HealthWatch Magazine Feb 2016

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CROSBY — There are few greater frustra-

tions in life than not being able to reach your

healthcare provider.

Whether it’s a prescription that needs re�lling, tracking down medical records or test result infor-mation or even just asking a simple health-related question, reaching out to health care providers often feels overwhelming and unrequited.

Cuyuna Regional Medical Center is out to change that.

Last May, CRMC switched their medical record management software to Epic, a system allowing con-trolled patient access to the same medical records their doctor uses.

Epic works with MyChart, a browser and mobile ap-plication giving patients round the clock access to their own secured medical records. Patients create their own secured-login to access their MyChart account. Then they can view and cancel upcoming appointments, ac-cess test results, medical records, request prescription

re�lls, view a child’s records, manage care for elderly parents, view visit summaries and even email their own health care providers directly.

Patients can also view their statements, billing in-formation and account balance with CRMC and make payments through MyChart.

They also have access to a downloadable record to be shared with another provider as needed.

MyChart is available on both browser and app for Apple and Android, providing access from anywhere.

Soon users will be able to request a new appoint-ment through MyChart.

“It has been really well received by our patients,” said Julie Iten, registration and scheduling supervisor at CRMC. “They’ve really embraced it.”

Iten said natural concerns about the security of re-cords have drawn some hesitancy, but Iten compared the security of MyChart to online banking. Patient con�-dentiality is the No. 1 concern at CRMC, Iten said, “We take that very seriously.”

On the provider side, Iten said CRMC doctors and nurses have embraced the use of MyChart. “It’s a nice

way to interact with patients in real time,” she said. Doctors can follow up with patients after appoint-

ments to provide test results, further explanation on medication prescribed or to make sure a patient clearly understands their treatment plan.

“It’s that extra level of contact,” Iten explained. Iten also noted that the nursing staff has access to their pro-viders’ charts providing an extra set of eyes on every-thing.

Iten said MyChart and Epic have come with a learn-ing curve for all involved including a great deal of edu-cation for providers, but CRMC is committed to better-ing the way it interacts with its patient population “It’s a great service,” she said. “That is widely recognized.”

Iten noted that CRMC anticipated a greater patient response from younger patients who tend to be more comfortable with electronic communication, but all patient demographic groups have embraced the new system.

“We want our patients to feel connected and in con-trol of their own health,” she said. “That’s the biggest goal.”

By SARAH NELSON KATZENBERGER Editor

My ChartCUYUNA REGIONAL MEDICAL CENTER GIVES PATIENTS BETTER ACCESS TO RECORDS

SARAH NELSON KATZENBERGER

My ChartTO RECORDS

CROSBY — There are few greater frustra

By By SARAH NELSON KATZENBERGER

My ChartCUYUNA RUYUNA RUYUNA EGIONAL M


tions in life than not being able to reach your

healthcare provider.


3

ContentsPublisher • Pete Mohs

Advertising • Susie Alters and Phil Seibel

Editor • Sarah Nelson Katzenberger

Art Direction/Design • Jan Finger

Contributing Writers

Sheila Helmberger • Jodie Tweed • Joshua Kempf, DO • Sarah Nelson Katzenberger • Jenny Holmes

Health Watch is a quarterly publication of the Brainerd Dispatch.

Read Health Watch online at www.brainerddispatch.com

For advertising opportunities call Susie Alters at 218-855-5836.

Email your comments to [email protected] write to:Brainerd DispatchP.O. Box 974Brainerd, MN 56401

My Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2CRMC gives patients better access to records . . . . . . .By Sarah Nelson Katzenberger

Essentia Health Family Birthplace. . . . . . . . . . . . . . . . . . . 4Recognized as ‘Baby-Friendly’ . . . . . . .By Essentia Health-St. Joseph’s Medical Center

Teen Depression. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Watch for the warning signs . . . . . . . . . . . . . . . . . . . . . . . . By Jodie Tweed

So fresh and clean. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Woman’s mission provides healthy makeup line for women . . . . . . . By Jenny Holmes

CentraCare Kidney Program at Essentia Health . . . . . . . . . 10Provides lifeline for dialysis patients . . . . . . . . . . . . . . . . By Sheila Helmberger

International Medicine . . . . . . . . . . . . . . . . . . . . . . . . 12CRMC OB nurse changes lives in Haiti . . . . . . . . . . By Sarah Nelson Katzenberger

‘It just hurt really bad’ . . . . . . . . . . . . . . . . . . . . . . . . 14Appendicitis sidelines hockey player. . . . . . . . . . . . By Sarah Nelson Katzenberger

Osteopathic Medicine . . . . . . . . . . . . . . . . . . . . . . . . 15A Healthy Touch of Medicine . . . . . . . . . . . . . . . . . . . By Joshua Kempf, DO

Cover illustration by Jan FingerCover illustration by Jan Finger

Table of

4

Alissa Lindner has learned no two

births are alike and that experienced

nurses are a laboring mother’s best

friend.

When her son was born two years ago, Alissa labored for nearly 12 hours. She labored a little over two hours with her daughter, who was born just 13 minutes after Alissa arrived in the Family Birthplace at Essentia Health-St. Joseph’s Medical Center on Oct. 14.

Alissa’s surprise at such a fast labor dissolved after Lily was born and she held her daughter skin-to-skin, sharing the experience with her husband, Dan. “When they laid Lily on me, that was the coolest part,” she recalls. “She was there. It was painful but she made it all OK. I just felt really content.”

One of Alissa’s memories will be the �rst night she spent with her daughter. “I felt better and more comfortable with her on me — it was the most comfortable feeling ever,” she remembers.

Alissa appreciates that Lily wasn’t bathed or measured until she decided to take a shower the next morning. Lily didn’t have to leave the room, which was different than when her son Jack was born and she was encouraged to send him to the nursery so she could rest.

The change is a result of aligning care of mother and newborns to achieve “Baby-Friendly” designation that aims to provide the gold standard of care, explains Dr. Alicia Prahm, an obstetrician and gynecologist with Essentia Health.

Skin-to-skin contact helps mother and baby transition from the birth. “Babies are surprised at their entrance into the world after birth and they’re crying and screaming. Then we give them skin-to-skin contact on mom’s chest,” says Jill Lechner, a registered nurse who cared for Alissa and Lily. “Babies instinctively know it’s all right. They smell their mothers and look at them. They calm down.”

Mothers have the same reaction, which helps regulate their vital signs. “Mothers begin bonding with their babies,” Jill explains. “They begin breastfeeding quicker and get a better start. It’s absolutely beautiful to watch. Baby gets to know Mom, Mom gets to know baby and they know what to do together.”

Alissa says Lily picked up breastfeeding from the beginning while she and Jack had a

few problems that a lactation counselor helped solve. She also noticed that nurses didn’t offer her a paci�er for Lily as they did with Jack, which is another strategy for successful breastfeeding.

While breastfeeding aids bonding, the nurses know not all mothers want to breastfeed and respect that decision. They encourage mothers to have skin-to-skin contact, talk with their babies and learn the babies’ cues that they’re hungry or need affection. Keeping mother and baby together throughout their hospital stay strengthens their bond.

Essentia Health-St. Joseph’s Medical Center has earned international recognition as a “Baby-Friendly” birth facility. The designation means its Family Birthplace offers the gold standard in care for mothers and babies.

The Baby-Friendly Hospital Initiative is a global program sponsored by the World Health Organization and the United Nations Children’s Fund. It recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding.

“We’re achieving the international best practice and standard of care for mothers and babies,” said Prahm, an Essentia Health obstetrician/gynecologist. “It is well recognized that hospital practices in the �rst hours and days after birth make a difference in breastfeeding success.”

Prahm said national health leaders, including the surgeon general, rank breastfeeding as a top health initiative, like cancer screening and reducing rates of obesity and smoking. The federal Centers for Disease Control are tracking the number of “Baby-Friendly” hospitals as part of its assessment of community health.

Based on the “Ten Steps to Successful Breastfeeding,” this Baby-Friendly award recognizes birth facilities that offer breastfeeding mothers the information, con�dence and skills needed to successfully initiate and continue breastfeeding their babies.

Essentia Health-St. Joseph’s Medical Center is the only facility north of the Twin Cities to earn the international award. Only nine facilities in Minnesota have achieved the designation after a rigorous on-site survey.

To learn more about prenatal care and obstetric services at the Family Birthplace, go to EssentiaHealth.org/MatchOB.

By ESSENTIA HEALTH-ST. JOSEPH’S MEDICAL CENTER

Essentia Health Family BirthplaceR E C O G N I Z E D A S ‘ B A B Y - F R I E N D L Y ’Alissa Lindner has learned no two

births are alike and that experienced

nurses are a laboring mother’s best

friend.

5

Essentia Health’s cancer experts are here to make sure that the best care is available close to home, family and friends.

Dr. Laura Joque

EssentiaHealth.org/BrainerdCancerCenter

EssentiaHealth.org

Essentia Health’s cancer experts are deeply committed to caring for cancer patients in the Brainerd Lakes Area. From participating in community events to raise awareness about the importance of cancer screenings to raising money that directly impacts the patients we care for, we are here with you in every way.

Our team consists of oncology and hematology providers, specialized surgeons, radiologists and pathologists, dieticians, specialized nurses and therapists, a nurse navigator, social worker, clinical research nurse, and so many more. We understand that patients want personalized care and we are here to make sure that the best care is available close to home and close to family and friends.

The Essentia Health Cancer Center team continues to demonstrate a commitment to delivering the highest level of cancer care to patients and families. Our Center is certified, accredited and recognized by the following:

When it’s cancer, we’re here with you every day. Close to home.

From left to right:Missy Laposky, RN, BA, OCN;Laura Joque, MD; Barb Morris, RN, BSN, OCN; Aby Z. Philip, MBBS andJessica Nybakken, AOCNP

“I take whatever comes my way, and I stay positive.”

EssentiaHealth.org






– Ramona B., Brainerd

Early detection has helped Ramona survive not one, but two cancers. Like most people diagnosed with lung cancer, the tumor in Ramona’s left lung was discovered when she had an X-ray for another condition.

Until recently, there was no screening test for lung cancer. Low-dose CT scans are now being o ered for people ages 55-77 who are long-time smokers and therefore at high risk for developing lung cancer.

To schedule a lung cancer screening, you need to �rst meet with your primary care physician to determine if you meet the criteria and to discuss the risks and bene�ts of a low-dose CT scan. To make an appointment with your primary care provider, call 218.828.2880.

Dr. Anusha Madadi Dr. Aby Philip

Missy Laposky, RN, BA, OCNClinical Patient Navigator

Jessica Nybakken, AOCNP

EssentiaHealth.org






EssentiaHealth.org






Erin Kennedy, RN,Clinical Patient Navigator

6

By JODIE TWEED Contributing Writer

• Illustration by Jan Finger

TEEN DEPRESSION—

When teenagers commit suicide, their

parents and friends are left behind in

grief and with unanswered questions.

Unfortunately, many teens who suffer from depression often don’t ask for help. Untreated depression is the No. 1 cause of suicide. More than 90 percent of people who died by suicide were struggling with a mental illness at the time of their death.

Kenneth Fogal, a licensed psychologist at Cuyuna Regional Medical Center in Crosby, works with many teens, as well as adults, struggling with depression. Fogal said he sees many teens today who are struggling with anxiety due to external pressures to be “perfect” in school and/or with their external appearance. They may be dealing with family problems or are being bullied or harassed at school or on social media networks, often without their parents or teachers knowing.

Fogal said social media has changed how teens are bullied. Teens may not be physically bullied at school. Instead, bullying takes a different, more invasive form, often through text or Snapchat messages — which make it easier to bully without being identi�ed.

“They often don’t think anybody can help,” Fogal explained. “Life can be dif�cult for all of us, but in the adolescent world, especially. They can become isolated and withdrawn, and that’s a big warning sign.”

One of Fogal’s patients, a 16-year-old girl being treated for depression and for cutting herself, said she was always afraid to say something about the bullying and harassment she was experiencing from other teens. Instead, she internalized her pain.

“I’ve never really gone to a teacher for help,” she said. “I felt alone. I couldn’t talk to anybody about it. I felt like nothing could be done.”

She said most teens don’t talk to others about how they feel.

“Keeping it bottled up really hurts you. I know that for sure,” she said.

Fogal said the teen began therapy about three months ago. As a result, she’s no longer harming herself and is working on building her own personal empowerment skills. She is learning how to love and respect herself and identify skills and strategies to deal with con�ict. Life is beginning to turn around for her.

“She’s feeling stronger and empowered with therapy,” Fogal said of his 16-year-old patient. “She has also reached out more with her mom for support.”

Fogal said many parents tell him that their teens won’t talk to them, and they’re not likely to open up to a therapist. This is not always true. Fogal said he’s had teens seated in his of�ce, slumped down in their chairs, arms crossed and their sweatshirt hoods pulled over their heads, angry that they’re being forced to be there. It may take 10 minutes or maybe even a couple of sessions, but they almost always open up, sharing their pain and struggles. Sometimes they may need a neutral party to come forward and offer advice and support.

“Take the time to ask the questions. Listen. If you know something is wrong, get some help,” Fogal said. “Get them in, even if they don’t want to.”

Fogal recommends starting with the school counselor, or another adult that you feel they can connect with, whether it is your pastor or an adult relative, someone who can offer support and direction.

“A lot of adolescents are not going to talk to their parents about this stuff,” he said. “Yet, by making the extra effort to listen and spend quality one-to-one time with your teens can make all the difference. Encouragement, keeping open communication and creating an environment which fosters love and trust can go a long way.”JODIE TWEED, a former Brainerd Dispatch reporter, is a freelance writer and editor who lives in Pequot Lakes.

Watch for the WARNING SIGNSWhen teenagers commit suicide, their

parents and friends are left behind in

grief and with unanswered questions.

Unfortunately, many teens who suffer from

7

Depression in Teens: Warning Signs

Sometimes it is dif�cult to determine whether your teen’s emotions and behaviors are all just part of being a teen or the result of depression. If you’ve noticed any of these emotional

and behavioral changes in your teen, or anyone in your life, talk to them. If depression is interfering in their life, get them some help. Depression won’t get better on its own, and it may lead to other problems if left untreated. Teens can be at risk of suicide even if signs and symptoms don’t appear to be severe.

� LOOK FOR THESE EMOTIONAL CHANGES• Feelings of sadness; which may include crying for no

apparent reason.• Feeling hopeless or empty.• Acting irritable or annoyed.• Exhibiting frustration or anger, even over small problems.• Loss of interest or pleasure in normal activities.• Low self-esteem.• Feelings of worthlessness or guilt.• Fixation on past failures or exaggerated self-blame or self-

criticism.• Extreme sensitivity to rejection or failure, and the need for

excessive reassurance.• Trouble thinking, concentrating, making decisions and

remembering things.• Ongoing sense that life and the future are grim and bleak.• Frequent thoughts of death, dying or suicide.

� WATCH FOR THESE BEHAVIORAL CHANGES• Tiredness and loss of energy.• Insomnia or sleeping too much.• Changes in appetite, either decreased appetite and weight

loss or increased food cravings and weight gain.• Use of alcohol and drugs.• Agitation or restlessness.• Slowed thinking, speaking or body movements.• Frequent complaints of unexplained body aches and

headaches, which might include frequent visits to the school nurse.

• Social isolation.• Poor school grades or frequent absences from school.• Neglected personal appearance.• Angry outbursts, disruptive or risky behavior, or other ways

of acting out.• Self-harm, such as cutting, burning or excessive piercing or

tattooing.• Making a suicide plan or a suicide attempt.

Information provided by Mayo Clinic.

Need someone to talk to? Call the Crisis Line and Referral Service

The Crisis Line and Referral Service was established in 1988 in response to an alarming increase in the suicide rate in Crow Wing County. It is a 24-hour crisis line that serves people in Crow Wing, Cass, Aitkin, Morrison, Todd and Wadena counties. It is meant to help people when they are in a crisis or before their problems become a crisis. You can also call for a referral for resources in the Brainerd lakes area and surrounding counties. If you need help or support, call the Crisis Line and Referral Service at 800-462-5525 or 218-828-HELP (4357).

8

PEQUOT LAKES — Having grown up

the daughter of a farmer, Joanie Weg-

man has always had an appreciation

and respect for nature. Calling herself

a “country girl,” Wegman strives to sur-

round herself with all things healthy and

natural – both personally and profes-

sionally.

Nine years ago, Wegman and husband Adam moved to the lakes area to purchase a historical building on Main Street in Pequot Lakes. What originally was home to a church and later a cof-fee house, was renovated into a wellness salon and spa.

“When we �rst walked into this place, I knew it was going to be the salon,” Wegman said, look-ing around at the ornate features of the 109-year-old structure. Ironically, the grand opening of J’Amelia Wellness Spa and Salon was also the building’s centennial.

Wegman offers full service spa and salon ser-vices, including massages in the church’s old choir loft and a variety of spa services including facials, body wraps, haircuts, hair color, mani-cures and pedicures. Her personal specialty is special event hair and makeup. She styles roughly 30 weddings each year.

In keeping with organic products for her cli-ents, Wegman said she began to research make-up lines with clean, pure ingredients but, after months of searching, came up empty handed.

“I just couldn’t �nd lines that did what I want-ed them to do as far as performance,” Wegman noted. “Having a wellness salon and spa, I have a goal to bring healthy, clean lines to people. Our Eufora shampoo line was the start of it, but I couldn’t �nd that in makeup.”

By JENNY HOLMES Contributing Writer

PEQUOT LAKES WOMAN EMBARKS ON A MISSION TO PROVIDE NATURAL MAKEUP LINE FOR WOMEN

So fresh clean

Joan Wegman applies natural make up to a client at

her salon and spa, J’Ameilia, in Pequot Lakes.

a goal to bring healthy, clean lines to people. Our Eufora shampoo line was the start of it, but I

Joan Wegman applies natural make up to a client at Joan Wegman applies natural make up to a client at

her salon and spa, J’Ameilia, in Pequot Lakes.her salon and spa, J’Ameilia, in Pequot Lakes.

PEQUOT LAKES — Having grown up

the daughter of a farmer, Joanie Weg

man has always had an appreciation

and respect for nature. Calling herself

001365103r1

Instead, Wegman opted to create her own line that combined performance with purity — products she felt good offering her clients. After four months and exploring 25 different manufacturers, Wegman found a reputable company she would partner with to create and customize her product line of makeup and skin-care.

From ingredients gathered in Italy, down to the packaging, Wegman was able to hand pick and per-sonalize this labor of love. J’Amelia’s Botanical Min-eral Makeup and Skincare is “gluten free, dye free, paraben free, everything free. But still performs,” Weg-man said.

After a four-month production process, the line was released to the public, sold in her spa and salon, as well as online at cherrypicksmakeup.com. Weg-man said she and husband Adam came up with do-main name ‘Cherrypicks’ since ingredients are cherry picked or chosen exclusively.

“The response has been amazing,” Wegman said, noting she is currently shipping throughout the coun-try, including Hawaii.

Her website allows women to complete a pro�le to help them get exactly what they want and need for their individual skin types.

Items in the makeup line include foundation, min-eral eye shadows, all-in-one applicator for loose pow-der foundation, lip gloss, eyeliner, cream cheek rouge, bronzer, skin tone balancing foundation, baked trio eye shadows with moisture, self-adjusting colors, and mas-cara. For skin care, Wegman offers cleansers, toners, serums, scrubs, masks and moisturizers. All are avail-able for women with sensitive skin, combination skin or those looking for products with anti-aging properties.

“My passion is for offering women amazing prod-

ucts that aren’t full of chemicals that will harm them. I’m really health conscious about what goes into our bodies and how it affects us. If I’m going to offer and stand behind a product that I know is full of chemicals — I just can’t do it. Yes, this is a business but that’s not where my heart is.”

The makeup and skincare lines are created for women of all ages, skin colors and types. Wegman said ingredients are botanically based, including rose-mary, lavender, thyme, and green tea; all created to treat a woman’s skin as she wears them.

“Wellness is overlooked in this industry. So I feel that’s part of what I’ve been called to do. It’s a perfect combination. Many women react to chemicals in a typical salon. Allergies prohibit women from wearing makeup. This is something they can �nally try.”

Wegman said she also wanted to create lines that are easy for women to apply, knowing many women who admit they don’t know how to wear makeup the “right way.”

“It’s not complicated makeup. I wanted to target people that I know were struggling. I would hear that a lot: ‘I just don’t know how to put makeup on.’”

Wegman also posts start-to-�nish makeup applica-tion videos on her website and Facebook page, The Hairstylist Homesteader, offering tips and tricks for colors and effects.

“Beauty comes from the inside,” Wegman said. “But sometimes it starts for women to be able to grow in other areas. They believe things they’ve heard be-fore — that they’re ugly or not enough.

“Women want to feel beautiful. It’s more about bringing out beauty and empowering them to be who God created them to be, not comparing themselves to other women, but being beautiful in their own skin.”

Pequot Lakes resident Joanie Wegman launched a

wellness salon and spa and just recently has added

her own line of clean beauty products.

Pequot Lakes resident Joanie Wegman launched a

wellness salon and spa and just recently has added

her own line of clean beauty products.

10

This morning I had three

cups of coffee. This afternoon

I had a soda with ice and a

decent sized glass of orange

juice in hopes of �ghting a

cold I feel coming on. I had

another glass of water after

that and then a glass of wine

with dinner and then anoth-

er cup of coffee after. These

were not options for my own

mother, who spent seven

years on dialysis before she

passed away.

Seven years of tri-weekly trips to a dialysis clinic where needles were always a part of the process and she was forced to limit her beverage in-take every single day, lest she go in to her next appointment with too much �uid that would make her feel like she was suffocating. It was a tall order for a lifelong lover of coffee and a lady who could appreciate a cold can of soda — basic pleasures I am acutely aware I take for granted.

Knowing that she would need dialysis for the rest of her life was not news my mom welcomed. Years of medication for other ailments took a toll on her kidneys. Traveling to a facility three times a week to be hooked to a machine for three hours each visit, meant the people she saw there became another fam-ily. The nurses and other patients there became an important part of

By SHEILA HELMBERGER Contributing Writer

CentraCare KIDNEY Program at Essentia Health provides LIFELINEThis morning I had three

cups of coffee. This afternoon

I had a soda with ice and a

decent sized glass of orange

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my parents’ lives. They celebrated birthdays, holidays

and one another’s good news and bad news. Besides accounting for her �u-id intake, my mother, depending on whether it was the day before, the day of, or the day after a dialy-sis treatment, would feel exhausted, energetic and in acute pain from cramp-ing.

Sitting with her while her blood snaked in and out of tubes was always hard to watch, but the treatments gave us seven more years. The kidneys, it turns out, have very impor-tant jobs.

Although most people don’t even know it’s there, the CentraCare Kidney Pro-gram, located at the Essentia Health St Joseph’s-Brainerd Clinic, has been providing comprehensive kidney care for patients and those in end-stage renal disease in the Brainerd area for over two decades.

Comprised of a team of physicians, nurses, dieticians, social workers and administrative staff, the work they do is no doubt as valuable to their pa-tients and their families as my mother’s dialysis team was to us.

A kidney doctor is called a ne-phrologist. This past summer, Essentia Health added nephrologist Dr. Dipal Patell to their staff. She sees patients at the Brainerd Clinic. The medical direc-tor for the CentraCare Kidney Program is Board Certi�ed Nephrologist Chad Haroldson, MD.

“The CentraCare Kidney Program has developed a patient-centered team approach, utilizing the latest medical

technology, capitalizing on the skills of a multidisciplinary kidney team all the while symbiotically working closely with the physicians, advanced practice providers and nurses at Essen-tia Health,” explained Dr. Haroldson.

The dialysis center at the Brainerd Clinic is a very busy place. Over 70 patients are seen for at least thrice weekly dialy-sis appointments. Some patients are lucky and the treatment is temporary or until a transplant can be done. Other health issues meant my own mother was not a candidate for a transplant, and one lo-cal patient in Brainerd has been on dialysis for more than 30 years.

Dialysis is done through a machine that works as an arti�cial �ltration sys-tem for your blood to remove waste and excess water when your kidneys can’t do the job.

During my mother’s time on dialy-sis we learned how critical the work of kidneys truly is, how well hydrogen peroxide removes blood from clothing and other items when her port would leak, and how important a good dialy-sis family is in making a bad experi-ence just a little bit easier.

The kidneys are also responsible for producing important hormones to control blood pressure, blood cell production and bone health. Hemodi-alysis uses an access point that is put in the arm during a surgical procedure and the dialysis machine pumps the blood out and through the dialyzer and returns the cleaned blood back into the body.

Hemodialysis patients also take medications to replace hormones their kidneys can no longer create. Perito-neal dialysis uses the blood supply in the large lining of your abdominal cavity. An access point is put into the abdomen and a solution called dialy-sate is sent to the midsection to absorb the waste and extra �uid and drains it out of the catheter. These patients may also need medications to replace hor-mones the kidneys no longer generate.

Patell says she chose nephrology for many reasons, “Mostly because it’s so interesting to me,” she said, “and man-aging the complexity of patients with kidney disease really keeps me on my toes. I love the detailed thought pro-cesses that go into caring for these pa-tients. My goal is to treat my patients the way I would treat my own family members and to do whatever it takes to provide them with the best possible care.”

Healthwatch

contributor Sheila

Helmberger (right)

with her mother.

Her mother died

last fall after spend-

ing seven years on

kidney dialysis.

Healthwatch

contributor Sheila

Helmberger (right)

with her mother.

Her mother died

last fall after spend

ing seven years on

kidney dialysis.

of, or the day after a dialy-sis treatment, would feel exhausted, energetic and in acute pain from cramp-

Sitting with her while her blood snaked in and out of tubes was always hard to watch, but the treatments gave us seven more years. The kidneys, it turns out, have very impor-turns out, have very impor-turns out, have very impor

Although most people

the Brainerd Clinic is a very busy place. Over 70 patients are seen for at least thrice weekly dialysis appointments. Some patients are lucky and the treatment is temporary or until a transplant can be done. Other health issues meant my own mother was not a candidate for a transplant, and one local patient in Brainerd has DR. DIPAL PATELL

Hagestuen examines an infant at a mobile clinic in Pignon, Haiti.

Hagestuen has traveled to Haiti since 2006 to help treat patients

and train medical staff.

12

CROSBY — Delivering a baby is a life

changing experience no matter where it

takes place. For most women in the U.S.,

childbirth involves a controlled, sterile

environment with plenty of medical

personnel present and the tools and

technology necessary to ensure the safest

delivery possible.

This is the environment Cuyuna Regional Medical Center (CRMC) OB nurse Kelly Hagestuen works in everyday. And she loves it.

Hagestuen’s passion for her everyday work is what has compelled her to share her expertise abroad so that women with less privilege have the same chance of health pregnancy, safe delivery and full recovery from childbirth.

Since 2006, Hagestuen has traveled to Haiti nine

times help educate and empower Haitian health care providers to improve the care provided to mothers and babies.

“We really feel like we can make a huge difference,” Hagestuen said.

On her �rst two trips to Haiti Hagestuen traveled with a surgical team to the city of Pignon.

Not trained as a surgical nurse, Hagestuen said she most spent her time teaching nurses how to provide recovery care after surgery and what kinds of things to watch for post-operation.

“Instead of just throwing patients in a room after surgery and letting them wake up when they wake up, the goal is to provide that extra education,” Hagestuen said, “And to listen to their stories.”

Hagestuen was so moved by the stories shared, she said she knew she wanted to do more.

“There’s just such an incredible need,” Hagestuen said. “I came home saying, ’This is something I want to do.”

Feeling like she would be more effective in an OB educational setting, Hagestuen said she searched the

Internet for medical missions opportunities in Haiti and came across an organization called Midwives for Haiti.

“I contacted them and just said, “I’m an OB nurse — I’m not an OBGYN, I’m not a midwife — but is there anything I could possibly do,” Hagestuen recalled. “Three days later I got a phone call.”

Since 2010, Hagestuen has traveled to Haiti to serve with the Midwives for Haiti, whose goal is pro-vide education on life saving intervention from pre-natal care, delivery and postpartum care. The effort was just getting off the ground and Hagestuen said initial efforts involved working with mobile clinics to provide medical supplies to villages.

The organization is also a school that prepares Haitian women to become midwives and skilled birth attendants as a greater effort to decrease the infant and mother mortality rate from preventable complications. Things like postpartum hemorrhaging can quickly lead to tragic loss.

“But we can teach them how to stop (hemorrhag-ing) or understand when to intervene — that means

International medicine —CRMC OB NURSE USES EVERYDAY SKILLS TO CHANGE LIVES IN HAITI

CROSBY — Delivering a baby is a life CROSBY — Delivering a baby is a life

changing experience no matter where it

takes place. For most women in the U.S.,

childbirth involves a controlled, sterile

Hagestuen examines an infant at a mobile clinic in Pignon, Haiti.

Hagestuen has traveled to Haiti since 2006 to help treat patients

and train medical staff.

CROSBY — Delivering a baby is a life times help educate and empower Haitian health

CRMC OB NURSE USES EVER


YDAY SKILLS


Cuyuna Regional Medical Center OB nurse Kelly Hagestuen treats patients at a

mobile clinic in Pignon, Haiti.


Cuyuna Regional Medical Center

OB nurse Kelly Hagestuen treats

patients at a mobile clinic in Pignon,

Haiti. Hagestuen has traveled

to Haiti since 2006 to help treat

patients and train medical staff.

Cuyuna Regional Medical Center

OB nurse Kelly Hagestuen treats

patients at a mobile clinic in Pignon, Cuyuna Regional Medical Center OB nurse Kelly Hagestuen (back row, center) along with clinical nurse educator Lisa Slepica (bottom left) served alongside a medical team in Haiti. Hagestuen and Slepica plan to return to Haiti later this spring.

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life,” she said. Hagestuen said what she loves most

about working with Midwives for Haiti is they way they educate and empower nationals to take on the responsibility for themselves. Every graduate from Mid-wives for Haiti is employed either in a hospital or rural setting.

“They’re not just going in and doing it for them,” she said. “They educating them in skills that are very basic, but they teach them to use them in a safe manner.”

Hagestuen said in her time in Haiti she has witnessed the repercussions of poor birthing environments with unsanitary surgical conditions, rusted, out-dated equipment, and uneducated mothers with little recovery support. “It can be so devastating, but the goal is to teach them that it doesn’t need to be,” she said.

Hagestuen recalled one experience when she was in the operating room where a cesarean-section was to be performed. Before the operation began, the doctor turned on the air conditioning unit and dust �ew throughout what should have been a sterile environment

“Thankfully, things have changed since then,” Hagestuen said.

Often times, something as basic as access to care can be a challenge for Haitians. Women might have to walk

miles through rough terrain and extreme climate just to get to a prenatal visit making normally monitored issues like preeclampsia and high blood pressure a much greater risk factor.

“It’s much easier if we can go to them,” Hagestuen said.

Midwives for Haiti visits remote villages in its neon pink mobile clinic to take care to the women to cut back on the unnecessary increase in risk due to environmental factors.

On Jan. 12, 2010, the day Haiti was devastated by a massive 7.0 earthquake, Hagestuen said she has a very clear memory of what she was doing when she heard the news.

“I was packing,” she said. “I was set to go three days later.” Hagestuen said all that ran through her head was how fast she could get to Haiti and what she could do to help. “I know these people — these are friends,” she said. Three weeks later, Hagestuen was able to get to Haiti to help.

“Their need for care continued,” she said.

Hagestuen has returned to Haiti every year, except for 2015, “It killed me not to go,” she said.

Hagestuen along with CRMC clinical nurse educator Lisa Slepica plan to re-turn to Haiti later this spring. Hagestuen said though she’s returned so often each

trip really puts things into perspective. “You get so much more back than you even give,” she said. “We are incredibly blessed by what we have here.”

Cuyuna Regional Medical Center OB nurse Kelly Hagestuen (back row, center) along with clinical nurse educator Lisa Slepica (bottom left) served alongside a medical team in Haiti. Hagestuen and

Cuyuna Regional Medical Center OB nurse Kelly Hagestuen is pic-tured with school children in Haiti. Hagestuen has traveled to Haiti since 2006 to help treat patients and train medical staff.

You get so much more back than you even give. KELLY HAGESTUEN

BREEZY POINT— For 10-year-old Logan

Verville, hockey is life.

He’s been skating since he was 3, his dad, Steve, is a former player and coach and his younger brother, Wy-att, 7, is also a hockey player.

“I like to score a lot,” Logan said from the rink he’s been practicing at since he �rst learned to skate. “And I just like to be on the ice.”

After scoring three goals in a home game last October, Logan’s mom, Diana Verville, said her son came home complaining his hip was hurting. Chalking the pain up to a hard fought game and typical post game soreness, Diana sent Logan to bed to get some rest.

By morning, Logan was still in pain and told his mom he was worried about causing further injury at school and in gym class.

“It just hurt really bad,” Logan recalled. With Logan

being such an avid student and athlete, his parents knew it wasn’t like him to want to stay home from school. “I’m not really the mom who makes a big deal out of sick kids,” Diana said. “We don’t do a lot of meds. It’s just got to run its course.”

With no fever, and no other real symptoms, Diana sent Logan back to bed, but she said she knew something was off.

And she was right. Though he put on a brave front, Logan’s appendix

had ruptured, something Diana has �rst hand experi-ence with. Her own appendix ruptured when she was 7. “It was in the back of my mind for sure,” Diana re-called looking at Logan. “But you were just so tough.”

Most cases of appendicitis occur between the ages of 10 and 30 and there is added risk for boys and men with family history of the illness.

Logan was a prime candidate.

By SARAH NELSON KATZENBERGER Contributing Writer

Logan and Wyatt Verville take center ice at

the Breezy Point Ice Arena recently.

Photos by Steve Kohls • [email protected]

APPENDICITIS SIDELINESHOCKEY PLAYER

14


• Sudden pain that begins on the right side of the lower abdomen.

• Sudden pain that begins around your navel and often shifts to your lower right abdomen.

• Pain that worsens if you cough, walk or make other jarring movements.

• Nausea and vomiting.• Loss of appetite.• Low-grade fever that may worsen as the

illness progresses.• Constipation or diarrhea.• Abdominal bloating.

Appendicitis is an in�ammation of the appendix, a �nger-shaped pouch that projects from your colon on the lower right side of your abdomen. The appendix doesn’t seem to have a speci�c purpose.

Appendicitis causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. As in�ammation worsens, appendicitis pain typically increases and eventually becomes severe.

Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.

SYMPTOMS OF APPENDICITIS• Sudden pain that begins on the right side

of the lower abdomen.• Sudden pain that begins around your

navel and often shifts to your lower right abdomen.

• Pain that worsens if you cough, walk or make other jarring movements.

• Nausea and vomiting.• Loss of appetite.• Low-grade fever that may worsen as the

illness progresses.• Constipation or diarrhea.• Abdominal bloating.

Appendicitis is an in�ammation of the appendix, a �nger-shaped pouch that projects from your colon on the lower right side of your abdomen. The appendix doesn’t seem to have a speci�c purpose.

Appendicitis causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. As in�ammation worsens, appendicitis pain typically increases and eventually becomes severe.

Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical



He’s been skating since he was 3, his dad, Steve, is a



He’s been skating since he was 3, his dad, Steve, is a former player and coach and his younger brother, Wy-att, 7, is also a hockey player.

“I like to score a lot,” Logan said from the rink he’s been practicing at since he �rst learned to skate. “And I been practicing at since he �rst learned to skate. “And I just like to be on the ice.”

After scoring three goals in a home game last October, Logan’s mom, Diana Verville, said her son came home complaining his hip was hurting. Chalking the pain up to a hard fought game and typical post game soreness, Diana sent Logan to bed to get some rest.

By morning, Logan was still in pain and told his mom he was worried about causing further injury at school and in gym class.

“It just hurt really bad,” Logan recalled. With Logan

being such an avid student and athlete, his parents knew it wasn’t like him to want to stay home from school. “I’m not really the mom who makes a big deal out of sick kids,” Diana said. “We don’t do a lot of meds. It’s just got to run its course.”

With no fever, and no other real symptoms, Diana sent Logan back to bed, but she said she knew something was off. something was off.

And she was right. Though he put on a brave front, Logan’s appendix

had ruptured, something Diana has �rst hand experi-ence with. Her own appendix ruptured when she was 7. “It was in the back of my mind for sure,” Diana re-called looking at Logan. “But you were just so tough.”

Most cases of appendicitis occur between the ages of 10 and 30 and there is added risk for boys and men with family history of the illness.

Logan was a prime candidate.

Contributing Writer



Photos by Steve Kohls [email protected]

APPENDICITIS SIDELINESHOCKEY PLAYER

‘It just hurt ‘It just hurt REALLY

BAD’

14

By By By By By By SARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERSARAH NELSON KATZENBERGERContributing WriterEditorContributing Writer



Photos by Steve Kohls • [email protected]

PPENDICITISHOCKEY

removal of the appendix.



He’s been skating since he was 3, his dad, Steve, is a former player and coach and his younger brother, Wy

15

The body has an inherent ability to heal

and is truly a re�ection of the master

mechanic, our creator. Unfortunately,

life comes with trauma and disease.

The goal of Osteopathic Medicine is to

�nd any dysfunction, �x it and allow the

body to do the rest of the work.

Osteopathic manipulative treatment consists of numerous forms of hands-on manipulation to the body’s muscles, bones, ligaments, and joints including restrictions that affect the nerves, blood vessels, internal organs and lymphatic system.

For example, cervical and cranial restrictions are often found in people suffering from ear infections, upper respiratory infections, headache, migraine and vertigo. Restrictions in the rib cage and thoracic spine may contribute to or not allow a person to fully heal from pneumonia, bronchitis and other chronic breathing disorders including asthma and COPD.

Pelvic �oor disorders can lead to congestion which can play a substantial role in patients with urinary dysfunctions, prostate disease as well as pelvic pain. Rather than focus only a patient’s disease, Doctors of Osteopathy are trained to take a “whole person” approach toward �nding health.

Osteopathic medicine has been a part of Minnesota history for 120 years. In fact, the third Osteopathic medical school, the Northern Institute of Osteopathy was founded in Minneapolis in 1896 and later merged with the Des Moines Osteopathic medical school. Today there are over 600 Osteopathic physicians practicing in Minnesota.

DOs are fully licensed physicians and along with their MD counterparts, are able to specialize in every medical and surgical �eld. Growing in popularity, there are 30 Osteopathic medical schools throughout the U.S. It is estimated that by the year 2019, one in four graduating physicians will be a DO.

In addition to medicine, DOs learn OMT during four years of medical school and many continue this training during residency.

Osteopaths may even go on to specialize in Neuromuscular Medicine and Osteopathic Manipulative Medicine. Osteopathic physicians with this additional training are well versed in recognizing and often treating patients with a variety of neurologic, rheumatologic, orthopedic and musculoskeletal dysfunctions. One of the

tools available for treating this patient population is osteopathic manipulative treatment as often there is a mechanical component contributing to their disease symptoms.

Osteopaths who specialize in manipulation are able to treat the whole body including restrictions in the head, the chest/rib cage, arms, legs, feet, pelvis/sacrum and along the entire spinal column. Because the body is such a tightly connected network, a restriction in one part of the body can cause dysfunction and pain in another part of the body. A well trained Osteopathic Physician can recognize this important point to make correction of the most restricted area and affect the entire body including the nervous system, the circulation, the lymphatics, through the muscles, ligaments/tendons and bones. It is also important to apply the correct technique that best suits the patient’s particular dysfunction. Everything has to work in harmony for proper health. This includes the mind, body and spirit.

The treatments are unique to each person’s body type, skeletal structure and health goals. Types of Osteopathic techniques include: myofascial, articulatory, muscle energy, indirect and cranial-sacral. Most are gentle but powerful techniques used to restore normal structure and function.

Examples of patients who may bene�t from Osteopathic manipulative treatment include those who experience:• Acute or chronic back and neck pain.• Migraine and headache.• Misshapen head, feeding dif�culties, colic and

torticollis in newborn and pediatric patients. • Joint pain, arthritis and soft tissue sprains and

strains as a result of sports injuries. • Pelvic pain.• Pain during and after pregnancy.

OMT can help restore normal function by relieving dysfunction that is causing or contributing to one’s symptoms and/or disease. This may be one of the best forms of preventative medicine with the least side effects. OMT can promote healing, ease pain, reduce stress by relieving mechanical restrictions in the musculoskeletal system, balance the autonomic nervous system, and improve overall mobility.

DR. JOSHUA KEMPF, DO recently joined the Family Medicine Department at the Essentia Health St. Joseph’s-Baxter Clinic in Baxter, and specializes in Osteopathic Manipulative Treatment. To schedule an appointment with Dr. Kempf, call 218-828-2880. To see his full pro�le, visit EssentiaHealth.org and click on “Find a Medical Professional.”

By JOSHUA KEMPF, DO Contributing Writer

Osteopathic MedicineA HEALTHY TOUCH OF MEDICINE

At the Breezy Point Hockey Arena recently, Wyatt

(left), Diana, Steve, and Logan Verville talk about

Logan’s close call with a ruptured appendix.

Logan was a prime candidate.Diana kept a close eye on Logan and when he

woke up an hour or so later, she put pressure on his lower right abdomen, where he complained of pain the night before. It was still tender and Logan was starting to show other symptoms of appendicitis.

It was time to see the doctor. Diana contacted the Essentia Health Clinic in

Pequot Lakes, but was ultimately sent to the Essentia Health-Baxter Clinic for necessary blood testing.

Logan underwent a blood test and a CT scan to con�rm his appendix had in fact ruptured and he would need emergency surgery — something Logan was not excited about.

“I thought they were going to put weird stuff on me. They told me I had to go to sleep,” he recalled. “I was really scared. I didn’t want to not wake up.”

Logan said he remembers going into the operating room and later waking up to the anesthesiologist showing him a video of a great goal scored by the Minnesota Wild on his phone.

“And I remember I got lots of popsicles,” Logan said.

Appendicitis is fairly common, affecting approximately 1 in 1,000 people in the U.S. and providing the most common need for emergency abdominal surgery in children. However, the statistics provide little comfort for parents of children requiring emergency surgery. Even with her own personal experience with appendicitis, Diana said Logan’s experience was a nightmare. She said it wasn’t until she arrived home after Logan’s surgery that she really came face to face with her emotion. “I just lost it,” she recalled. “You stay strong for the kids — you’re just in mom mode, but of course you’re terri�ed.”

Diana said there was a great deal of peace that came with working with the staff at Essentia who took time to talk directly to Logan and answer all of his questions. “We knew they really cared,” she said.

After his surgery, Logan was eager to get back on the ice, even asking his mom to see if they could schedule his follow-up appointment sooner so his doctor could clear him to play again.

Two weeks later, with a small, but “pretty cool” scar on his abdomen, Logan was cleared to play hockey again. He says his game is still better than Wyatt’s, but Wyatt is quick to point out, “Yeah, but you’re not as good as Dad.”

At the Breezy Point Hockey Arena recently, Wyatt

(left), Diana, Steve, and Logan Verville talk about

Logan’s close call with a ruptured appendix.

The body has an inherent ability to heal

and is truly a re�ection of the master

mechanic, our creator. Unfortunately,

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Documents

HealthWatch Magazine Feb 2016