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New
Trinity Health campus takes shape Trinity Health’s new healthcare campus and medical district continues to progress as winter sets in, with roughly a third of the overall construction of the project complete. Significant advancements were achieved this fall with the site’s utilities, foundation, superstructure, exterior envelope, MEP (mechanical, electrical, and plumbing), and other activities. For example, first placement of asphaltic paving occurred on the perimeter road and main access road to the campus, including curb and gutter. The south parking area is paved, and sidewalk from the property to 37th Avenue is placed. Preparation for paving the west portion of the site is underway. Additional site and utility work includes installation of transformer pads and electric gear adjacent to the Central Energy Plant (CEP), and completion of site rough grading at the building perimeter. Installation of underground fuel tanks and distribution piping is near completion. The CEP is enclosed at this point. Masonry and auger-cast piles are 100% complete, foundations are 95% complete, and backfill is 98% complete. Crews also completed the west Emergency Room access and parking structure, and have made progress on grade-level, subgrade, and raised parking. Structural steel is in place and the two tower cranes have been removed from the site, which is a visible change from the street view of the construction site. Roof work continues. All concrete is complete at the elevated floor decks in both the hospital
Submitted Photo
Significant progress has been reported at the new Trinity Health campus going up in southwest Minot.
and medical office building. Medical, electrical, and plumbing are progressing within the hospital, medical official building, and building connector. The topping out of the medical office building–which signifies the placement of the final steel beam on top of the structure– was achieved in October. This followed the earlier topping out of the hospital building in July. Randy Schwan, a Trinity Health Vice President, noted that despite events earlier in the year that delayed work around the project, officials are still targeting its completion in 2021. “Although our momentum was temporarily interrupted by the fire and other events earlier this year, we are encouraged with the forward movement of construction and how the campus is taking shape. The developing structure is impressive and signals the promise of a state-of-the-art facility that the people of this region can be proud of.”
About Trinity Health A member of the Mayo Clinic Care Network, Trinity Health is a nonprofit, integrated healthcare system accredited by the Joint Commission. With a tertiary care hospital in Minot, ten rural health facilities and a long-term care center, Trinity provides a full complement of healthcare services to communities across North Dakota and Eastern Montana.
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NOVEMBER 2019
Trinity Health to launch ultrasound training program By ANDREA JOHNSON
Staff Writer ajohnson@minotdailynews.com Minot area residents interested in becoming an ultrasound technologist will now be able to receive training right here in Minot. Trinity Health is launching its own Diagnostic Medical Sonography Program beginning next year. The program began taking applications this fall and were conducting interviews in November. Jim Coffin, director of radiology at Trinity, and Dione Bohl, ultrasound supervisor, said there is currently a high demand for ultrasound technologists. There is a training program at Sanford Health in Fargo, but students who have completed the program are quickly hired by medical facilities there and tend to stay in
Submitted Photo
Trinity Health is starting an ultrasound training program. Two people demonstrate a procedure in this photo by Pete Ladendorf.
the area where they were trained. “We’re focusing in on our region,” said Bohl. Trinity has served as a
training site for two out-of-state ultrasound programs for a number of years, said Coffin. “With that experience we’ve developed the confidence that
we are a very strong clinical site for those training programs,” Coffin said. “Our vision is to attract great local students and create excellent sonographers that will likely stay in and around our location. This will be good for Trinity Health, Minot, and our surrounding rural communities.” Coffin said ultrasound is a growing field. Advances in technology means that the equipment will be used to diagnose more conditions, no longer just in obstetrics. The technology uses high frequency sound waves to observe various structures and functions within the body, according to Trinity. It is used to look at heart function, blood flow, fetal growth, breast tissue, and other structures. Unlike Xray, there is no ionizing radiation used to perform a sonogram, according to Trinity.
More information about the program can also be found at: www.trinityhealth.org /trinity-healthcareers/dmsprogram/ The program at Trinity will focus on training students in abdominal, obstetric, and small parts imaging. Ultrasound is also more convenient and cost-effective than other methods of diagnosis. Bohl said the program has enough volume to accept three to four students at a time into the 18-month program. The number of students that can be admitted to the program is
based on the volume of procedures at Trinity. The next group of applications for the second class will be accepted from July to October 2020. Graduates will receive a Certificate in Diagnostic Medical Sonography, or through a consortium agreement with the Dakota College at Bottineau, an Associate of Applied Science., according to Trinity. At the end of the training program, students will take a national certification examination that will qualify them to work at entry level in the field. There will also be opportunities to obtain further training and move up in the field. Amy Hofmann, the program director, teaches the course. She can be reached at amy.hofmann@trinityhealth.org
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Health providers urge people to get immunized By ANDREA JOHNSON
Staff Writer ajohnson@minotdailynews.com
Jill Schramm/MDN
Tammy McAllister, operations administrator with the Department of Clinical Genomics and Center for Individualized Medicine at Mayo Clinic, answers questions at a public presentation at Trinity Health, Oct. 1, as Mayo pharmacist Eric Matey listens at right.
Individualized medicine
Genetics guide health care decisions By JILL SCHRAMM
Senior Staff Writer jschramm@minotdailynews.com Edith Christenson of Minot had tried various medicines over many years of psychiatric care. Some drugs worked better than others, and some not at all, she recalled. The experimentation required to find the right drugs ended a few years ago when Christenson underwent genetic testing through her provider at Trinity Behavioral Health Services to identify medicines best suited to her DNA. “That really gave us a much more in-depth idea of the kinds of medicines I could tolerate,” Christenson said. “There were quite a few that would not work. I could take them but they wouldn’t do anything.” Now with medicines specifically targeted to her genetic makeup, Christenson said she is doing much better and has persuaded others to
Tonya Anderson
have their genomes tested as well. “I am glad that the doctors have this available. It’s awesome,” she said. Since introducing genetic testing in her practice seven years ago, nurse practitioner Tonya Anderson with Trinity Behavioral Health Services said she’s found patients have a high success rate with initial drugs prescribed. Patients also better understand their treatment plans when they can see why certain medicines are prescribed, said Anderson, who now encourages all her patients to get tested.
“It individualizes every person’s medical plan,” she said. “Truly, medicine is really going in that direction now.” In addition to its use in the mental health field, genetic testing is used to guide more precise cancer treatment and is increasingly being looked at for application across other medical specialties. There are a number of genetic traits and mutations for which tests can screen. Genome testing for mental health purposes focuses on the inherited drug pathways to the liver, where medicines are metabolized. Anderson explained there are several pathways different types of drugs take to the liver. Depending on an individual’s genetics, a pathway might have full or limited access. A pathway might even be absent. That can affect which drugs will work, the proper dosage, frequency and timing. See GENES — Page 7
Health care providers in the area are urging people to get caught up on their shots to protect themselves and everyone around them. “In reality, we’re not at our goal, which is a 95 percent coverage rate,” said Lacey McNichols, RN, First District Health Unit. “(That is) herd immunity. (Ninety five percent) is the magic number you want to keep vaccine preventable diseases from even entering the community. So, if we’re not at 95 percent, we can host an outbreak at any time.” According to state law, children entering school must receive required immunizations or their parents must submit an exemption form indicating that the child will not be immunized for medical reasons or because the parents are opposed to immunizations due to philosophical or religious reasons. McNichol said North Dakota is among the most lenient of states when it comes to vaccine exemptions. At a national level, she said, the trend is to do away with exemptions for philosophical or religious reasons. The state requires that children receive im-
munizations for tetanus, diphtheria, and whooping cough, Hepatitis B, polio, measles, mumps, and rubella, chickenpox, and meningococcal. Children who were not up to date on their shots or did not have an exemption form filed with the school district by Oct. 1 were not allowed to attend school. In most cases, parents had simply neglected to file the necessary forms and kids quickly caught up on their shots and were allowed to go back to school. However, McNichols said there tend to be clusters of people who object to vaccines, both at a national level and in the local area. Clusters of unvaccinated kids can mean certain schools or areas will be more apt to have disease outbreaks. McNichols also urged people of all ages to get vaccinated for the flu before the flu season hits. She said vaccines are covered by insurance and are also available at a free or discounted rate for people who are unable to afford them. McNicols said there is a much greater danger that people will catch a disease and have an adverse reaction or be injured in a car accident on their way to the doctor’s clinic than there is that they will have an adverse reaction to the shots.
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Minot’s new medical marijuana dispensary, Herbology, opened near Dakota Square in September.
Herbology opens in Minot Dispensary provides medical marijuana option to patients By JILL SCHRAMM
Senior Staff Writer jschramm@minotdailynews.com
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ǁ ǁ ǁ͘ Ś Ğ Ă ƌ Ě Ă ŬŽ ƚ Ă ͘ Đ Ž ŵ 1400 37th Ave SW Minot ND 701-852-6565 800-735-5866
Minot’s new medical marijuana dispensary has seen a strong start since opening Sept. 19 near Dakota Square, according to the company’s retail manager. “The momentum behind it has been really great, and how we’ve been received by the community has also been great,” said Talley Wettlaufer, vice president and head of retail for Herbology. “We are excited to build on that and continue to be an active member of the community.” Herbology became a member of the Minot Area Chamber of Commerce and looks to play a role in Minot as it has in other communities. “It’s very common for us to have support groups around medically qualified conditions and do other wellness events,” Wettlaufer said. As of the first week of November, there were 1,662 North Dakotans with qualifying conditions who have been medically approved to purchase marijuana. Wettlaufer said Herbology in Minot sees a wide variety of conditions among people who purchase products. “People are looking for help. A lot of our patients have been just let down by modern medicine and are just in their last place,” she said.
“They’re just trying to figure out how to make themselves feel better. And that’s what we’re here for. We’re there to guide them. We are there to listen. We’re there to have conversations and understand what they’re looking for and what they’re comfortable with and what their issues are and then, based on the staff training and experience, really find some solutions for them. “We’re a place that’s inclusive and wants to help anyone we can. We’ve really been excited to be able to do that and bring people release and help guide them on their journey to figuring that out with cannabis and getting a better quality of life,” she added. The dispensary was designed as a warm, inviting place, with wooden floors, comfortable furniture and vintage prints on the walls. People are initially greeted by a receptionist, who inquires about their conditions and where they are on their medical journeys. They later talk with a staff member within the dispensary, who can work with them to find the best solutions, Wettlaufer explained. There is a wide variety of products from flowers to concentrate to tinctures to lotions. Because medical marijuana is often new to a patient, it can be overwhelming. See HERBOLOGY — Page 7
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Genes
Continued from Page 5
Genetic tests, using just a cheek swab, can prevent the frustrations associated with drug side effects and interactions or drugs that aren’t effective, Anderson said. While valuable in selecting psychiatric medicines, that pathway information also can guide prescription choices for other health conditions. Christenson said her genome information was given to her primary-care provider to help in selecting other medicines she needs. “The testing for psychological and physical health has helped bring those two areas together so that the medicines aren’t fighting one another. I think I’ve a lot more stability with the medications,” she said. Insurance companies will cover genome testing for psychiatric care because it’s been shown the right drug at the right time can significantly save on health care costs, Anderson said. Genomind, the company used by Trinity Behavioral Health, conducted a
study showing health care costs over six months were $1,948 lower in individuals who received its pharmacogenomic testing. Anderson said Genomind offers price breaks for patients without insurance or who are low income. The cost shouldn’t exceed $330 if not covered by insurance, she said. “It will probably be the best $330 you ever paid,” she said. Representatives from Mayo Clinic, who spoke to Trinity physicians and at a public educational event at Trinity in October, said the cost of genetic sequencing has dropped from about $3,000 for nine genes nine years ago to an average cost of around $300 for
more genes today. Depending on the test, a patient may need to submit saliva, blood or a swab from inside the cheek. Medicine that is personalized to the patient isn’t necessarily new, according to Tammy McAllister, operations administrator with the Department of Clinical Genomics and Center for Individualized Medicine at Mayo Clinic. “What’s new is in the last 10 years there’s been great, significant growth in technology and understanding about how our bodies work at a molecular level. This leads to new advancements in diagnostics and informatic approaches that provide understanding of how
the molecular level of our body works, or our DNA. That gives us a stronger lens to explore disease in ways that we haven’t been able to before,” McAllister said. “In 2012, Mayo Clinic created the Center for Individualized Medicine, and it was set as a strategic priority for Mayo to help figure out how to translate that promising science and the technology advancements in the Human Genome Project, and figure out how to use it to benefit our patients,” she said. “The goals of using individualized medicine are really creating a more accurate diagnosis, better therapy selection and better prediction for, hopefully, prevention from diseases.” The human body has trillions of cells, each containing 23 pairs of chromosomes, each with 20,000 to 30,000 genes. “All that material is replicated in almost every cell in our body, and this is what our DNA is,” McAllister said. “It’s an incredible tool. It really gives us so much information, but we have to figure out how to use it to actually help patients.”
for team members that not only have a passion for cannabis but also a real passion about helping people and have real empathy for what our patients are going through.” All Herbology products are North Dakota-grown and processed. “These are large-scale operations that are very focused on safety and quality and creating a natural plant-based medicine,” Wettlaufer said. “It is highly regulated business, and there is a testing and transparency.” On its website, Herbology explains that marijuana works because it contains cannabinoids, which also are naturally found in the human brain and body. The body’s Endocannabinoid System (ECS) is a network of receptors through
pain, memory, mood and appetite. There are two types of ECS receptors. One type acts on the mind and the second type is associated with the immune system. Cannabinoids give the ECS information that helps keep the body in balance and regulate the immune system, according to Herbology. Marijuana contains psychoactive compounds – the most common known as THC. It also contains non-psychoactive compounds and other compounds called terpenes, which also are found in some fruits, herbs or other plants. Different compounds are used to treat differing types of conditions or diseases. However, research has been limited on the efficacy of medical marijuana. Evidence often is anecdotal, which
laufer said. In addition, each patient differs in symptoms and what works, she said. To obtain medical marijuana in North Dakota, residents must have one of 26 qualifying conditions, which include diseases such as Alzheimer’s and cancer and conditions such as migraines, autism or neuropathy. They must obtain a health care provider’s signature and pay a $50 application fee to get an authorization card. Grassroots Cannabis, which received the license to operate Minot’s Herbology dispensary, also has operations in Jamestown and Devils Lake and will be opening in Dickinson. The company has operations in 10 states, opening its initial dispensary in Illinois five years ago.
‘It’s an incredible tool. It really gives us so much information, but we have to figure out how to use it to actually help patients.’ – Tammy McAllister, operations administrator, Department of Clinical Genomics and Center for Individualized Medicine, Mayo Clinic
said. “We start with how the body that regulate systems means individual treatment Herbology laufer we hire, ensuring that you look such as sleep, inflammation may be trial and error, Wett-
Continued from Page 6
“That’s why we’re there to guide you and use our staff experience, our knowledge, to help our patients find the right solution for them. And it’s different for everybody,” Wettlaufer said. “It’s important for our staff to be educated and for our patients to be open with us and have good conversation and honesty and trust, so that we can help help bring release to them.” Herbology employees undergo training on the science of cannabis, cannabinoid indications for different conditions, patient safety and compliance. Minot’s Herbology has 10 employees, recruited from within the community. “People are a really important part of Herbology,” Wett-
PAGE 7 Mayo Clinic is using DNA sequencing to diagnose and treat rare diseases and identify mutations that can help lead to the right therapy to target that mutation. It is using genome information to predict risk and prevent disease. An inherited gene variant associated with cancer, for instance, can be identified within a family, enabling family members to be proactive in their health care. Mayo also offers genome testing to target drug treatment. A few years ago, Mayo did a small study of 1,000 patients and found everyone had one or more variants that might cause them to process medications differently, McAllister said. Because of genetic makeup, some people’s bodies break down certain medications too slowly. The medication builds up in the body, causing severe side effects. Other people’s bodies break down the same medication too quickly, elimi-
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nating it before it has a chance to work at effective levels. Pharmacogenomic testing can identify variations in specific genes related to breaking down different drugs. “Pharmacogenomics is an added tool that clinicians can utilize to improve your medication experience. It is not the magic bullet, but it should be considered when providing the best care for patients,” Mayo pharmacist Eric Matey said. Although he cautioned genome testing won’t answer all questions, he said the science is improving, and more gene connections likely will be found in the future. Matey advises people interested in genome testing to talk with their medical providers. Such consults are important to ensure the desired genes of interest are included on any test panel requested of the laboratory and that complex results are professionally interpreted.
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Planet Fitness opens in Minot By KIM FUNDINGSLAND
Staff Writer kfundingsland@minotdailynews.com It’s called a “judgment free zone” where anyone, from newcomers to established gym fanatics, will feel comfortable regardless of their level of workout. “That’s our main focus. We want people to come in, feel comfortable and really want to come back to the gym,” said Brandon Chrest, Planet Fitness area manager. “We have a great facility here. It’s beautiful.” There’s no arguing that. From the bold colors on the outside of the building to the colorful and new workout equipment inside, Planet Fitness boasts a very friendly appeal. The location is in front of Menard’s at 10 28th Avenue SW, in what formerly was the office supply store Staples. Hours are 12 a.m. Monday to 9 p.m. Friday and 7 a.m. to 7 p.m. Saturday and Sunday. “Besides being new with brand new equipment, we’re hard to beat with our prices,” said Chrest. “We have a monthly membership of $10 a month. A lot of people like to try out the gym with that. It’s really affordable for a lot of people and they can come back every day.”
For those who desire extra benefits, Planet Fitness offers a “black card” membership that includes a number of extra amenities. Those extras include use of standing and lie-down tanning facilities, unlimited guest passes, soothing hydro-beds, massage chairs and use of any of 2,000 Planet Fitness centers worldwide. Planet Fitness welcomes people of all age who wish to work out and improve their health. A certified trainer is on staff to help establish a workout regimen compatible with any need or physical ability. “We do focus on all age groups,” said Chrest. “At my Bismarck gym we have people 85-plus years old that come in every day. They do little workouts, do the hydro massage or massage chairs and then they are out. It’s fun to see all the people come in.” Planet Fitness offers a variety of classes for those who prefer to workout with others under the direction of a trainer and at a level with which they are comfortable. There’s also treadmills, stair steppers, free weights and several other machines designed for whatever challenge a person would like to do. “It’s all new Matrix equipment. It’s great stuff,” remarked Chrest. “I’d love to have my Bismarck gym updated like this.”
Kim Fundingsland/MDN
A woman watches television while utilizing one of approximately 50 new treadmills at Planet Fitness. The colorful fitness center has a wide variety of machines and equipment to accommodate virtually any workout regimen for people of all ages and abilities.
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