HealthWatch Magazine: Jan 2013

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Table of

Contents

Who We ArePublisher • Tim BogenschutzAdvertising • Sam SwansonEditor • Sarah Nelson KatzenbergerCover Design • Jan Finger

Contributing WritersJodie Tweed, Jenny Holmes, Sheila Helmberger

Healthwatch is a quarterly publication of the Brainerd Dispatch.

Read HealthWatch online at www.brainerddispatch.com

For advertising opportunities call Sam Swanson at 218-855-5841.

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

DATE WITH A DOCTOR . . . . . . . . . . . . . . . . .Everything you need to know about medical screenings and immunizations By Sheila Helmberger

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A LITTLE TOO SWEET? . . . . . . . . . . . . . . . . . .Brain study shows frutcose may spur overeating Associated Press

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HOW TO SAVE A LIFE . . . . . . . . . . . . . . . . . . .Cuyuna Regional Medical Center works to change cardiac arrest outcomes By Sarah Nelson Katzenberger

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BABY BOOM . . . . . . . . . . . . . . . . . . . . . . . .ICU nurses deliver comfort care — and their babies two at a time By Jodie Tweed

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DO YOU KNOW THE DRILL? . . . . . . . . . . . . . Your medical chart could include exercise minutes Associated Press

FEELING SAD? . . . . . . . . . . . . . . . . . . . . .Seasonal Affective Disorder common in the dark winter months By Jessi Pierce

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FLU? MALARIA? . . . . . . . . . . . . . . . . . . . . .Disease forecasters look to the sky Associated Press

18HEALTHY LIVING THROUGH LIFELONG LEARNING. . .

CLC and Essentia Health partner to make life-long learners of lakes area seniors By Jenny Homes19

STAND ALONE EMERGENCY ROOMS . . . . . . .Hospitals expand with independent ERs Associated Press

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Steve Kohls •[email protected]

On the coverCuyuna Regional Medical Center ambulance team members (left to right), EMT Mike Seitzer, and paramedics Ryan Franz and Corey Nelson, demonstrated the use of the LUCAS 2 device. The LUCAS 2 is used to provide chest compressions to a patient who has suffered out of hospital cardiac arrrest.

FLU VIRUS WIDESPREAD THROUGHT U.S. . . .Experts recommend � u shot for everyone over six-months-old Associated Press

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A date with the doctor

Whether you use one of the new electronic methods or still rely on the old faithful post-it-on-the-wall calen-dar you’ve probably started to docu-ment important dates that lie in the year ahead. You’ve probably already noted all of those weddings, birthdays, anni-versaries and vacations that are planned for 2013.

But there are a few other important ones you shouldn’t forget.

Did you include any reminders to add routine health care exams for your family? What about needed immuniza-tions?

Depending on the ages of the mem-bers of your household it might be time to pencil in some trips to the clinic, or reminders for some general screenings and routine check-ups that are easy to forget about otherwise.

This year the � u is making daily news headlines both for its popular oc-currence and its severity. If you haven’t had one yet, an appointment for a � u shot might be the � rst one you need to make.

Dr. Marcy Byrns, Internal Medicine at Essentia Health-St. Joseph’s Medical Center in Brainerd, said just because you took a pass last fall, if you’re hav-ing second thoughts it isn’t too late. “You will still get some bene� t from a late � u season immunization,” she said. “Even if you didn’t get it yet this year, you should and especially because this is such a vigorous � u season.”

Dr. Byrnes said another immuniza-tion you might want to update is your

tetanus shot. If you haven’t had one in a while,

it’s another preventive measure that can pay off right away, especially if you are around young children or infants. The immunization now includes protection from whooping cough, which is show-ing up in record numbers recently as well, and although it might not be se-vere for adults, it can be deadly if you pass it on to young children or babies.

So, if you’re otherwise healthy, who needs to see a doctor and when? Children. Visits to a physician are recommended for children the � rst week of birth and again at two, four, six, nine, 12 and 15 months of age. Height and weight will be documented at these visits as well as vision and hearing screenings to make sure their growth is on track. Various necessary immunizations are administered at each visit also (see box). Children should be added to the family calendar for doctor visits again at two, three, four, � ve and six years old as well as at eight, 10, 12, 14, 16 and 18 years of age. Adults. Even adults need periodic screenings. The visits can be valuable for assessing general health conditions and early diagnosis of things that may require additional treatment.

From 19 until age 39, men should visit a doctor at least every � ve years and women should plan to visit every three to � ve years. Your blood pressure will be checked and assessments will be made for other health risks.

Adult women should expect to have

a clinical breast exam every three years and continue to schedule an annual mammogram. The latest recommenda-tions suggest that women should sched-ule visits for a pap test and pelvic exam every three years (after three years of normal test results in a � ve year period) after age 21 or three years after they � rst become sexually active.

Blood pressure readings should be checked every two years for all adult men and women if the readings are less than 120/80 and annually if readings are higher than 120-139/80-89. It’s impor-tant to have your cholesterol checked at least every � ve years and update any adult immunizations that might be needed including chicken pox, tetanus and Hepatitis B.

Colon cancer screenings for both men and women begin at age 50 and men should also start to have PSA lev-els checked as well as prostate exams. Women, as always, should continue to visit the doctor for annual clinical breast exams and mammograms.

Adults over 65, both men and wom-en, should make appointments for a complete physical every one to two years.

Just to make sure you’re ahead of the game, make a note for next fall to get the � u shot for next year’s season. Vis-its to the doctor might not be a popular day on the calendar, but they can help make it possible to enjoy all of those weddings, birthdays, anniversaries and vacations.

Recommended immunizations for

birth to 24 years

• Diphtheria, tetanus, pertussis, hepatitis B and poliovirus (DTaP-HepB-IPV): 2, 4 and 6 months.

•Haemophilus infl u-enza type B (Hib): 2 and 4 months.

• Pneumococcal con-jugate (PCV13): 2, 4, 6 and 12 months.

• Rotavirus (Rv): 2, 4 and 6 months.

• Measles, mumps, rubella, vari-cella (chickenpox) (MMRV): 12-15 months

• Hepatitis A: 12-15months and 18-23 months

• Diphtheria, tetanus, pertussis, haemophi-lus in� uenza type B (DTaP-Hib): 15 months

• Infl uenza: every year for ages 6 months and older

Recommended immu-nizations 2 -6 years

• Diphtheria, tetanus, pertussis (DTaP): 5 years

• Poliovirus (IPV): 5 years

• Measles, mumps, rubella, vari-cella (chickenpox) (MMRV): 5 years

• Infl uenza: every year Recommended Im-

munizations 7 to 12 years

• Tetanus, diphtheria, pertussis (Tdap) at age 12

• Meningococcal conjugate (MCV) at age 12

Recommended Immu-nizations 13 to 18 years

• Meningococcal conjugate (MCV) at age 16

• Human papilloma-virus (HPV): females only

Information provided by

Essentia Health.

• Associated Press

Welectronic methods or still rely on the Welectronic methods or still rely on the old faithful post-it-on-the-wall calen-Wold faithful post-it-on-the-wall calen-

A date A date

By SHEILA HELMBERGERContributing Writer

Whether you use one of the new Whether you use one of the new Whether you use one of the new Whether you use one of the new tetanus shot. tetanus shot. a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years a clinical breast exam every three years

• Hepatitis A:

• Diphtheria, tetanus, • Associated Press Associated Press

WWhether you use one of the new WWhether you use one of the new

Everything you need to know about medical screenings and immunizations.

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This is your brain on sugar — for real. Scientists have used imaging tests to show for the � rst time that fructose, a sugar that saturates the American diet, can trigger brain changes that may lead to overeating.

After drinking a fructose beverage, the brain doesn’t register the feeling of being full as it does when simple glucose is consumed, researchers found.

It’s a small study and does not prove that fructose or its relative, high-fructose corn syrup, can cause obesity, but experts say it adds evidence they may play a role. These sugars often are added to pro-cessed foods and beverages, and consumption has risen dramatically since the 1970s along with obe-sity. A third of U.S. children and teens and more than two-thirds of adults are obese or overweight.

All sugars are not equal — even though they con-tain the same amount of calories — because they are metabolized differently in the body. Table sug-ar is sucrose, which is half fructose, half glucose. High-fructose corn syrup is 55 percent fructose and 45 percent glucose. Some nutrition experts say this sweetener may pose special risks, but others and the industry reject that claim. And doctors say we eat too much sugar in all forms.

For the study, scientists used magnetic resonance imaging, or MRI, scans to track blood � ow in the brain in 20 young, normal-weight people before and

TTThis is your brain on sugar — for real. Scientists TThis is your brain on sugar — for real. Scientists This is your brain on sugar — for real. Scientists TThis is your brain on sugar — for real. Scientists have used imaging tests to show for the � rst time that Thave used imaging tests to show for the � rst time that fructose, a sugar that saturates the American diet, can Tfructose, a sugar that saturates the American diet, can

AP Medical Writers

This is your brain on sugar — for real. Scientists TThis is your brain on sugar — for real. Scientists TThis is your brain on sugar — for real. Scientists

AP Medical Writers

Fructose may spur overeating

after they had drinks containing glucose or fructose in two sessions several weeks apart.

Scans showed that drinking glucose “turns off or suppresses the activity of areas of the brain that are critical for reward and desire for food,” said one study leader, Yale University endocrinologist Dr. Robert Sherwin. With fructose, “we don’t see those changes,” he said. “As a result, the desire to eat continues — it isn’t turned off.”

What’s convincing, said Dr. Jonathan Purnell, an endocrinologist at Oregon Health & Science University, is that the imaging results mirrored how hungry the people said they felt, as well as what earlier studies found in animals. “It implies that fructose, at least with regards to promoting food intake and weight gain, is a bad actor compared to glucose,” said Purnell.

He wrote a commentary that appears with the federally funded study in Wednesday’s Journal of the American Medical Association.

Researchers now are testing obese people to see if they react the same way to fructose and glu-cose as the normal-weight people in this study did. What to do? Cook more at home and limit pro-cessed foods containing fructose and high-fructose corn syrup, Purnell suggested. “Try to avoid the sugar-sweetened beverages.

It doesn’t mean you can’t ever have them,” but control their size and how often they are con-sumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage.

However, independent experts say the methods are too � awed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly high-er risk of death than those who were overweight.

Many experts criticized that work, saying the re-

searcher — Katherine Flegal of the Centers for Dis-ease Control and Prevention — painted a mislead-ing picture by including smokers and people with health problems ranging from cancer to heart dis-ease. Those people tend to weigh less and therefore make pudgy people look healthy by comparison.

Flegal’s new analysis bolsters her original one, by assessing nearly 100 other studies covering almost 2.9 million people around the world. She again concludes that very obese people had the highest risk of death but that overweight people had a 6 percent lower mortality rate than thinner people. She also concludes that mildly obese people had a death risk similar to that of normal-weight people.

Critics again have focused on her methods. This time, she included people too thin to � t what some consider to be normal weight, which could have taken in people emaciated by cancer or other diseases, as well as smokers with elevated risks of heart disease and cancer.

The problems created by the study’s inclusion of smokers and people with pre-existing illness “can-not be ignored,” said Susan Gapstur, vice president of epidemiology for the American Cancer Society.

Flegal defended her work. She noted that she used standard categories for weight classes. She said statistical adjustments were made for smokers, who were included to give a more real-world sam-ple. She also said study participants were not in hospitals or hospices, making it unlikely that large numbers of sick people skewed the results.

“We still have to learn about obesity, including how best to measure it,” Flegal’s boss, CDC Direc-tor Dr. Thomas Frieden, said in a written statement. “However, it’s clear that being obese is not healthy - it increases the risk of diabetes, heart disease, cancer, and many other health problems.

Small, sustainable increases in physical activity and improvements in nutrition can lead to signi� -cant health improvements.”


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brain in 20 young, normal-weight people before and see if they react the same way to fructose and glu-cose as the normal-weight people in this study did. What to do? Cook more at home and limit pro-cessed foods containing fructose and high-fructose corn syrup, Purnell suggested. “Try to avoid the sugar-sweetened beverages.

It doesn’t mean you can’t ever have them,” but control their size and how often they are con-sumed, he said.

A second study in the journal suggests that only severe obesity carries a high death risk — and that a few extra pounds might even provide a survival advantage.

However, independent experts say the methods are too � awed to make those claims.

The study comes from a federal researcher who drew controversy in 2005 with a report that found thin and normal-weight people had a slightly high-er risk of death than those who were overweight.

Many experts criticized that work, saying the re-• Associated Press

Brain image study shows

A little too sweet?

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save a lifeBy SARAH NELSON

KATZENBERGERHeathwatch Editor

Cuyuna Regional Medical Center works to change cardiac arrest outcomes

Sometimes it’s a simple change that makes all the difference.

When the American Heart Association recon-sidered their stance on how to administer cardio-pulmonary resuscitation (CPR) and who is quali-� ed to do it, things changed for victims of cardiac arrest.

Up until April 2008, the standard procedure for administering CPR involved both chest com-pressions and mouth-to-mouth resuscitation — something that Dr. Mark Gujer, Medical Director of Ambulance, at Cuyuna Regional Medical Cen-

ter (CRMC) in Crosby, said could be a preven-tative barrier when it comes to people actually administering CPR.

“You see some go down across the lobby and it’s not likely you’re going to run over there and start mouth-to-mouth,” Gujer said.

When it comes to CPR, Gujer said the rules have changed — and that’s a good thing.

In 2008, the American Heart Association re-leased an advisory notice after scienti� c and medical research showed that hands-only CPR was more effective in saving lives when it comes

to out-of-hospital cardiac arrest.“This will save more lives,” Gujer said.When cardiac arrest occurs, a person’s heart

stops contracting resulting in a loss of blood cir-culation to vital organs. When blood stops cir-culating, so does oxygen. Gujer explained that, physiologically, chest compressions help manu-ally move blood — and oxygen — throughout the body and sustain blood pressure while a vic-tim suffers cardiac arrest. Essentially chest com-pressions force the heart to do its job even while it is incapacitated.

When a person administering CPR stops chest compressions to administer mouth-to-mouth, blood pressure plummets, against constricting the � ow of oxygen throughout the body. Rebuilding the blood pressure needed to circulate oxygen requires addi-tional chest compressions.

“It makes more sense not to let them breathe,” Gujer said. The ambulance team at Cuyuna Regional Medical Center is mak-ing a concerted effort to increase the num-ber of survivors when it comes to cardiac arrest cases suffered out of hospital.

CRMC’s Director of Ambulance, Rob Almendinger and Gujer attended a medi-cal conference in 2011 that led them to ask themselves if a rural EMS system, like CRMC’s, is capable of achieving the same successful rates as an urban system in re-gards to the survival rate of out of hospital cardiac arrests.

“When we came back from the confer-ence and really looked at our data, CRMC had had 14 out-of-hospital arrests and zero saves. So we thought, ‘Let’s see where this goes,’” Almendinger said.

SSometimes it’s a simple change that makes all SSometimes it’s a simple change that makes all the difference.Sthe difference.

When the American Heart Association recon-SWhen the American Heart Association recon-sidered their stance on how to administer cardio-Ssidered their stance on how to administer cardio-

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From left, EMT Mike Seitzer and paramedics Ryan Franz and Corey Nelson demonstrate the use of the LUCAS 2, a device used by the Cuyuna Regional Medical Center’s ambu-lance team to administer chest compressions to indviduals who have suffered out-of-hospital cardiac arrest.

Steve Kohls • [email protected]

How to

See CPR, Page 9

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Rob Almendinger (left) and Dr. Mark Gujer head Cuyuna Regional Medical Center’s ambulance service. The pair said in increaser in paramedic and EMT training and well as public intervention is the key to positive outcome when it comes to treating out-of-hospital cardiac arrest.


See CPR, Page 10

“We can train as much as we want, but we will never be

successful without public in-tervention. If they’re not do-ing CPR when we get there we don’t have a chance.”

-ROB ALMENDINGER, CRMC AMBULANCE DIRECTOR

Almendinger and Gujer looked at what the most successful systems do differently and found ways to improve their own system.

The ambulance service has adjusted their CPR and Advanced Cardiovascular Life Support (ACLS) requirements from a two year training review to an annual requirement.

“It’s made a big difference,” Almendinger saidCRMC Ambulance also requires their EMT and

paramedic staff members to complete a quarterly competency course on cardiac arrest management. Almendinger said the focus of the competency re-quirement is to minimize the interruptions in chest compressions.

The team uses a new chest compression called the LUCAS 2. The portable electronically powered device administers what Guyer calls, “perfect com-pressions.” It can be strapped over the chest of a victim within a few seconds, minimizing the num-ber of interrupts between chest compressions and allowing the responding EMTs and paramedics to

CPR, From Page 8

10

The NEW CPRIn case you � nd yourself in a situation where an adult or a teen has collapsed, three

simple steps can save a life:

1. Call 911.2. Put the heel of one hand into the center of the victim’s chest and your other hand

over top.3. Push hard and fast until emergency help arrives.

The American Heart Association says to push at a rate of about 100 beats per minute — or to the tune of Stayin’ Alive.

For more information visit the American Heart Association’s CPR website at www.heart.org/HandsOnlyCPR

The LUCAS 2 (above) is a portable electronically powered de-vice administers perfect compressions on a victim that has suf-fered cardiac arrest and requires Cardiopulmonary Resuscita-tion (CPR).The LUCAS 2 can be strapped over the chest of a victim within a few seconds, minimizing the number of interrupts between chest compressions and allowing the responding EMTs and paramedics to focus on the victims vital statistics.


CPR, From Page 9

“There was a day when BLS (basic life support) meant nothing — it was just put them on a stretcher and go...

And that wasn’t all that long ago.”- DR. MARK GUJER

focus on the victims vital statistics.“There was a day when BLS (basic life

support) meant nothing — it was just put them on a stretcher and go,” Gujer said. “And that wasn’t all that long ago.”

In addition to providing better training for EMT and paramedic team members, Gujer and Almendinger found that provid-ing better CPR education to the commu-nity increases the chances that a person who suffers out-of-hospital cardiac arrest will receive hand-only CPR immediately, ultimately providing them a better survival outlook.

“We can train as much as we want, but we will never be successful without public intervention,” Almendinger said. “If they’re not doing CPR when we get there we don’t have a chance.”

Almendinger said the CRMC ambu-lance team’s efforts have included pub-lic CPR training sessions. Since October 2011, the team has trained more than 1,000 individuals in CRMC’s service area in hands-only CPR. “As long as they can physically compress the mannequin, we teach them,” Almendinger said. “Anyone that invites us to go, we go.”

The efforts are working.Almendinger said data from October

2011 through October 2012 shows of 14 out of hospital arrests, 7 achieved a re-turn to spontaneous circulation (ROSC) — three of which walked out the hospital under their own power.

“It will be interesting to see this anoth-er year or two down the road,” Almend-inger said.

Gujer said that even with the positive numbers, the efforts continue to improve. “We’ve watched this project evolve,” he said.

Gujer and Almendinger continue to attend conferences looking for ways to better their methods. “Every time we bring something back to tweak our sys-tem,” Almendinger said.

Gujer and Almendinger agreed that the most important thing people can do is learn to administer hand-only CPR and teach � ve other people to do the same.

“We want to see this go viral,” said Gujer, adding that if there’s one thing that needs to be remembered when ad-ministering hands-only CPR: “You can’t push too hard.”

SARAH NELSON KATZENBERGER may be reached at [email protected] or 855-5879.

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Cuyuna Regional Medical Center has joined the Healthy Communities Partnership, a three-year, $6.5 million program to experiment with different health improvement methods in 13 communities throughout Minnesota and western Wisconsin. The Healthy Communities Partnership includes the George Family Foundation, Allina Health, and ten other health organiza-tions.

“We are grateful for this grassroots opportunity to engage our residents to identify ways to achieve sustainable improvements in community wellness and take ownership of their health. The Healthy Communities Partnership gives us the � exibility to develop initiatives and enhance wellness in a way that � ts the speci� c needs of our community. With 12 other communities being a part of this, we are excited to contrib-ute to something that has the potential to make a positive impact on our entire state,” said John Solheim, Cuyuna Re-gional Medical Center’s CEO.

Other healthcare providers and communities joining Cuyuna Regional Medical Center in the Healthy Com-munities Partnership are: Riverwood Healthcare Center, Aitkin; Baldwin Area

Medical Center, Baldwin, Wis.; Buffalo Hospital, Buffalo; Cambridge Medical Center, Cambridge; District One Hos-pital, Faribault; Grand Itasca Clinic and Hospital, Grand Rapids; Regina Medi-cal Center, Hastings; Hutchinson Area Health Center, Hutchinson; FirstLight Health System, Mora; River Falls Area Hospital, River Falls, Wis.; Ridgeview Medical Center, Waconia; and Rice Memorial Hospital, Willmar.

The program is managed by the Penny George Institute for Health and Healing, the part of Allina Health that is responsible for health promotion and wellness. George, also co-founder of the George Family Foundation, says in-tegrative medicine will be woven into the fabric of local health services.

“This program recognizes that at least 40 percent of deaths in the U.S. are attributed to four behaviors: unhealthy eating, inadequate exercise, smoking and hazardous drinking, and about 95 percent of the population lives with an identi� able risk factor,” said Courtney Baechler, MD, vice president of the Penny George Institute for Health and Healing, the part of Allina Health.

Communities customize the pro-gram to � t their speci� c needs and

resources, but some components are consistent, including:

—Each community will hold base-line screenings. Each participant and community will know their “health score.”

—Participants will use an online tool called The Family Health Manager and allow researchers access to anony-mous data.

—An inventory of local resources will identify and � ll gaps in local well-ness programming, such as smoking cessation classes.

—A wellness care guide will work with each participant on a health im-provement plan that combines medi-cal and non-medical approaches.

—Participants will be rescreened each year.

In the � rst phase of the program, participating partners will hold the baseline health screenings. Then, based on results and the inventory of local re-sources, community interventions to enhance wellness programming will be developed. Over the duration of the program, the goal is to improve health screening scores and build a sustain-able framework of health and wellness support.

CRMCpartners with Allina Health and George Family Foundation in Healthy Communities Partnership

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The nursing staff provides around-the-clock complete care for some of the sickest patients in the hospital. Not only can it be physically and emotionally demanding work, but every minute – and every decision – is a matter of life and death.

ICU nurses also provide comfort and support for the families who are forced to helplessly watch their loved ones struggle to live.

In the midst of so much sadness, worry and grief, there is life.

Something special has been happening in this third-� oor unit. Patients and their families have even taken no-tice, providing them with a bit of sunshine in an otherwise emotionally-charged environment.

Three ICU nurses, all friends and colleagues, have re-cently given birth or are pregnant with twins. For several

weeks, all three of them were pregnant with twins at the same time while work-

ing in the same unit.

Brenda Jentsch, a Registered Nurse in the Intensive Care and Telemetry units for the past 10 years, recently gave birth to her second set of twins. She and her husband, Mike, have twins, Michael and Emma, 5; a singleton, Jo-seph, 3; and twins Anna and Thomas, 5 months, born July 26. Jera Powell, a Registered Nurse in both the ICU and Telemetry unit for the past � ve years, gave birth Nov. 26 to twin boys, Noah and Logan. She and her husband, Jer-emy, also have a 4-year-old daughter, Gabriella.

Jackie Sullivan, also an ICU Registered Nurse for the past � ve years, is pregnant with twin girls and due March 16. She and her husband, Eric, are excited to meet their girls, who are fraternal twins.

First Jentsch announced she was pregnant again with twins, then Powell. By the time it was Sullivan’s turn to share her news, she said she was afraid to tell her super-visor. But, she said, everyone, including her boss, was happy for her double blessing.

Jackie Sullivan (left), Brenda Jentsch and Jera Powell are Registered Nurses in the Intensive Care Unit at Es-sentia Health-St. Joseph’s Medical Center in Brainerd. They are all expecting or recently had twins. Sullivan is pregnant and due March 16 with twin girls; Jentsch

is shown with her twins, Anna (left) and Thomas, 5 months, twins Emma and Michael (top left),

5, and son Joseph, 3; while Powell is with her twins, Noah (left) and Logan, and

daughter, Gabriella, 4.


By JODIE TWEEDContributing Writer

Essentia Health ICU nurses deliver comfort, care –

and their babies

HOSPITAL BABY BOOM

2The nursing staff provides around-the-clock complete

at a timeIf you or a loved one

have ever been critical-

ly ill, you understand

the dif� cult job that the

dedicated nurses on

the third-� oor Intensive

Care Unit at Essentia

Health-St. Joseph’s

Medical Center in

Brainerd face during

each 12-hour

nursing shift.

Jackie Sullivan (left), Brenda Jentsch and Jera Powell are Registered Nurses in the Intensive Care Unit at Es-are Registered Nurses in the Intensive Care Unit at Es-sentia Health-St. Joseph’s Medical Center in Brainerd. They are all expecting or recently had twins. Sullivan is pregnant and due March 16 with twin girls; Jentsch

is shown with her twins, Anna (left) and Thomas, 5

12

The nursing staff provides around-the-clock complete care for some of the sickest patients in the hospital. Not only can it be physically and emotionally demanding work, but every minute – and every decision – is a matter of life and death.

ICU nurses also provide comfort and support for the families who are forced to helplessly watch their loved ones struggle to live.

In the midst of so much sadness, worry and grief, there is life.

Something special has been happening in this third-� oor unit. Patients and their families have even taken no-tice, providing them with a bit of sunshine in an otherwise emotionally-charged environment.


weeks, all three of them were pregnant weeks, all three of them were pregnant with twins at the same time while work-

By JODIE TWEEDContributing WriterContributing WriterContributing WriterContributing WriterBy JODIE TWEEDContributing WriterBy JODIE TWEED


and their babiesand their babiesandI

HOSPITAL BABY BOOM

2The nursing staff provides around-the-clock complete

2at a time2at a time2If you or a loved one IIf you or a loved one Ihave ever been critical-

ly ill, you understand

the dif� cult job that the

dedicated nurses on

the third-� oor Intensive

Care Unit at Essentia

Health-St. Joseph’s

Medical Center in

Brainerd face during

each 12-hour

nursing shift.

HOSPITAL BABY BOOM

The nursing staff provides around-the-clock complete care for some of the sickest patients in the hospital. Not only can it be physically and emotionally demanding work, but every minute – and every decision – is a matter

ICU nurses also provide comfort and support for the families who are forced to helplessly watch their loved

In the midst of so much sadness, worry and grief, there

Something special has been happening in this third-� oor unit. Patients and their families have even taken no-tice, providing them with a bit of sunshine in an otherwise





their babies

The nursing staff provides around-the-clock complete

at a time

The nursing staff provides around-the-clock complete care for some of the sickest patients in the hospital. Not only can it be physically and emotionally demanding work, but every minute – and every decision – is a matter

ICU nurses also provide comfort and support for the families who are forced to helplessly watch their loved

In the midst of so much sadness, worry and grief, there

Something special has been happening in this third-� oor unit. Patients and their families have even taken no-tice, providing them with a bit of sunshine in an otherwise





their babies

The nursing staff provides around-the-clock complete

at a time

13

Jentsch returned to work dur-ing Powell’s last weekend of work before her maternity leave. Powell will be returning to the ICU from her maternity leave around the time that Sullivan will be starting her leave.

Not only did the timing work out well, but all three nurses expe-rienced normal, healthy twin preg-nancies. Jentsch and Powell de-livered their sets of twins – where else? – on the hospital’s third � oor Family Birthplace Unit.

Both women had C-sections; Dr. Pamela Rice delivered the Jentsch twins while Dr. Hal Leland deliv-ered Powell’s twin boys. Sullivan also plans to deliver her twin girls at Essentia Health. Her doctor is Dr. Alicia Prahm.

“I felt more comfortable, know-ing I knew the staff, and if anything went wrong, I knew I’d be just � ne,” Jentsch said, of delivering her babies at Essentia.

Powell said she’d never before had surgery until her C-section, so she was apprehensive about that. It helped calm her fears because she knew the medical staff in the oper-ating room.

The three sets of twins aren’t the only babies in the unit. Two of their co-workers also have newborn babies, though they were born as singles.

“Everyone says they’re not com-

ing to our � oor and drinking the water,” Sullivan said.

Powell and Sullivan said it’s been nice to get pregnancy, breast-feeding and parenting advice from Jentsch, who has � ve children ages 5 and younger.

Jentsch said her three “must haves” as a mother of two sets of twins is “coffee, a supportive hus-band and a large-capacity washer and dryer.”

“When I see you doing it, I know I can do it,” Powell told Jentsch with a smile.

Jentsch’s 5-month-olds are al-ready sleeping through the night. She said she has learned that a schedule is important, especially with � ve children. She always car-ries some sort of snack in her purse when they are on the go.

“Deep breaths are always good, too,” Jentsch said with a good-na-tured laugh. “Just enjoy it. They are more fun than work.”

“I’m going to miss being preg-nant,” Sullivan said as she cradled a sleeping Thomas Jentsch in her arms. “I love feeling them kick.”

“You’re a natural, Jackie,” Jentsch told her.

Jodie Tweed, a former longtime Brainerd Dispatch reporter and HealthWatch editor, is a stay-at-home mom and freelance writer. She and her husband live in Pequot Lakes with their three daughters.

Life is a juggling act for Brenda Jentsch,

who has � ve chil-dren, including two

sets of twins. But the Essentia Health

registered nurse has become adept at

multi-tasking. She is shown at her Baxter

home holding her 5-month-old twins, Anna and Thomas,

while her 5-year-old twins, Michael and

Emma, are gripping onto her. Joseph, 3,

her middle son, is on the couch.

Life is a juggling act for Brenda Jentsch,

who has � ve chil-dren, including two

sets of twins. But the Essentia Health

registered nurse has become adept at

multi-tasking. She is


14

Wait, what?If the last item isn’t part of the usual drill at your doctor’s

of� ce, a movement is afoot to change that. One recent na-tional survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.

Kaiser Permanente, one of the nation’s largest nonpro� t health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost 9 million patients are asked at every visit, and some other medical systems are doing it, too.

Here’s how it works: During any routine check of vital

signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it’s among the � rst things the doctor sees.

“All we ask our physicians to do is to make a comment on it, like, ‘Hey, good job,’ or ‘I noticed today that your blood pressure is too high and you’re not doing any ex-ercise. There’s a connection there. We really need to start you walking 30 minutes a day,’” said Dr. Robert Sallis, a Kaiser family doctor. He hatched the vital sign idea as part of a larger initiative by doctors groups.

He said Kaiser doctors generally prescribe exercise � rst,

Running club members train in Pasadena, Calif. Dr. Robert Sallis says some patients may not be aware that research shows physical inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November 2012, a government-led study concluded that people who routinely exercise live longer than others, even if they’re overweight.

By LINDSEY TANNERAP Medical Writer

Wait, what?If the last item isn’t part of the usual drill at your doctor’s

of� ce, a movement is afoot to change that. One recent na-tional survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.

Kaiser Permanente, one of the nation’s largest nonpro� t health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost

signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it’s among the � rst things the doctor sees.

“All we ask our physicians to do is to make a comment on it, like, ‘Hey, good job,’ or ‘I noticed today that your blood pressure is too high and you’re not doing any ex-ercise. There’s a connection there. We really need to start you walking 30 minutes a day,’” said Dr. Robert Sallis, a

Running club members train in Pasadena, Calif. Dr. Robert Sallis says some patients may not be aware that research shows physical inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November 2012, a government-led study concluded that people who routinely exercise live longer than others, even if they’re

Running club members

exercise minutesCHICAGO (AP) — Roll up a sleeve for the blood pressure cuff. Stick out a wrist for

the pulse-taking. Lift your tongue for the thermometer. Report how many minutes you

are active or getting exercise.CCCHICAGO (AP) — Roll up a sleeve for the blood pressure cuff. Stick out a wrist for CCHICAGO (AP) — Roll up a sleeve for the blood pressure cuff. Stick out a wrist for

the pulse-taking. Lift your tongue for the thermometer. Report how many minutes you Cthe pulse-taking. Lift your tongue for the thermometer. Report how many minutes you

are active or getting exercise.C

are active or getting exercise.

exercise minutesexercise minutesexercise minutesexercise minutesexercise minutesexercise minutesexercise minutesexercise minutesexercise minutesexercise minutes

Your medical

chart could

include


15

instead of medication, and for many patients who follow through that’s often all it takes.

It’s a challenge to make progress. A study looking at the � rst year of Kaiser’s effort showed more than a third of patients said they never exercise.

Sallis said some pa-tients may not be aware that research shows physi-cal inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November a government-led study concluded that people who rou-tinely exercise live longer than oth-ers, even if they’re overweight.

Zendi Solano, who works for Kaiser as a research assistant in Pasadena, Calif., says she always knew exercise was a good thing. But until about a year ago, when her Kaiser doctor started routinely measuring it, she “really didn’t take it seriously.”

She was obese, and in a family of diabetics, had elevated blood sugar. She sometimes did push-ups and other strength training but not anything very sustained or strenu-ous.

Solano, 34, decided to take up running and after a couple of months she was doing three miles. Then she began training for a half marathon — and ran that 13-mile race in May in less than three hours. She formed a running club with co-workers and now runs sev-eral miles a week. She also started eating smaller portions and buying more fruits and vegetables.

She is still overweight but has lost 30 pounds and her blood sugar is normal.

Her doctor praised the improve-ment at her last physical in June and Solano says the routine exer-cise checks are “a great reminder.”

Kaiser began the program about three years ago after 2008 govern-ment guidelines recommended at

least 2 1/2 hours of mod-erately vigorous exercise each week. That includes

brisk walking, cycling, lawn-mowing — anything that gets

you breathing a little harder than normal for at least 10 min-

utes at a time.A recently published study of

nearly 2 million people in Kai-ser’s southern California network found that less than a third met physical activity guidelines dur-ing the program’s � rst year end-

ing in March 2011. That’s worse than results from national studies. But promoters of the vital signs effort think Kaiser’s numbers are more realistic because people are more likely to tell their own doctors the truth.

Dr. Elizabeth Joy of Salt Lake City has created a nearly identi-cal program and she expects 300 physicians in her Intermountain Healthcare network to be involved early this year.

“There are some real opportuni-ties there to kind of shift patients’ expectations about the value of physical activity on health,” Joy said.

NorthShore University Health-System in Chicago’s northern sub-urbs plans to start an exercise vital sign program this month, eventu-ally involving about 200 primary care doctors.

Dr. Carrie Jaworski, a North-Shore family and sports medicine specialist, already asks patients about exercise. She said some of her diabetic patients have been able to cut back on their medicines after getting active.

Dr. William Dietz, an obesity expert who retired last year from the Centers for Disease Control and Prevention, said measuring a pa-tient’s exercise regardless of meth-od is essential, but that “naming it as a vital sign kind of elevates it.”

Figuring out how to get people to be more active is the important next step, he said, and could have a big effect in reducing medical costs.

It’s a challenge

to make progress.

instead of medication, and for many patients who follow through that’s often all it takes.

It’s a challenge to make progress. A study looking at the � rst year of Kaiser’s effort showed more than a third of patients said they never exercise.

Sallis said some pa-tients may not be aware that research shows physi-cal inactivity is riskier than high blood pressure, obesity and other health risks people know they should avoid. As recently as November a government-led study concluded that people who rou-tinely exercise live longer than oth-ers, even if they’re overweight.

Zendi Solano, who works for Kaiser as a research assistant in Pasadena, Calif., says she always knew exercise was a good thing. But until about a year ago, when her Kaiser doctor started routinely

least 2 1/2 hours of mod-erately vigorous exercise each week. That includes

brisk walking, cycling, lawn-mowing — anything that gets

you breathing a little harder than normal for at least 10 min-

utes at a time.A recently published study of

nearly 2 million people in Kai-ser’s southern California network found that less than a third met physical activity guidelines dur-ing the program’s � rst year end-

ing in March 2011. That’s worse than results from national studies. But promoters of the vital signs effort think Kaiser’s numbers are more realistic because people are more likely to tell their own doctors the truth.

Dr. Elizabeth Joy of Salt Lake City has created a nearly identi-cal program and she expects 300 physicians in her Intermountain Healthcare network to be involved early this year.

“There are some real opportuni-

It’s a challenge

to make progress.to make progress.

16

It can be known as the dark days of winter. Sunrise and sunset leave the Brainerd lakes area with just

8-9 hours of daylight between De-cember and March and often times can lead to an overall glum feeling.

But that glum feeling is not just an emotional sad day – sometimes it can be something much more.

Seasonal Affective Disorder (SAD) is a type of depression that is recognized in climates where sun-light decreases during the winter season.

According to Dr. Mark Holub, an on-staff psychiatric specialist at Lakewood Health in Staples, de-pression is the most common be-havioral condition treated at Lake-wood and the most treatable. And in the months following holiday spending, snow and an increase in darkness, Holub said that is when the number of patients with SAD really rises.

“SAD has both biological, psy-chological and emotional compo-nents in it,” said Holub, who has been with Lakewood Health for � ve years. “As a physician, we focus on the biological part aspect.

“In the winter, the low amount of light, especially in our area, the human brain releases more mela-tonin in response to the low light, giving people those symptoms of wanting to sleep all day, eating ab-normally and usually low energy. In the spring and summer patients di-agnosed with SAD tend to do pretty well and are not in a depressive state, but when they wake up for work and it’s dark and they come home and it’s nearly dark, that low light increases those symptoms, usually worse in January, February and March.”

Playing into the biological symp-toms are also the social aspects of depression. According to Dr. Corrie Brown, a clinical therapist at Lake-

wood Health, due to the often frigid climate and darkness, she sees patients also missing that social interaction in the winter months that is often necessary for human’s emotional and behav-ioral state.

“People tend to isolate themselves more in the winter months,” said Brown who has been at Lakewood Health nearly � ve years. “They aren’t getting that regular social interaction or going to their regular activities maybe due to weather or road conditions.

“At the same time we see them then not eating well or get-ting their exercise, walking to the mailbox to get their mail and that often times can lead to a depres-sive state.”

So how do you treat SAD?Holub said � rst and foremost

people who suspect something is off and think they might be suf-fering from SAD should visit their primary physician. Holub said that other things could be leading to the symptoms that they are feel-ing like thyroid disease and a doc-tor should � rst rule those out before considering SAD

Holub said for those who are experiencing those symptoms and it is SAD, antidepressants are very affective. Another unique treatment Holub said studies have shown to work is a 10,000 lux light therapy, where patients dose themselves with light for 30-45 minutes � rst thing in the morning.

“What this does, is it tricks the brain into thinking that it’s bright sunshine,” he said. “However it is something that needs to be very measured and isn’t an instance where more is better. I usually rec-ommend patients get up an hour earlier and use the light during that time.”

Holub said that the lights can be purchased online or at most stores like Target or Walmart. He stressed that patients shouldn’t go over-board with the treatment. Excessive use often times results in insomnia and interfering with normal sleep regiman.

In addition to medications and treatments, Brown said she practic-es a lifestyle change as well to fur-ther help patients overcome their depressive state.

“From my approach, I teach skills on managing the diagnosis of SAD and removing those barriers for a behavioral change,” she said. “One of the biggest things is when people deny that they have a problem with depressing. They have to learn how to � rst deal with being diagnosed and then adjust and manage that accordingly.

“It’s not something that happens

overnight (accepting that a person has depression) and it requires a lifestyle change. But once patients come to terms they � nd that it re-ally is easily managed along with diet and exercise.”

And no matter the depth of de-pression, whether it’s a year, a month or a few weeks, Brown add-ed that it is something that is easily � xed.

“The rate of recovery is so high from depression that what we are passionate about doing is removing those barriers and stigma that is as-sociated with it,” said Brown. “We are working so hard to treat it be-cause it is so treatable and we have these services in the lakes area for people suffering.”JESSI PIERCE, staff writer, may be reached at 855-5859 or [email protected]. Follow her on Twitter at www.twitter.com/jessi_pierce (@jessi_pierce).

Feeling SAD? By JESSI PIERCE

Contributing Writer

Seasonal Affective Disorder common in the dark winter months

Dr. Mark Holub (R), an on-staff psychiatric speacialist at Lakewood Health in Staples chats about Seasonal Affective Depression (SAD) with collegue and clinical therapist at Lakewood Health, Dr. Corrie Brown. SADis a commonly found in patients in the winter months where sunlight is minimal and is a very treatable form of depression.

Jessi Pierce • [email protected]

17

Too many tests? Routine checks getting second look

WASHINGTON (AP) — Recent headlines offered a fresh example of how the health care system sub-jects people to too many medical tests — this time research showing millions of older women don’t need their bones checked for osteoporosis nearly so often.

Chances are you’ve heard that many expert groups say cancer screening is overused, too, from mam-mograms given too early or too often to prostate cancer tests that may not save lives. It’s not just cancer. Now some of the nuts-and-bolts tests given during checkups or hospital visits are getting a second look, too — things like routine EKGs to check heart health, or chest X-rays before elective surgery. Next under the microscope may be women’s dreaded yearly pel-vic exams.

The worry: If given too often, these tests can waste time and money, and sometimes even do harm if false alarms spur unneeded follow-up care.

It begs the question: Just what should be part of my doctor’s visit?

If you’re 65 or older, Medicare of-fers a list of screenings to print out and discuss during the new annual wellness visit, a bene� t that began last year. As of November, more than 1.9 million seniors had taken advan-tage of the free checkup.

For younger adults, � guring out what’s necessary and what’s overkill is tougher. Whatever your age, some major campaigns are under way to help. They’re compiling lists of tests that your doctor might be ordering more out of habit, or fear of lawsuits, than based on scienti� c evidence that they are really needed.

“Too often, we order tests without stopping to think about how (if at all) the result will help the patient,” wrote Dr. Christine Laine. She’s editor of An-nals of Internal Medicine, which this month published a list of 37 scenarios where testing is overused.

Medical groups have long urged patients not to be shy and to ask why they need a particular test, what its pros and cons are, and what would happen if they skip it. This spring, a campaign called Choosing Wisely promises to provide more speci� c advice. The group will publish a list

of the top 5 overused tests and treatments from different spe-cialties. Consumer

Reports will publish a layman’s trans-lation, to help people with these awk-ward discussions.

For now, some recent publications offer this guidance:

—No annual EKGs or other car-diac screening for low-risk patients with no heart disease symptoms. That’s been a recommendation of the U.S. Preventive Services Task Force for years. Simple blood pressure and cholesterol checks are considered far more valuable.

—Discuss how often you need a bone-density scan for osteoporosis. An initial test is recommended at 65, and Medicare pays for a repeat every two years.

—Women under 65 need that � rst bone scan only if they have risk fac-tors such as smoking or prior broken bones, say the two new overtesting lists.

—Most people with low back pain for less than six weeks shouldn’t get X-rays or other scans, Weinberger’s group stresses.

—Even those all-important choles-terol tests seldom are needed every year, unless yours is high, according to the college of physicians. Other-wise, guidelines generally advise ev-ery � ve years.

—Pap smears for a routine cervical cancer check are only needed once every three years by most women. So why must they return to the doctor every year to get a pelvic exam (mi-nus the Pap)? For no good reason, the Centers for Disease Control and Pre-vention reported last month. Pelvic exams aren’t a good screening tool for ovarian cancer, and shouldn’t be required to get birth control pills, the report says.

A close relationship with a prima-ry care doctor who knows you well enough to personalize care maxi-mizes your chances of getting only the tests you really need — without wondering if it’s all just about saving money, says Dr. Glen Stream of the American Academy of Family Physi-cians.

“The issue is truly about what is best for patients,” he says.

WWWWWASHINGTON (AP) — WWASHINGTON (AP) — Recent headlines offered a WRecent headlines offered a fresh example of how the Wfresh example of how the

ASSOCIATED PRESS

18

Flu? Malaria?

NEW YORK (AP) — Only a 10 percent chance of showers today, but a 70 percent chance of fl u next month.

That’s the kind of forecasting health scientists are trying to move toward, as they increasingly include weather data in their attempts to predict disease outbreaks.

In one recent study, two scientists reported they could predict — more than seven weeks in advance — when fl u season was going to peak in New York City. Theirs was just the latest in a growing wave of computer models that factor in rainfall, temperature or other weather conditions to forecast disease.

Health offi cials are excited by this kind of work and the idea that it could be used to fi ne-tune vac-cination campaigns or other disease prevention efforts.

At the same time, experts note that outbreaks are infl uenced as much, or more, by human behavior and other factors as by the weather. Some argue weather-based outbreak predictions still have a long way to go. And when government health of-fi cials warned in early December that fl u season seemed to be off to an early start, they said there was no evidence it was driven by the weather.

This disease-forecasting concept is not new: Scientists have been working on mathematical models to predict outbreaks for decades and have long factored in the weather. They have known, for example, that temperature and rainfall affect the breeding of mosquitoes that carry malaria, West Nile virus and other dangerous diseases.

Recent improvements in weather-tracking have helped, including satellite technology and more sophisticated computer data processing.

As a result, “in the last fi ve years or so, there’s been quite an improvement and acceleration” in weather-focused disease modeling, said Ira Longi-ni, a University of Florida biostatistician who’s worked on outbreak prediction projects.

Some models have been labeled successes.In the United States, researchers at Johns Hop-

kins University and the University of New Mexico tried to predict outbreaks of hantavirus in the late 1990s. They used rain and snow data and other information to study patterns of plant growth that attract rodents. People catch the disease from the droppings of infected rodents.

“We predicted what would happen later that year,” said Gregory Glass, a Johns Hopkins re-searcher who worked on the project.

More recently, in east Africa, satellites have been used to predict rainfall by measuring sea-sur-face temperatures and cloud density. That’s been used to generate “risk maps” for Rift Valley fever — a virus that spreads from animals to people and in severe cases can cause blindness or death. Re-searchers have said the system in some cases has given two to six weeks advance warning.

Last year, other researchers using satellite data in east Africa said they found that a small change in average temperature was a warning sign cholera cases would double within four months.

“We are getting very close to developing a vi-able forecasting system” against cholera that can help health offi cials in African countries ramp up emergency vaccinations and other efforts, said a statement by one of the authors, Rita Reyburn of the International Vaccine Institute in Seoul, South Korea.

Some diseases are hard to forecast, such as West Nile virus. Last year, the U.S. suffered one of its worst years since the virus arrived in 1999. There were more than 2,600 serious illnesses and nearly 240 deaths.

Offi cials said the mild winter, early spring and very hot summer helped spur mosquito breeding and the spread of the virus. But the danger wasn’t spread uniformly. In Texas, the Dallas area was particularly hard-hit, while other places, including some with similar weather patterns and the same type of mosquitoes, were not as affected.

“Why Dallas, and not areas with similar eco-logical conditions? We don’t really know,” said Roger Nasci of the Centers for Disease Control and Prevention. He is chief of the CDC branch that tracks insect-borne viruses.

Some think fl u lends itself to outbreak forecast-ing — there’s already a predictability to the annual winter fl u season. But that’s been tricky, too.

Seasonal fl u reports come from doctors’ offi c-es, but those show the disease when it’s already spreading. Some researchers have studied tweets on Twitter and searches on Google, but their work has offered a jump of only a week or two on tradi-tional methods.

In the study of New York City fl u cases pub-lished last month in the Proceedings of the Na-tional Academy of Sciences, the authors said they could forecast, by up to seven weeks, the peak of fl u season.

They designed a model based on weather and fl u data from past years, 2003-09. In part, their

design was based on earlier studies that found fl u virus spreads better when the air is dry and turns colder. They made calculations based on humidity readings and on Google Flu Trends, which tracks how many people are searching each day for infor-mation on fl u-related topics (often because they’re beginning to feel ill).

Using that model, they hope to try real-time predictions as early as next year, said Jeffrey Sha-man of Columbia University, who led the work.

“It’s certainly exciting,” said Lyn Finelli, the CDC’s fl u surveillance chief. She said the CDC supports Shaman’s work, but agency offi cials are eager to see follow-up studies showing the model can predict fl u trends in places different from New York, like Miami.

Despite the optimism by some, Dr. Edward Ryan, a Harvard University professor of immu-nology and infectious diseases, is cautious about weather-based prediction models. “I’m not sure any of them are ready for prime time,” he said.

Disease forecasters look to the sky

ASSOCIATED PRESS


A

19

A growing number of Lakes area adults, aged 50 and greater, have re-turned to college over the past several months – but not for the reasons you may think.

Roughly one year ago, Central Lakes College, Brainerd Campus intro-duced The Center for Lifelong Learning; an opportunity for aging adults and retired individuals to participate in classes, workshops and presentations with topics geared speci� cally toward issues affecting them as they enter a new phase in their lives.

Bill Brekken has served as the Director for The Center for Lifelong Learn-ing since its inception and says even in its infancy, The Center has been well-received by individuals in the area looking to pursue interests and lifelong learning opportunities.

“We’re proud of the success we’ve had,” Brekken said. “In our � rst year alone, we’ve offered 37 programs with over 900 participants. In this coming year, we are excited as we continue to add programming and partnerships to enhance opportunities for our community.”

A program committee for The Center for Lifelong Learning meets regu-larly to review potential topics, brainstorm instructors or presenters, and work with CLC to schedule events that appeal to their target audience. Arla Johnson serves on the program committee and has emphasized a need for regularly-scheduled, health-related topics for aging adults.

“Life experiences have taught me the importance of healthy living,” John-son said. “Many of the adults participating in our program are in a transition phase in their lives – including empty nesters, retirees, and even those facing serious health issues.”

Collaboration is key when it comes to providing quality offerings, Brek-ken noted. Through a special partnership with the Lakes Area Memory Aware-ness Advocates, a workshop was offered in 2012 entitled “Living Well with Alzheimer’s,” and focused on the aspect of the caregiver.

“The one thing where I see The Center really meeting a need, is that of assisting caregivers,” Brekken added. “That’s really where my heart has been touched. I’ve seen what they face and have to deal with on a daily basis. If we can provide programming for healthy living and staying healthy, that is vital.”

The Center for Lifelong Learning also works with Essentia Health and other entities in the health care � eld to present timely and relevant topics for participants. From Alzheimer’s to arthritis and eating to eye disease, The Center is always interested in relevant topics in health care and other � elds of interest.

The Center for Lifelong Learning is also hosting several sessions in the coming months on health-related topics, including joint health, � tness after 50, and the importance of laughter to a healthy lifestyle.

“We’re always looking for topics and presenters,” Brekken said. “In our area, we have such a diverse population of individuals with such a varied knowledge base and experiences. We welcome suggestions, proposals, pre-

senters, and participants. The Center for Lifelong Learning is completely com-munity-driven and designed to help individuals navigate the transitions life takes at various stages. We are all about discovering ways to give back to our community.”

Johnson agreed from a standpoint of a passion for educating others on improving or maintaining health at a pivotal point in their lives.

“We want to meet everyone where they’re at and equip them with the tools and resources to help them make the most quality decisions facing their health care and lifestyles.”

By JENNY HOLMESContributing Writer

Healthy living

Central Lakes College and Essential Health partner to create lifelong learners of Lakes area seniors

through lifelong learning

20

CHICAGO (AP) — One recent evening after of� ce hours, Dr. James Magee got a phone call about a patient, a woman in her 40s. She complained of tingling on one side of her body, in her arm and leg. Could it be a stroke?

Magee told the woman’s husband to rush her to the free-standing emergency room downstairs from his of� ce in the Chicago suburb of Homer Glen. He told the man: “This is not something that can afford to wait.”

The convenience of 24-hour emergen-cy care may be coming to more Illinois communities as hospitals make plans to build stand-alone ERs up to 50 miles from their � agship facilities.

For hospital executives, it’s a way to expand turf, compete for patients and prepare for an aging population and more Americans gaining insurance under the federal health overhaul law. For families who live far from a hospital, stand-alone emergency rooms provide the comfort of knowing trained doctors and nurses are nearby and ready to handle most health crises.

But for the health care system as a

whole, the trend could raise costs, par-ticularly if more patients use emergency rooms for non-emergency problems in-stead going to an urgent care clinic or pri-mary care provider.

While hospitals and insurance compa-nies contest the question of costs, Illinois is poised for a possible miniature boom in miniature ERs. The state now has � ve stand-alone emergency rooms. In the Chi-cago suburb of Frankfort, two hospitals are competing to build another after state lawmakers last year extended a sunset date for new licenses.

Fewer than 300 hospitals in the U.S. have free-standing emergency depart-ments, nearly double what it was in 2005, according to an American Hospital Asso-ciation survey.

Dr. Alex Rosenau, president-elect of the American College of Emergency Phy-sicians, said he expects demand for emer-gency care to increase as President Barack Obama’s health care law expands the number of people with insurance starting in 2014.

“Urgent care centers will probably ex-pand. And hospitals may see � t to open

more free-standing emergency depart-ments,” Rosenau said.

Urgent care centers can handle prob-lems that aren’t life-threatening, such as sprains, cuts, insect bites and simple bro-ken bones. They usually are open late and on weekends.

In contrast, free-standing emergency centers are staffed around the clock. They can handle many life-threatening emer-gencies, although patients who need sur-gery and other complex procedures are transferred to full-service hospitals. They generally are equipped with imaging tools such as CT scanners and MRI machines.

Blue Cross and Blue Shield of Illinois spokesman Michael Deering said free-standing ERs “demand signi� cantly higher reimbursement rates from insurers than an urgent care clinic or a retail clinic be-cause they bill for costly facility fees that urgent and retail clinics do not.” Deering is worried patients will be confused about where they should seek care.

Hospital leaders counter that patients usually know when they need an ER and when they need urgent care.

The Illinois health planning board will

Stand alone emergency roomsHospitals expand with indepentent ERs

“”

This is another

tool that hospi-

tals can use to

grow...It’s a way

to get patients

into the doors of

your system.”

CCHICAGO (AP) — One recent evening CCHICAGO (AP) — One recent evening after of� ce hours, Dr. James Magee got a Cafter of� ce hours, Dr. James Magee got a phone call about a patient, a woman in Cphone call about a patient, a woman in her 40s. She complained of tingling on C

her 40s. She complained of tingling on

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See STAND ALONE, Page 21

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decide which hospital system — if any — will get a permit for the Frankfort facility. Hospitals nearby are worried a competing ER would siphon away nurses and contribute to a staf� ng shortage.

Hospitals nationally have been using free-standing ERs to attract patients in prosperous suburbs with growing, well-insured popula-tions, said Emily Carrier, co-author of a 2012 study on hospital expansion and a senior health researcher at the nonpartisan Center for Studying Health System Change in Wash-ington, D.C.

Free-standing emergency rooms cost less to build than full-service hospitals, she said, but hospitals can charge the same rates and transfer patients into their main hospitals.

“This is another tool that hospitals can use to grow. You can locate a free-standing emer-gency department in a community where you’d like to have a presence,” Carrier said. “It’s a way to get patients into the doors of your system.”

Another study found that most free-stand-ing ERs are in urban areas, even though they originally were conceived as a solution for rural areas with no hospitals narby.

Illinois law says each free-standing emer-gency department must be in a city with a population of no more 50,000. It must be

staffed 24 hours a day by at least one board-certi� ed emergency doctor. It must have an ambulance that can take patients to a full-ser-vice hospital if necessary. It must be owned by a hospital system and can’t be marketed as a hospital emergency department.

Riverside Medical Center in Kankakee and Silver Cross Hospital in New Lenox are competing to build the Frankfort center. Both systems have noted the area’s popula-tion growth. Silver Cross operates the existing Homer Glen free-standing ER.

“How we deliver health care keeps evolving and this is one more evolution in how we deliver health care closer to patients,” said Maggie Frogge, senior vice president of corporate strategy for Riverside Medical Center.

Magee, the Homer Glen doc-tor who is a member of the Silver Cross medical staff, said the patient with the possible stroke turned out to be suf-fering from something less life-threaten-ing.

“We’re still in the process of sorting that out,” he said. He added that he’s grateful the stand-alone ER was available.

“That’s the kind of convenience that is good for me as a physician.”

vice hospital if necessary. It must be owned by a hospital system and can’t be marketed as

Riverside Medical Center in Kankakee and Silver Cross Hospital in New Lenox are competing to build the Frankfort center. Both systems have noted the area’s popula-tion growth. Silver Cross operates the existing

“How we deliver health care keeps evolving and this is one more evolution in how we deliver health care closer to patients,” said Maggie Frogge, senior vice president of corporate strategy

tor who is a member of the Silver Cross medical staff, said the patient with the possible stroke turned out to be suf-fering from something less life-threaten-

“We’re still in the process of sorting that out,” he said. He added that he’s grateful the

“That’s the kind of convenience that is

vice hospital if necessary. It must be owned by a hospital system and can’t be marketed as

Riverside Medical Center in Kankakee and Silver Cross Hospital in New Lenox are competing to build the Frankfort center. Both systems have noted the area’s popula-tion growth. Silver Cross operates the existing

“How we deliver health care keeps evolving and this is one more evolution in how we deliver health care closer to patients,” said Maggie Frogge, senior

Cross medical staff, said the patient with the possible stroke turned out to be suf-fering from something less life-threaten-

“We’re still in the process of sorting that out,” he said. He added that he’s grateful the

“That’s the kind of convenience that is

STAND ALONE, From Page 20

NEW YORK (AP) — Flu is now widespread in all but three states as the nation grapples with an earlier-than-normal season. But there was one bit of good news Friday: The number of hard-hit areas declined.

The � u season in the U.S. got under way a month early, in December, driven by a strain that tends to make people sicker. That led to worries that it might be a bad season, following one of the mildest � u seasons in recent memory.

The latest numbers do show that the � u sur-passed an “epidemic” threshold last week. That is based on deaths from pneumonia and in� uenza in 122 U.S. cities. However, it’s not unusual — the ep-idemic level varies at different times of

the year, and it was breached earlier this � u season, in October and No-vember.

And there’s a hint that the � u season may already have peaked in some spots, like in the South. Still, of� cials there and

elsewhere are bracing for more sicknessIn Ohio, administrators at Miami University are

anxious that a bug that hit employees will spread to students when they return to the Oxford campus next week.

“Everybody’s been sick. It’s miserable,” said Rit-ter Hoy, a spokeswoman for the 17,000-student school.

Despite the early start, health of� cials say it’s not too late to get a � u shot. The vaccine is considered a good — though not perfect — protection against getting really sick from the � u.

Flu was widespread in 47 states last week, up from 41 the week before, the Centers for Disease Control and Prevention said on Friday. The only states without widespread � u were California, Mis-sissippi and Hawaii.

The number of hard-hit states fell to 24 from 29, where larger numbers of people were treated for � u-like illness. Now off that list: Florida, Arkansas and South Carolina in the South, the � rst region hit this � u season.

Flu vaccinations are recommended for everyone 6 months or older. Since the swine � u epidemic in 2009, vaccination rates have increased in the U.S., but more than half of Americans haven’t gotten this year’s vaccine.

Nearly 130 million doses of � u vaccine were distributed this year, and at least 112 million have

been used. Vaccine is still available, but supplies may have run low in some locations, of� cials said.

To � nd a shot, “you may have to call a couple places,” said Dr. Patricia Quinlisk, who tracks the � u in Iowa.

The vaccine is no guarantee, though, that you won’t get sick. On Friday, CDC of� cials said a recent study of more than 1,100 people has con-cluded the current � u vaccine is 62 percent effec-tive. That means the average vaccinated person is 62 percent less likely to get a case of � u that sends them to the doctor, compared to people who don’t get the vaccine. That’s in line with other years.

The � u’s early arrival coincided with spikes in � u-like illnesses caused by other bugs, including a new norovirus that causes vomiting and diarrhea, or what is commonly known as “stomach � u.” Those illnesses likely are part of the heavy traf� c in hospital and clinic waiting rooms, CDC of� cials said.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomit-ing and diarrhea, and some develop pneumonia or other severe complications.

Most people with � u have a mild illness. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medica-tions to ease symptoms.

the year, and it was breached earlier this � u season, in October and No-vember.

And there’s a hint that the � u season may already have peaked in some spots, like in the South. Still, of� cials there and



Flu virus widespread throughtout U.S.Experts recommend � u shot for everyone over six-months-old

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HealthWatch Magazine: Jan 2013