat or convince others that this virus is real, stressing the need to wear a mask while in public or quarantine if they feel sick in the same breath. It is quite the balancing act!

things that binds us together. I also have a new appreciation for the word tired. Between the long shifts, stress, and uncertainty of everything else, sleep is a luxury that many of us don’t have anymore.

Q: What is your message to our community?

Q: We call you healthcare heroes. Do you feel like a hero?

need a source for information look to credited resources such as the Centers for Disease Control and Prevention, Minnesota Department of Health and our Mankato Clinic website at www.mankatoclinic.com/ covid-19-information.

my co-workers this question, the answer I got unanimously was “No.” We are doing what we are supposed to do. I think that you would be hard pressed to find a nurse in our group that would say differently. We signed up to be nurses, this is why we are here. We want to be there for our community and help people get better.

A: Please, educate yourselves about the virus. If you

Please wear a mask and wear it correctly covering both the nose and the mouth. There are many studies that have proven time and time again that masks help us slow the spread of COVID and we truly need your help to slow this down! Remember to take care of yourselves; everything has been stressful and we can’t forget about our own mental health and finding ways to re-charge!

Q: What is a 12-hour day like in the Respiratory Clinic? A:

For me, the day starts around 7:30 am to open the rooms, check supplies and see if the floor nurses need anything. Then I log into our Electronic Health Records system for test Jeff Haala, RN results that came in overnight. The phones are already ringing with people hoping to get their results so they can go to work. Over the course of the day, we field phone calls, call patients with results, answer the COVID-19 Hotline, do infusions, and help with any needs that arise on the floor. The word teamwork doesn’t even begin to cover it. Everyone from the front to the back, top to the bottom, chips in to keep the day moving.

A: No, I don’t feel like a hero. When I asked some of

Q: You played a major role in history. What will you tell future generations about being a healthcare worker during COVID-19?

A: 2020 was an election year and with that COVID was turned into a political tool. As nurses we saw the division happen in real time. COVID-19 drastically changed the face of health care. We had to change almost every facet of how we do our jobs. From adding a COVID-19 phone triage hotline, virtual visits, drive-thru testing and respiratory clinics, we have needed to pivot almost constantly. Plus we had to do it all through an extra layer of protection.

Q: What is your message to our community?

A: We know that you’re tired. We know that your lives

are flipped upside down due to this pandemic, and we empathize. Please remember that healthcare workers are going through the same trials and hardships while also caring for you. Please be kind and patient while we do our best to provide care for you.

Q: How did COVID-19 change your life in 2020?

A: When Adams Street Urgent Care was temporarily

closed, my coworkers and I moved to the Respiratory Clinic. Knowing the character of my fellow co-workers and nurses, we still would have volunteered to be part of the Respiratory Clinic. Our drive to help is one of the

Jeff Haala, RN, meets patients, one at a time, at the door of the Respiratory Clinic, to bring them into the clinic for care. Winter 2021• Think Wellness • 7


Top 5 Tips to Take On Winter 1. Get physically active.

Shorter days and cold weather make us want to dive into our couch with a cozy blanket. Get moving instead. Moderate physical activity, such as walking, can boost your mood and energy. Here’s why. Your body releases endorphins which can bring you a sense of well-being. Regular exercise, 30 minutes a day, 5 days a week, can improve your heart health, sharpen your thinking and focus, help you sleep better and reduce your risk of depression and anxiety.

2. Warm up with soup

In the winter, it’s normal to crave rich comfort foods and sweets. They warm us from the inside and bring us pleasure. You can feed your body and soul with soup that can be rich in vegetables, beans and whole grains. Add a lean protein like chicken. Look for lots of easy and yummy soup recipes online and try a new one every week!

3. Get outside

Get outside in the winter to take walks, build a snowman, go sledding, visit a nature center or nearby park, play with your kids. Natural daylight can raise serotonin levels, which is one of your body’s feel-good chemicals. Going outside during the day will help your body get more daylight which can improve your mood. When possible, adjust your schedule to get outdoor breaks during the day.

4. Sleep for 8 hours a night

Studies show that humans want to sleep more during the winter due to the reduction in daylight. Sleep experts advise 7-9 hours of sleep for healthy adults year-round. Go to sleep and wake at roughly the same times on weekdays and weekends. Turn off electronic devices like mobile phones, laptops and TVs for a halfhour or more before bed. Remember, it’s best to sleep in your bed – so go to bed before falling asleep on the couch!

5. Try something new

With more time at home this winter, it’s a great time to learn a new skill and feel a sense of accomplishment. Start small so you don’t get discouraged. Try a craft project that seems doable and fun! There are lots of FREE virtual classes on knitting, crocheting, needlepoint, cooking, jewelry making, home décor and more! Do a puzzle or build a model. Maybe you’ll find a new hobby. 8 • Think Wellness • Winter 2021

Expert Advice

Bob Olson, MD

Mankato Clinic Psychiatrist

Watch for signs of Seasonal Affective Disorder (SAD). SAD is a type of depression that typically affects people in the winter months. Common signs of SAD are feeling depressed all day, nearly every day, losing interest in activities you enjoyed, overeating, weight gain and oversleeping. SAD can be treated with light therapy, psychotherapy and antidepressant medications. Talk to your primary care provider if you notice these symptoms. To learn more about Mankato Clinic Department of Psychiatry, visit www.mankatoclinic.com/psychiatry-1.


COVID-19 vaccine: What you need to know By Marie Wood

safety standards set by the U.S. Food and Drug Administration (FDA).

Katie Anderson, MD, Mankato Clinic Family Medicine “As a frontline healthcare physician, I will be receiving the COVID-19 vaccine as soon as it is available to me. I am getting the vaccine because it will protect me, my patients and my family, especially my loved ones who may be at higher risk for severe illness from COVID-19. I am confident in the safety and effectiveness of this vaccine. The new COVID-19 vaccines have met rigorous

I strongly recommend that people over age 16 get the vaccine as it becomes available in the coming months. The COVID-19 vaccine is our best hope to help us end the COVID19 pandemic and make life more normal again. The vaccine is an important tool to protect ourselves, our loved ones and our community from COVID-19.” Here’s a Q&A about the COVID-19 vaccine from the Centers for Disease Control and Prevention. Q: Should I get vaccinated for COVID19? A: Yes, when it is available to you. The vaccine will help protect you from getting COVID-19. If you still get infected after you get vaccinated, the

vaccine may prevent serious illness. By getting vaccinated, you can also help protect people around you. Q: Can the vaccine give me COVID19? A: No. None of the COVID-19 vaccines currently authorized for use or in development in the U.S. use the live virus that causes COVID-19. Then it typically takes a few weeks for the body to build immunity after vaccination. Q: Why do I need two COVID-19 shots? A: Currently authorized vaccines, and most vaccines under development, require two doses of vaccine. The first shot helps the immune system recognize the virus, and the second shot strengthens the immune response. You need both to get the best protection. Q: Will the shot hurt or make me sick? A: There may be side effects, but they should go away within a few days. Possible side effects include a sore arm, headache, fever or body aches. This does not mean you have COVID19. Side effects are signs that the vaccine is working to build immunity. If they don’t go away within three days, or you have more serious symptoms, call your doctor. Q: How do I know if the COVID-19 vaccine is safe? A: All COVID-19 vaccines were tested in clinical trials involving tens of thousands of people to make sure they meet safety standards and protect adults of different ages, races and ethnicities. There were no serious safety concerns. CDC and the FDA will keep monitoring the vaccines to look for safety issues after they are authorized and in use. Q: How can I learn more? A: Visit www.cdc.gov/coronavirus/ vaccines and www.mankatoclinic.com/ covid-19-vaccine-information.

Winter 2021• Think Wellness • 9


From refugee to American citizen: Maryan Mohamed realizes her dream with help from the Good Counsel Learning Center

By Marie Wood In 2007 after having been shot in the leg, Maryan Mohamed fled the violence in Somalia to Uganda with her mother, father and one brother. There she married and had three children. During her seven years as a refugee in Uganda, she was encouraged to apply for a visa to the United States. She would have had to pay $3,500 which was impossible to raise. Eventually a woman from the United Nations convinced her to go by herself, that she would find the strength. In late 2013, Maryan arrived in the United States with her 4-year old daughter, Fathi, leaving her older daughter and son with her husband. Upon arriving to the United States, she learned she was pregnant. Nalyal was born in March 2014. After six months in Arizona, Maryan and her daughters moved to Mankato in October 2014. In December of 2014, Maryan and Fathi began going to the Good Counsel Learning Center where they were tutored one-on-one by sisters and lay teachers. Maryan worked on reading and conversational English and becoming an American citizen. “They are good teachers. They help a lot of people in my community,” Maryan said. 10 • Think Wellness • Winter 2021

In 2019, the Good Counsel Learning Center tutors helped Maryan study for her citizenship test. She had much to learn and attended summer school with her daughters Fathi and Nalyal. She scheduled her test for early July. All along Maryan expressed her faith in prayer: “I pray to God. God told me I will pass.” And she did! “Being literate is the foundation for participating in our society via reading advertisements that come with groceries, information from kids’ schools and understanding civic issues. We view literacy as the key to empowering people to be the best version of themselves,” said Cimarron Burt, academic manager at Good Counsel Learning Center. In the last four years, Maryan has worked diligently with her attorney to get her husband and two children to come to the United States. Her setbacks began with a travel ban on Muslims followed by expensive DNA testing to prove her children in Uganda are hers. Just when her family had cleared the final hurdle, the COVID-19 pandemic interfered. While Maryan works to raise the needed money for the plane fare, she keeps in touch with her family through Skype, Facetime and WhatsApp, trusting that the day will come when they will all be re-united. Maryan tells her children to pray and “Maybe someday we will all be together.”


Good Counsel Learning Center By Marie Wood Good Counsel Learning Center provides one-on-one tutoring in reading, language arts, math, and civics/ citizenship for kindergarten to adult learners. This includes clarity in speaking and writing, improved vocabulary, greater comprehension, basic math skills and preparation for the naturalization test. Tutoring is offered both in-person and online. The Mankato Clinic Foundation awarded Good Counsel Learning Center $4000 in 2020. The mission of the Mankato Clinic Foundation is to encourage and support the health and well-being of our community through health initiatives that promote and improve community wellness. Empowering new Americans with language and literacy skills can help families thrive! Imagine going to a clinic in a foreign country where you don’t know the language. Even with the help of an interpreter, it would be very difficult. Maryan Mohamed with her daughters, Nalyal (left), and Fathi (right), are learners at the Good Counsel Learning Center. Maryan works on speaking, reading and writing English while her daughters work on reading and math.

“Just talking to Maryan, you can see her resilience,” Cimarron said. “Nothing ever slows her down or seems to get to her. She’s always very kind, gentle and happy.” This year, Maryan, and daughters Fathi and Nalyal continue to study two hours a week with the Good Counsel Learning Center. Due to COVID-19, tutoring has gone online. But progress continues. When Fathi takes tests at school, she knows all the answers. “They really helped me at the Learning Center,” Fathi said.

“When we see families in our clinic, we share critical health information – such as when to get vaccines or how to manage a condition. It’s so wonderful when we can talk directly with each and every one of our patients,” said Dr. Katie Anderson, Mankato Family Medicine, chairperson of the Mankato Clinic Foundation Board. For many families, the journey at Good Counsel Learning Center, begins with tutoring for their children. Then the parents enroll when they find Good Counsel can teach them too. “Family literacy is such a big need. Our children are here because children are supposed to learn and go to school. Adults are here because they want to build these skills for themselves and their families,” Cimarron said. To learn more about Good Counsel Learning Center, visit www.gclearningcenter.org. To learn more about the Mankato Clinic Foundation, visit www.mankatoclinic.com/mankatoclinic-foundation. The Foundation receives the majority of its funding from Mankato Clinic physicians, along with giving by Mankato Clinic staff and the greater Mankato community. In 2020, the Mankato Clinic Foundation provided more than $130,000 to worthy non-profit organizations and initiatives including the COVID-19 Community Response Fund, Get Mankato PPE, and First Steps/ Next Steps to support healthy babies and families. The next grant application deadline is March 1.

Winter 2021• Think Wellness • 11


Beckie and Greg Swanson did the Lindy Hop at their wedding before the pandemic.

With happy feet, Beckie Swanson pursued her passion By Marie Wood Our feet take us where we want to go. Beckie Swanson learned how true this is when foot pain stood in the way of a career in fitness and an active lifestyle outside the gym. 12 • Think Wellness • Winter 2021

About 10 minutes into teaching her ZUMBA class at Fitness for $10 in Mankato, Beckie Swanson’s right foot hurt. With deep pain in her arch, she was uncomfortable throughout her class.


Expert Advice

James Nack DPM

Beckie leads ZUMBA classes at Fitness For $10 in Mankato. After jamming her big toe a few years back, she saw Dr. James Nack at the Mankato Clinic Foot and Ankle Center. During that visit, she learned she had a bunion that could be removed. A bunion is a bony bump that forms on the joint at the base of the big toe. She was hesitant at first and put off the surgery. “My long term goal was to work full time as a fitness instructor. As long as I kept putting off the surgery, I was putting off my goals and passion,” Beckie said. “Take care of your body. That’s what I tell other people to do. I needed to listen to my own advice.” A lifelong dancer who also skated on the Mankato Area Roller Derby team, Beckie hasn’t always been kind to her feet. In August 2019, Dr. Nack performed her bunion surgery to remove the bunion, relieve pain and realign the joint at the base of the big toe. She is so happy she did it! Today Beckie is the Member Experience Manager at Fitness for $10. As a certified Les Mills instructor, she teaches a variety of classes as well as spin and Zumba at the gym. “Teaching classes is enjoyable again. It’s nice to be able to walk normally again and teach a class without pain,” Beckie said. Beckie was also experiencing knee pain. Dr. Nack explained how the bunion can affect other parts of her body. As the pain moved up the back of her leg, she compensated by walking on the side of her foot instead of rolling off her heel onto her toes. “A bunion is a joint that’s becoming out of alignment. When your car’s out of alignment, you’re not going to go that far down the road,” said Dr. Nack. “Beckie’s young. She’s very healthy. She’s very active. You want to get the foot in better alignment sooner rather than

Bunion surgery is an elective procedure. Patients usually come to me when the bunion begins to cause pain and they notice redness, tenderness and swelling. They may also have decreased motion in the big toe. While surgery is the only way to correct the bunion, I also encourage conservative care. Here is a conservative care approach to reduce pain and slow the progression of bunions. • Wear custom foot orthotics prescribed by a podiatrist. Evidence shows orthotics decrease foot pain and improve function. • Wear good, supportive shoes with plenty of room in the toes. Do not wear narrow, pointed shoes that pinch or force the toe into an unnatural position. Ditch the flip flops too! • Do not wear heels more than 2 inches in height. • Stretch the Achilles tendon for 10-12 minutes. • Strengthen the muscles of the arch. Try picking up 20 marbles with your toes and placing in a bowl. Use one foot to pick up all the marbles. Repeat with the other foot. I recommend this same conservative care after bunion surgery as well. It’s so important to protect and take care of our feet! Bunion surgery can benefit people who have significant pain that limits everyday activities and walking as well as chronic swelling of the big toe joint. A big toe that’s drifting toward the smaller toe is also a sign that you could benefit from surgery. When considering bunion surgery, I advise patients to keep a calendar for a month. Mark a red X on any day you don’t want to walk the dog because your foot or knee hurts. If you have 20 red X’s a month, then you are likely living with more pain than necessary. To learn more, visit www.mankatoclinic.com/podiatry-foot-and-ankle.

Winter 2021• Think Wellness • 13


later. You want to be proactive.” Bunions can be caused by heredity due to the shape and structure of the foot, foot stress or injuries. Let’s face it, our feet take a beating. We also know that poorly fitting shoes particularly those with a pointed toe that forces the toes into an unnatural position help bunions develop and worsen. Outside of the gym, Beckie runs, plays sports, hunts and enjoys the outdoors. When the gym was shut

down due to COVID-19, Beckie offered virtual Zumba classes via Zoom. With two dogs to walk, she logged many miles and discovered new trails in the area. A lifelong dancer, Beckie and her husband enjoy swing dancing together, especially the Lindy Hop which is a little faster than traditional swing dancing. “I wanted to keep dancing because I love it!”

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Local Hospice Care You Can Trust

During recovery, Beckie wore her boot to teach a spin class at Fitness for $10 in Mankato

Surgery and recovery

When Dr. Nack examined and x-rayed Beckie’s foot, he recommended a less complex bunion surgery which would allow her to bear weight on the foot more quickly after surgery. In a non-weight bearing bunion surgery, the patient is casted and uses crutches or a scooter throughout recovery. Beckie said her surgery went awesome. She felt very prepared for the recovery because Dr. Nack told her exactly what to expect and mapped out a plan from day 1 to 84 of her recovery. Bones take 6-8 weeks to heal. That’s why Dr. Nack follows his patients weekly for 2 months after bunion surgery. “If there are no surprises along the way, people do much better,” Dr. Nack said.

Hospice is not about giving up, it’s about choosing comfort and quality of life.

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Beckie followed up with Dr. Nack at 3-5 days from surgery. At 2 weeks, she returned to get her stitches removed. She stayed off her foot for the first 1-2 weeks, using crutches for about a week. She wore a boot to protect the toe and keep the foot in the right position. After 4 weeks wearing the boot, it was very exciting when she


Beckie, number 28, skated on the Mankato Area Roller Derby team.

g Revy.

with her do Beckie kayaks

Beckie and G reg Swanson enjoy hangin dogs, Winsto go n, the bigger dog, and Revy ut with their two , the smaller d og.

was released from the boot and into athletic shoes! Dr. Nack praised Beckie for closely following the postoperative plan for a great outcome. As prescribed, Beckie iced and elevated. Later she followed through with at-home exercises. She picked up marbles with her toes to strengthen her arch, drew the alphabet in the air with her big toe and ankles, and stretched the Achilles tendon. Dr. Nack even taught

Beckie how to shop for shoes! She looks for shoes that have a stiff sole and don’t bend too much in the middle. She opts for good support in both her sneakers and street shoes. When it comes to heels, wedges are the way to go. What’s Beckie’s advice to others? “Listen to your body. Don’t try to push through the pain. Do what’s right for you.” Winter 2021• Think Wellness • 15


Are you living in pain?

There are solutions to restore function, relieve pain and renew hope. By Marie Wood Mankato Clinic Pain Management Center can pinpoint the source of the pain and help patients who suffer from:

About 50 million Americans, or a little over 20% of adults, are living with chronic pain according to statistics from the Centers for Disease Control and Prevention. In fact, the overall prevalence of chronic pain in the United States is higher than that of diabetes, heart disease and cancer combined. You are not alone, but you may feel as if you are. Chronic pain affects your quality of life, mood and stamina. It can lead to stress, poor health and lost sleep. The Mankato Clinic Pain Management Center, formerly Advanced Pain Management, can help you find relief and long-term solutions to pain. The Pain Management Center offers advanced, minimally invasive diagnostic therapeutic services to help people who are suffering from pain to restore function, relieve pain and renew hope.

• Back pain • Carpal tunnel • Complex Regional Pain Syndrome (CRPS) • Diabetic neuropathic pain • Fibromyalgia • Headaches • Herniated Discs • Hip pain • Knee pain • Neck pain • Pelvic and abdominal pain • Sacroiliac pain • Sciatica • Shingles • Shoulder pain • Spinal Stenosis • Work and sports injuries

Manage Chronic Conditions Healthy Diet Exercise

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Education

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Socialization Good Sleep

million Americans have Alzheimer’s Disease

million are providing unpaid care to loved ones with dementia

Respite Center Support Groups Caregiving Coaching & Resources Fitness Opportunities Educational Presentations Social Groups


The first step is talking with your primary care provider about the pain you are experiencing. Your primary care provider can refer you to the Mankato Clinic Pain Management Center for specialized care and treatment. Mankato Clinic providers understand that pain management services are essential to the health, quality of life and well-being for so many people. “With the Pain Management Center being part of Mankato Clinic, we can work closely with our knowledgeable providers to help our patients enjoy life again,” John Benson, MD, Mankato Clinic Family Medicine, said.

Michael Muchiri, Certified Nurse Practitioner

Michael Muchiri, Certified Nurse Practitioner, works in the Pain Management Clinic. He helps patients stay on track with their treatment plan and supports patients in their journey to better health. Michael earned his bachelor of science in nursing from Minnesota State University in Mankato. He then went on to earn his master of science in family practice nursing at Metropolitan State University in St. Paul. Mankato Clinic Pain Management Center Madison East Center, Suite 402, Mankato 507-625-7246 www.mankatoclinic.com/pain-management-center If you are living in pain, see your primary care provider for a referral.

Ifechi Anyadioha, MD

Ifechi Anyadioha, MD, is the Medical Director of the Pain Management Center. He received his medical education at the Howard University College of Medicine in Washington, D.C. He then completed both his anesthesiology residency and pain medicine fellowship at the Medical College of Wisconsin Affiliated Hospitals. He is Board Certified in pain management and anesthesiology. His areas of interest include peripheral nerve and spinal cord stimulation systems to treat chronic pain. He also specializes in ultrasound-guided techniques and intrathecal pain pump implants. “Every pain patient is different and I keep those differences in mind when creating a treatment plan. We customize the treatment plan to each patient in order to provide the pain relief they deserve,” Dr. Ifechi said. An individualized treatment plan may include: • Co-management of patients with physical therapists, chiropractors and occupational therapists • Complementary and alternative medicine • Lifestyle modification (such as exercise, diet and smoking cessation) • Medication management • Minimally invasive procedure • Psychological therapies

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PEPTALK: Your Non-Diet New Year’s Resolution By Erin Gonzalez, MS, RD, LD, Mankato Clinic Nutrition Education

Erin’s Kitchen

It’s natural to start thinking about ways to make changes for the New Year ahead. How many years have you vowed to cut out all the sugar, exercise every day, and lose weight once and for all? Maybe you have had the experience of starting a new diet plan that promises “lifestyle change” only to feel restricted and deprived leading you to feel out of control around food. Instead of blaming your lack of will power, or self-control, it is important to know that dieting itself is the culprit and that you have never failed, instead you have only been failed. It’s diets and dieting mentality that is causing you to “fail.” Which is why I want you to make 2021 the year you vow to NOT go on a diet.

Here are 10 of my top New Year’s resolution Ideas: Winter is a great time for soups! One of my favorites is Creamy Chicken Tortilla Soup from Cooking Classy. You’ll find the recipe here: www.cookingclassy.com/ creamy-chicken-tortilla-soup.

18 • Think Wellness • Winter 2021

1. Ditch the scale as a measurement of success and instead focus on positive well-being. Health is not defined by a number or a body size. Instead of focusing on a number, seek ways to increase energy, improve flexibility, strength, or mobility, improve mood, lower blood glucose or cholesterol levels, etc.


2. Learn how to differentiate between physical hunger and overeating triggers.

9. Seek ways to move your body that you look forward to.

Physical hunger will always be accompanied by a physical cue: emptiness of the stomach, gnawing sensation, headache, loss of focus/concentration, irritability, etc. Overeating triggers on the other hand are typically felt from the neck up and are specific to a certain food and you cannot prolong them.

Shift your focus to how it feels to move your body, rather than the calorie-burning effect of exercise. When you shift your focus to how your body feels when you are active it can make all the difference between getting up for a morning walk or hitting that snooze button.

3. Get rid of the “should” and “shouldn’t” from your vocabulary. Instead, give yourself unconditional permission to eat. Deprivation can lead to uncontrollable cravings and often binging. Making peace with food involves eating foods you enjoy while staying connected to your hunger and fullness levels.

10.Choose foods that taste and feel good in your body. Your body naturally seeks balance with all foods, when you stop to ask and listen.

4. Stop labeling food as “good” or “bad.”

End the war with food. No one food, meal, or day of eating will change anything about your body.

5. Ditch the clean plate club and focus on tuning in to fullness cues. Listen for the body signals that tell you that you are no longer hungry. You are the expert of your own body. No point system, program, or calorie count will ever be as accurate as your own internal cues.

6. Seek satisfaction and enjoyment with food.

Food should be enjoyed! When you eat what you really want you are more likely to feel satisfied and content.

7. Practice daily self-care. Food is just one of many ways to feel better. When we regularly practice self-care we are more likely to meet our unmet physical, emotional and mental needs which can significantly reduce emotional eating triggers. Try journaling for 5 minutes at night before choosing to eat when struggling with food cravings.

8. Make changes because you love yourself rather than in order to love yourself.

Stop bashing your body and instead focus on showing your body gratitude for all it does for you. Get rid of clothes that no longer fit and buy clothes for your here and now body. You deserve it!

Erin Gonzalez, MS, RD, LD, is a non-diet, Intuitive Eating dietitian who helps people learn how to have a healthy relationship with food and their body so they can eat in a way that honors enjoyment and nourishment with food. Erin leads the Mankato Clinic Nutrition Education Center. She offers nutrition education for chronic health conditions, nutrition and lifestyle change coaching, and counseling for disordered eating. To learn more, visit www.mankatoclinic.com/ nutrition-education. Call 507-389-8572 to make an appointment. Winter 2021• Think Wellness • 19


Do you need help managing your diabetes? By Marie Wood Mankato Clinic has launched a Diabetes Care Center to help people live better with diabetes. People with diabetes have higher-than-normal levels of sugar, or glucose, in their blood. Insulin, a hormone produced by the pancreas, helps move glucose from the blood into the body for energy. The Diabetes Care Center offers comprehensive care for type 1, type 2 or gestational diabetes. Successfully managing diabetes is very important. High blood sugar is a clear sign that diabetes is uncontrolled. Uncontrolled diabetes can lead to serious health complications including kidney damage and a higher risk for a stroke and heart attack. Our care team helps people manage diabetes, control their blood sugar and lead healthy lives. Working with our primary care providers and specialists, the Diabetes Care Center team creates a treatment plan to meet the individual needs of each and every patient. Every treatment plan is unique. Led by Abel Alfonso, DO, a physician who specializes in diabetes, the team includes a pediatrician to care for children, certified diabetes care and education specialist, clinical pharmacist and registered nurse. 20 • Think Wellness • Winter 2021

“We offer individualized treatment, support, education and specialty care to help people successfully manage this condition. We are here to help our patients control their blood sugar and prevent complications that can impact their quality of life,” Dr. Abel Alfonso said. “We treat the whole person, not the condition.” Type 2 diabetes, which typically develops in middle age, is most common. People with type 2 diabetes produce their own insulin, but their cells don’t respond normally. Treatment for type 2 diabetes can include healthy eating, exercise, and medications to control blood sugar levels. People with type 2 diabetes may also need to monitor their glucose or take insulin. To learn more, visit www.mankatoclinic.com/diabetescare-center. Diabetes Care Center services are available with a referral from a primary care provider.


Meet our Diabetes Care Team:

Abel Alfonso, DO, Endocrinologist, Diabetes Care Center Lead Physician A specialist who treats diabetes, Dr. Alfonso works closely with the diabetes care team, primary care providers and specialists to customize a treatment plan.

Abby Tibodeau, RD, LD, CDCES

Nathan Evers, PharmD, BCACP

The Diabetes Care Center offers a diabetes education program recognized by the American Diabetes Association. A certified diabetes care and education specialist, Abby works one-on-one with patients to make a plan to manage their diabetes that works best for their bodies and lifestyle. She helps people understand how to control their blood sugar through diet, physical activity, glucose monitoring, medications and insulin therapy.

As a clinical pharmacist, Nathan meets with patients to make sure the medications are working well. He can help patients create a simple routine for medications, glucose monitoring and insulin use.

Are you at risk for diabetes?

Robert Larson, MD, Pediatrician Dr. Larson treats diabetes in children with a special focus in insulin pump therapy with continuous glucose monitoring systems.

About 88 million American adults have prediabetes and 90% don’t know it. Prediabetes means blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. Prediabetes puts people at higher risk for type 2 diabetes, heart disease and stroke. Take the 60-Second Type 2 Diabetes Risk Test from the American Diabetes Association at www.diabetes. org/risk-test. Then talk with your primary care provider about your risk factors. Your provider may recommend an A1C test – a simple blood test that measures your blood sugar and identifies prediabetes or type 2 diabetes.

Ashley Forstner, RN, BSN, As the Diabetes Care Center registered nurse, Ashley helps guide patients in their journeys to better health. She helps them stay on track, schedules appointments and coordinates care with other specialists.

Winter 2021• Think Wellness • 21


Are Your Beliefs Keeping You from Losing Weight? By Danette Peterson, RDN, LD | Profile by Sanford You did it! You packed yourself a healthy lunch and even remembered to bring it to work! Then ten minutes before your break, your boss hands you an urgent project that needs to be done by end of day. You drop everything and get to work. Three hours later you realize you are starving and grab a granola bar and some coffee to tie you over until dinner. You know this was probably not the best choice, but you tell yourself it could not be helped and that you will save that healthy lunch for tomorrow. When situations like this happen occasionally, they are not likely to have a huge impact on our healthy goals. What happens, though, when you find yourself making choices like this on a regular basis? What is driving your decision-making? Knowledge is certainly part of the equation, but our beliefs may play an even bigger part. As humans we are wired to seek safety and certainty. We form many of our beliefs early in life before we are even aware of what we are doing. We gather information through experiences, by observing our surroundings and through the actions and words of others. We make deductions, draw conclusions, and typically attach a positive or negative emotion to what becomes the belief. Let us look at a more obvious example: I know that statistically it is safer for me to fly in an airplane than to drive my car, but I believe the plane is more dangerous and I will choose my car over air travel whenever I can. I can not recall how I came to this belief, but the feeling of fear attached to it is very strong and it will override my rational thinking every time. Our beliefs about food can work this way also. Have you ever been at a party with the intention of avoiding the dessert table until your friend brings you a piece of the cake that she made and says, “You have to try this!”? Suddenly all your good intentions are out the window and you are eating the cake because you cannot bear to say no and risk hurting her feelings.

What can you do if you find yourself in situations where you keep making decisions that are not serving your health and weight loss goals? 1. Identify the belief. Begin by examining the choice you made until you become more aware of why you made the decision. This may take some time and self-reflection. 2. Question the belief. Can you know for sure your friend would be hurt if you declined the cake? 3. Gather new evidence. Have you ever asked your friend if she would be hurt by that? As your friend, might she be willing to support your healthy goals? You need to check it out to know for sure. 4. Reinforce the new information. If after talking to your friend you find she is supportive, remind yourself of that the next time you are in a similar situation. 5. Seek support. A health coach for weight loss can be a valuable resource to help you explore your beliefs and how they may be affecting your relationship with food. Changing our beliefs is not easy, however it is possible to “re-wire” our brains. Know that you will probably feel uncomfortable for a while. Think of this as “physical therapy” for your brain--much like doing physical therapy for your body. Give yourself grace as you practice. Eventually you will associate positive feelings with the new behavior and that will cement the new belief.

Danette Peterson, RD, LD

Danette is a Registered Dietitian with Profile by Sanford. She graduated from the College of St. Scholastica, in Duluth, Minnesota and completed her dietetic internship at Beth Israel Hospital in Boston, MA. Danette began her practice as a clinical dietitian and has spent the last 10 years coaching in weight loss and wellness. She is currently the Learning and Development Director for the Minneapolis Profile by Sanford Market and oversees the training and mentoring of the Coaching Staff. Danette has a passion for helping people understand how what and why we eat affects our health and how to navigate the complex food culture in which we live.

22 • Think Wellness • Winter 2021


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