HealthWatch Magazine - Summer 2011

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TTable of Contentsable of Contents

On the coverBrainerd

Dispatch/Kelly

Humphrey

Stephanie Zappa(right), herbrother, JoeSullivan, andcousin, MelissaGamello have allbeen diagnosedwithHuntington’sdisease and aresharing theirstory of hopeandperseverance.

Who we arePublisher — Tim BogenschutzAdvertising — Sam SwansonCover Design — Cindy SpilmanEditor — Jodi TweedJune Editor — Sarah Nelson

Healthwatch is a quartelypublication of the BranierdDispatch.

Read HealthWatch online atwww.upnorthhealthwatch.com

For advertisting opportu-nitues call Sam Swanson at(218) 855-5841.

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

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1286

Editor’s Noteby Sarah Nelson

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2220

2325

YOUTH AND SPORTSRecovering from sports injuriesby Jennifer Stockinger

HEALTHY EATING:8 things you should buy organicby Sarah Nelson

LIVING WITH HUNTINGTON’S DISEASEOne family’s struggleby Sarah Nelson

MINNESOTA PUBLIC HEALTHMDH launches Public Health database

SKIN CANCER AWARENESSWhat Lies beneath the UV Raysby Jenny Holmes

HEALTH SERVICES RECOGNITIONEssentia Health St. Joseph’s Medical Center receivesaward for establishing paternity

CANCER CONFERENCEEssentia Health contributes to patient careBy Renee Richardson

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

WEIGHT LOSS SURGERYCRMC offers bariatric surgery program

Q & AKari Johnson, Speech Pathologist

THE YEAR FOR FISHFish tops the list for new dietary guidelinesAssociated Press

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

A few years ago I saw the movie “North Country” that docu-mented the lives of the women working in the mines ofNorthern Minnesota, and I remember there was a character inthe film that was diagnosed with HD. So when Minna Wallincalled the Dispatch about her friend Stephanie, who has HD,that was the first thing I thought of.

Stephanie Zappa is one of the bravest people I have evermet. Having been diagnosed with this degenerative and debil-itating disease that has no cure, I think she kind of has to be.

I wasn’t exactly sure what to expect upon meeting withStephanie, along with her brother, Joe, and cousin Missy, allaffected by this disease that has ravaged through their family.

The three shared their experiences in coping not only withthe disease, but with a society that has so little understandingabout HD and its impact on those who suffer from it, that ittends to treat those suffering as if it’s their fault they are sick.

They’ve been asked to leave public places. They’ve beenaccused of public drunkenness. They hear words like stupid.Drunk. Crazy. Even retarded. And for the people who aren’taudacious enough to say what they’re thinking out loud —there are still the looks. The passing judgment. It’s enough tomake them not want to even be in public.

It’s not fair.All three of them would echo those words because it’s true

— it’s not fair.In Stephanie’s own words: “You judge me for something you

know nothing about.”We are so quick to make assumptions about people whose

stories we couldn’t possibly know.I’m guilty. We all are.Huntington’s disease changes the way a person walks, the

way they move and the way they speak. A little bit at a time,it changes and limits their everyday life. They can’t help it.They are trapped in a body that slowly and completely revoltsagainst them.

No one deserves to be treated as if they are less than others.No one deserves to be abused or marginalized because of an ill-ness or its symptoms, especially when they can’t do anythingto prevent the way it affects them.

After hearing the story of this family, that has been sodeeply affected by HD, my hope is that readers will not onlybecome more educated about the disease itself, but moreimportantly that it will challenge people to be more aware ofhow they treat others — no matter who they are.

— Sarah Nelson, June HealthWatch Editor

From the editor...

What is Huntington’s disease?➤Huntington’s Disease is a degenerative brain disorder whichresults in the loss of mental capacity and physical control. HD isan inherited disorder with a 50/50 that a child will inherit it froman affected parent. ➤It is estimated that 1 in 10,000 people in the U.S. are affectedby Huntington’s Disease; 1 in 1,000 directly affected.➤Symptoms usually appear between the ages of 30 and 50, butcan begin at any age.

Symptoms include:➤ involuntary movement➤ slurred speech➤ unsteady gait➤ difficulty swallowing➤ personality changes such as anti-social behavior, irritability,moodiness, restlessness, paranoia and psychosis.

Information provided by Huntington’s Disease Society of Americaand the National Institutes of Health.

Brainerd Dispatch/Kelly Humphrey

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BRAINERD— The Minnesota Department of HumanServices recognized Essentia Health St. Joseph’s MedicalCenter among 21 Minnesota hospitals for their work in estab-lishing children's paternity. The recognition was part of theFourth Annual Excellence in Birth Registration Training andConference, hosted by the Minnesota Department of Health,April 29 at the MDH Snelling Office Park, St. Paul, Minn.

“Establishing paternity is a critical step toward establishinglifelong relationships between parents and children,” saidDHS Commissioner Lucinda Jesson, who signed the awardsfor each of the hospitals. “We are very proud of what these hos-pitals have achieved, and recognize their contribution towardbuilding healthy families.”

Essentia Health St. Joseph’s Medical Center was among 14hospitals recognized for establishing paternity for at least 80percent of children born to unmarried parents who signed theRecognition of Parentage at the time of their children's birth.These hospitals will receive the Recognition of ParentageExcellence Award.

Essentia Health St.Joseph’s MedicalCenter receivesDHS recognitionfor helpingestablish paternity

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For youngathletes,recovering fromsports injuriesmeans takingthem seriouslyBy JENNIFER STOCKINGERStaff Writer

Brainerd

Dispatch/Steve

Kohls

Natalie Linn,athletictrainer atthe Staples-Motley HighSchool andexercisespecialist atLakewoodHealthSystem inStaples, inMay workedwith thenjunior GrantLongbellawith hislateralepicondylitisinjury.

STAPLES — In May, Grant Longbellawas getting ready to prep his game forthe upcoming tennis sectionals, hop-

ing to qualify for state.The then Staples-Motley High School junior

had to sit on the sidelines as he was diagnosedwith lateral epicondylitis, also known as tenniselbow.

Longbella dislocated his shoulder two years agofrom basketball and then in early May his rightarm started feeling pain to the point where he

could not serve the ball in tennis practice.Natalie Linn, athletic trainer and exercise spe-

cialist at Lakewood Health System, advisedLongbella to see Dr. Arden Beachy of Lakewood.Beachy diagnosed Longbella with lateral epi-condylitis and sent him to start his physical thera-py on May 16. Longbella had to go to physical ther-apy two days a week and had to conduct daily exer-cises/stretches to help his right arm and elbow, aswell as icing the injury.

Longbella worked hard to get his right arm inshape as the tennissections would begina week later. Linntold Longbella thatplaying in the sec-tion meet woulddepend on his paintolerance and if hecould correctly func-tionally hit the ballwith his right arm.

Longbella missedtwo tennis meetsfrom his injury, butsaid he was slowlymaking improve-ments.

“I had a full dayoff and that feltgood,” said Longbellawhile standing in theS-M tennis courts inMay. “When I’d play(tennis) it hurt. Oneday I couldn’t evenserve the ball. Butnow the muscles areloosening up andfeeling better.

“Every athletewants to play (the

game). They fear going to the athletic trainerbecause they worry that they won’t be able to play.But if they don’t go in right away their injury usu-ally won’t go away and will continue to botherthem. If they wait to long before they see an athlet-ic trainer it may be too late and they won’t be ableto play or they’ll be out of more games.”

Linn, who began at Lakewood 18-months ago,said she is working on her relationship with theathletes so they’re not afraid to come see her if theyare feeling pain.

“I want the athletes to know that if they come tome right away when they’re feeling pain, I will notnecessarily stop their activity, but I can give themexercises and stretches before their injury becomesdebilitating where they can not perform at theirhighest level any more,” said Linn. “I work hard toget them back into the game to be the best they canbe.

Linn watches the S-M athletes during practicesand games. When she sees an athlete struggle sheworks with them to see what’s going on. She makessure they stretch properly before and after practiceand games. She also will tape up any ankle sprainor other body part that is needed to help the stu-dent.

“This school year (2010-11) we didn’t have a lotof sport injuries,” said Linn. “We had two seasonendings because of an ACL (anterior cruciate liga-ment), a few concussions and some minor anklesprains.

“I stress to the coaches that we want them (theteams) to be successful, but my first priority is thesafety of the athletes,” said Linn. “It’s obvious thatwe did something right as we haven’t had a lot ofinjuries this school year.”

Dr. Beachy said the most common sportsinjuries in athletes in grades seven through 12,who he sees, are ankle sprains, lacerations in theface and the extremities, meniscus tears in kneesand shoulders, ligament injuries in the knees andankles and concussions.

Brainerd Dispatch/Steve Kohls

In May, Natalie Linn, athletic trainer at the Staples-Motley High School andexercise specialist at Lakewood Health System in Staples, worked with GrantLongbella, with one of his exercises for his sports injury of lateralepicondylitis he received from playing tennis.

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Beachy said that lacerations are commoninjuries in football, wrestling and basketball. Anklesprains are common in basketball, football and canoccur in soccer. Meniscus tears in knees often occurin swimming, volleyball and football. Dancers andgymnasts have a lot of leg and knee injuries andrunners, volleyball and soccer athletes can get moreshin splints.

Beachy said he saw five students this past schoolyear regarding concussions, but he said there mostlikely were more athletes who had concussions, butthey didn’t come forward because they wanted tostay in the game.

“There could have been a kid who could’ve hadfour or five concussions and they think they’ll be allright, but that is not always the case,” said Beachy.

Beachy said he mainly sees athletes fromStaples, Pillager, Verndale, Browerville and somefrom Wadena and Brainerd. He said a third of hisclients are students through age 18. He averagesabout 20 patients a day.

Beachy said in today’s world sports are fasterand the youth athletes are working harder, whichmeans there is a bigger potential for injuries.Beachy said another reason why more sportsinjuries are occurring is because there is no resttime for the athletes to rest their bodies and givetheir injuries time to heal. Athletes need time torecover from an injury and they need properstrength training.

Another aspect that’s causing more injuries,Beachy said is that more young athletes today arejust in one sport. Beachy said when an athlete isinvolved in just one sport they’re working the samemuscles and tissues over and over again. When an

athlete is in two or more sports, the athlete is work-ing different muscles in the body, which is healthi-er. Beachy said if an athlete is in just one sport, theyshould try to focus on more circuit and strengthtraining to help exercise other parts of the body.

Beachy highly recommends youths have a bal-anced diet, which will help the athlete performwell, as well as getting a good night’s rest.

The doctor said once he diagnosesthe problem with the athlete, the treat-ment to a sports injury is physical ther-apy about three times a week, a lot ofrest and a range of motion exercises.

Beachy said one of the biggest thingshe tells his patients is that just becausethey feel better does not mean they areinjury-free. Beachy said the athletesstill have to continue to work that mus-cle that was injured to make it stronger.

The faster the athlete becomesaware of their pain/injury and seekshelp, the faster the injury will behealed, said Beachy. The longer theywait, the more pain they will have.

“I’d say about 10 percent of mypatients have to have surgery,” saidBeachy. “The most serious injuries thatrequire surgery could have the athleteout of the game for a month or two.”

Beachy understands that athleteswant to be in the game, as he is thecoach for the Staples-Motley girls’ bas-ketball team. But Beachy said the mostimportant thing for the athlete and thecoach to remember is that the safety for

the youth comes first and the faster the injury ishealed, the faster the athlete can get back to thegame.

JENNIFER STOCKINGER may be reached at

[email protected] or 855-5851.


Stretching the wrist at a 90-degree angle is one of manystretches a person with lateral epicondylitis, also known astennis elbow, can do.

By SARAH NELSONStaff Writer

Buying organic is good for yourhealth, but it can be tough onyour wallet.

Everything organic can be a bit over-whelming. For most, the reason peopledon’t go the natural route is because theydon’t know where to start.

Crow Wing Co-op manager SteveMcKnight said these glossy-eyed first-timers make their way into the co-op all

the time.“Most people are interested in grocery

items,” McKnight said. “They want to buythe organic version of what they arealready eating.”

McKnight said part of changing people’sminds about buying organic is helpingthem understand how it benefits them.“Most of our customers walk in a fog,” hesaid. “Education is half the battle.”

McKnight said most people are sur-prised to find that buying organic itemsisn’t actually as expensive as the might

anticipate.“Probably the biggest myth we have to

fight is cost,” he said. “Often times, theorganic often ends up cheaper than mostitems because of packaging.”

Before you take the plunge into buyingall things organic, know the facts. Thereare some things you might want to buyorganic, some things you could buy organ-ic, and then there are the things youabsolutely should buy organic. Here areeight:

1 - Strawberries are a super-food andthat means they are packed withVitamins A, C and cancer-fighting antiox-idants. Plus they are super low in calories.The problem with strawberries is all ofthose tiny seeds make it tough to wash offpesticides. Since you eat strawberries withthe skin on that means you ingest morechemicals.

A good rule of thumb is to go organicwhen it comes to any soft-skinned fruitincluding berries, cherries, apples, peachesand pears. When it comes to the thick-skinned variety, like oranges, bananas andavocados it is pretty safe to take the stan-dard route.

2 - Water bottles are obviously not asuper-food, but they are a super source ofhydration. Reusable plastic water bottlesare better than the disposable kind for theenvironment, but they can do some lastingdamage to your body because. Reusableplastic is of BPA or bisphenol A, an organ-ic compound made of polycarbonate andepoxy resin. Canada has gone as far as toban the use of BPA in baby bottles and hasdeclared the compound a toxic substance.

Switch out your BPA plastic bottle forone made BPA-free or go for an unlinedstainless steel one instead.

3 - Beef is what’s for dinner and itcomes with some unexpected side dishes.Hormones. Lots of hormones. Standardbeef production includes a healthy dose of

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8 things you should buy organic


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

Brainerd

Dispatch/Kelly

Humphrey

It’s a good ideato buy organicwhen it comesto any fruitwith a softskin. Whetheryou eat theskin or not,pesticides usedto treat fruitcan be hard towash off,particularly in“bumpy” fruitslikes berries.

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hormone injections to help cows grow big and strong, butthose hormones are also linked to cancer in humans.

McKnight said that buying USDA certified is optimal, butnot completely necessary because there are plenty of localfarmers who aren’t USDA certified but still produce organicbeef. “It’s not as simple as organic — it’s about the source,”McKnight said. “We interact with the producers and trustthat it’s organic.”

4 - Got milk? Then just like beef, this cow dairy product ispacked with hormones. Milk contains natural hormones fromcows that account for more than half of our estrogen intake.Nearly 20 percent of cows are also treated with rBGH or rBSThormones to stimulate milk production by increasing the cir-culation of another hormone called IFG-1. And that, forhumans, might be too much estrogen.

Stick to milk without the artificial hormones.5 - Popcorn, particularly the microwavable kind, can take

on the toxic chemical, perfluorooctanoic acid, used to keep itfrom sticking to the paper bag it is packaged in. PFOA is alsoused in pre-treated carpet, wax remover, dental floss and cook-ware.

Not the kind of stuff you want touching your popcorn.Use an air-popper or make your popcorn in a pan. For a

lighter snack, try it with coconut oil instead of butter.McKnight said it’s not just popcorn you should by organic.

All corn products, including corn on the cob are a good item tobuy organic. Pesticides tend to get lots in the kernels and arevery hard to remove — even after rinsing. Corn produced pes-ticidefree prevents the unnecessary consumption of harmfulchemicals.


Reusable plastic water bottles can contain BPA, a material used inhard plastics that can seep into the water and lead to negative healtheffects. Stainless-steel unlined water bottles like these are oftenrecommended.

See EIGHT Page 10

Brainerd

Dispatch/Kelly

Humphrey

Dairy cows areoften pumpedwith artificial

hormones to helpstimulate milkproduction and

those hormonesend up in your

dairy products.Many consumersbuy milk that is“rBGH-free” or

produced withoutartificial

hormones.

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Ben’s StoryBen Maihot is serious about goingorganic. The 23 year old Brainerd res-ident said 95 percent of the productshe buys are made from all naturalingredients.In April 2010, Maihot reached theend of his rope. He had chronicdigestive issues that he just couldn’tseem to shake. “I tried everything,” he said. “Foodwas the only thing that had any con-sistency.”Maihot took drastic measures anddecided to completely overhaul hislifestyle abstaining from fast food,soda pop, “I haven’t even useddeodorant in a year,” he said.For Maihot the transition to organicwas foreign at best. “It was like learn-ing an entirely new language,” hesaid. “I had no idea was I was doing.”

Maihot said he started by purchasingthe ingredients to make an organicsoup that was supposed to help hishealth issues and educated himselfthrough the buying process.A year later, Maihot said his life iscompletely changed. His change indiet worked and he has never lookedback.He’s not only committed to eatingonly natural foods, but also using nat-ural hygiene products. Maihot now works part-time for CrowWing Co-Op, helping others under-stand organic living and is studyingto be a holistic health counselor. “Iwant to educate people on food andthe things they are putting in theirbodies,” Maihot said. “My dreamshave changed completely.

6 - Cleaning products are often madewith all kinds of harmful chemicals thatcan irritate your eyes, skin and lungs.McKnight said it’s important to knowthat household products list the ingredi-ents differently that food products. “Theydon’t have to label their ingredients likeyou do for groceries,” he said. “It’s a loteasier to skew a product’s contents.”

McKnight said that many “organic”home products aren’t actually organic,and in other cases, products that are notUSDA certified can actually be made of100 percent natural ingredients.“Certified isn’t as important as justknowing what’s in it,” he said, notingthat companies, including farms have topay to have the USDA certify their prod-ucts.

7 - Cookware of the non-stick varietyis convenient when it comes to making aperfect omelet, but that non-stick coatingcan become toxic when overheated. Youcan prevent the toxic release by keepingyour non-stick cookware at heated withlow-medium temperature and keepingmetal kitchen utensils away from theTeflon.

Whenever possible, use stainless steelor cast iron for your culinary needs, andif you’re worried about your ability toprevent sticking without the non-stick —try olive oil. It’s good for your heart.

8 - Celery is among the dirtiest offoods. According to the EnvironmentalWorking Group (www.ewg.org), celery isthe absolute worst when it comes toabsorbing chemicals. Celery stalks areextremely porous and absorb pesticidesthat are hard to wash off.


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

“Certifiedisn’t asimportant asjust knowingwhat’s in it.”

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Like fruit, it’s a good idea to go organicwhen it comes to soft skinned veggies —like bell peppers, spinach and even pota-toes.

McKnight said that organic goesbeyond buying natural groceries, it is alsoawareness of where products comes fromand how their production affects thatcommunity.

“There’s an extreme amount of waste,”McKnight said. “Knowing the land usedto produce is still going to be usable in 50years — that’s truly sustainable farming.

“That’s organic.”

SSAARRAAHH NNEELLSSOONN may be reached at

[email protected] or 855-5879.

Additional information provided by United States

Department of Food and Agriculure, Working

Environmental Group, Mayo Clinic and

www.nutrition.gov.


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

Organic continued...

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Living With Huntington’sdisease — one family’sstruggle By SARAH NELSON | GUEST EDITOR


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

Stephanie Zappajust wants peopleto understand one

thing — she didn’tchoose this.

“(People) judge me forsomething they know noth-ing about,” Stephanie said.“They just don’t get it.”

Stephanie has beenaccused of being drunk inpublic. She has had her men-tal aptitude questioned timeand again. People call hernames to her face and whis-per them behind her back.On one particular occasionshe was assaulted with ashopping cart in an areastore by individuals whothought she was intoxicated.

Stephanie is not a drunk.She’s not a drug addict. Andshe is not crazy.

At the age of 19, Stephaniewas diagnosed withHuntington’s disease, adegenerative illness thataffects the way she walksand talks and thinks andhas in many ways takenaway her independence.

“It’s hard to deal with theconcept of giving up so manythings,” she said. “If you tellme I can’t do something, itmakes me want to do itmore. I hate being told no.”

Huntington’s is a heredi-tary disease that affects onein 10,000 people. There are30,000 people in the U.S.with HD and up to 200,000are at risk. HD symptomsappear gradually and often

do not show up until mid-life,between the ages of 30 and50, and can progress for upto 25 years.

Sometimes longer.Stephanie said her HD

symptoms started showingup when she was about 32 —more than a decade after shewas diagnosed. “You have tolive knowing you have it,”she said.

Stephanie is not alone; noteven in her own family. Hermother, Connie, was diag-nosed with HD whenStephanie was a teenager. “Ithappened early for her,”Stephanie recalled.

Now in her 60s,Stephanie’s mother is unableto communicate andrequires around the clockcare.

Stephanie’s brother, JoeSullivan, and her firstcousin, Melissa Gammello,also have HD.

Melissa “Missy” was diag-nosed with HD at the age of32. “I started droppingthings at work and didn’tknow why,” said Missy, whowasn’t aware of her risk forHD until she met her fatherlater in life. “It was a bigshock.”

Missy’s father also hadHD.

“We were raised with it,”Stephanie added.“Missy wasnever really exposed to it.”

Every child born to a par-ent affected by HD has a 50-percent chance of being bornwith the gene that causesthe disease. It shows

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up equally in men and women, anddoes not “skip” a generation.

While HD presents differently inevery case, some of the more commonsymptoms include involuntary move-ment, called chorea, changes in coordi-nation, difficulty thinking through aproblem, changes to mood and deterio-rating motor skills.

Missy said the progression of her HDforced her to quit working 10 years ago.“I miss the independence and beingaround people,” she said. Missy workedas a medical secretary for EssentiaHealth St. Joseph’s-Brainerd Clinic.

At home, Missy said she had constantissues with maintaining her balanceand would often trip and fall over herfurniture.

“(My) mom got me a round coffeetable,” she laughed. “You gotta laugh —you got no choice.”

As symptoms progress, those withHD require more care and often have ahard time finding it.

“Places won’t take people withHuntington’s,” Joe Sullivan said. Joe, aformer delivery truck driver, said hisHD led to the end of his career and thedissolution of his marriage.

Stephanie and her husband, Allen,have conservatorship over Joe and planto add onto their house so Joe can even-tually live with them. Stephanie saidassisted care facilities are not typically

set up to handle patients with HD andoften won’t accept them because of thedanger their symptoms can present toother patients.

As chorea, and mood changes worsen,movement can become violent.Medication for chorea can help relieveinvoluntary movement and physicaltherapy is often needed to help patientsmaintain control of voluntary move-ments.

In the most progressed stages of HD,patients become totally dependent oncare from others.

As symptoms tend to vary in eachcase, chorea may become worse or itmay end completely. Patients often losetheir ability to walk and speak com-pletely.

Minna Wallin, a longtime familyfriend of the Sullivans, said she hasspent the last two decades watching thefamily deteriorate.

When Joe’s and Stephanie’s motherreached the stage in her HD where shecould no longer care for herself, sheasked Minna to be her conservator.

“Connie said, ‘If I have to have aguardian I want it to be Minna,’” Minnarecalled of the role she has served insince Stephanie was in high school.

“It’s just so hard to watch them gothrough this,” she said. “Some peopledon’t get it until they’re closer to 50.Their family seemed to get it really

young.”Learning to live with Huntington’s

disease means different adjustmentsfor different people.

Stephanie said one of her greateststruggles in dealing with HD is takingcare of her family. “It’s very hard to be amother and not be able to function as amother,” she said. “My kid has to takeon my role.

“I’m trying to not let it affect her, butshe has to do a lot more work because ofme.”

Stephanie said she received hershare of criticism for having a childknowing she could potentially pass onHD, but she sees it differently.

“There could be a cure for this gener-ation,” she said. “You have to experiencelife.”

Stephanie’s daughter, Kayla, is 18,and now eligible for testing to deter-mine if she will develop HD symptomslater in life. Like her mom, Kayla has a50/50 chance of carrying the gene thatcauses HD.

Dr. Martha Nance, medical director ofthe Huntington’s Disease Center ofExcellence at Hennepin CountyMedical Center in Minneapolis, saidthe number of potential HD carriersthat get the genetic test to find out ifthey carry the gene is 10 percent orfewer.

“The vast majority of those at risk are


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

“I wish we had aT-shirts that said, ‘Ihave Huntington’s.Ask me about it,’ ...That would bebeautiful.”

— Melissa Gammello

14

not getting tested,” Nance said. “Each person has tomake that decision individually. Siblings in the samefamily may make different decisions on whether to betested or not.”

Nance has specialized in the treatment and researchof Huntington’s disease for more than 20 years.

Nance said there are somewhere between 500 and1,000 families in Minnesota, South Dakota and NorthDakota that are directly affected by HD.

Treatment of Huntington’s disease can be brokendown into four general areas — movement, cognitivechanges, emotional behavior and weight loss.

Nance said medication is used to treat the involun-tary movement involved with HD, however, as symp-toms progress medication seems to make less impact.Patients’ voluntary movement can change making itimpossible for them to do the things they want to.

“There are no pills to treat that,” Nance said.Huntington’s disease may cause patients to develop a

form of dementia that differs from the kind seen inAlzheimer’s patients. While Alzheimer’s dementia tends todiminish existing memory, the dementia that affects HDpatients contributes to the inability to learn new informa-tion.

Some doctors do prescribe medication used to treatAlzheimer’s dementia, and other HD symptoms like depres-sion, anxiety and paranoia, however Nance said there is nodefinitive research that those medications work in HDcases.

Weight loss is an issue most HD patients face because ofthe constant movement and dementia that can contributeto patients forgetting to eat.

Nance said her clinic works directly with other medicalfocuses, like speech therapy, to better address HD on a holis-tic level.

Nance said: “It truly is a disease that lends itself to ateam management approach.”

Nance said clinics specialized in treating HD are growingfewer. Most clinics tend to treat other neurological disorderslike Alzheimer’s or Parkinson’s disease. “To have a clinicthat is specifically devoted to HD is pretty rare,” she said.

Nance said she is proud of the network of support thatsurrounds those affected by HD in the state of Minnesota.“If you give people a firm base to stand on they’ll use theircreativity to educate others,” Nance said. “It really aremarkable community surrounding HD.

“There’s a lot of beauty that comes out of such great sor-row.”

For Stephanie, Missy and Joe, the hardest part of livingwith Huntington’s disease is the lack of understanding theyget from a general public they said remains grossly unedu-cated about the disease and its symptoms.

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

Missy said she was once at an area high school baseballgame with her daughter and heard other parents talkingabout her and making fun of her movements and the wayshe spoke. When she went to leave, one person went as faras to approach Missy’s vehicle and asked her not to comeback.

“I don’t like to be in public by myself,” she said. “You trynot to let it get to you, but it does.”

Stephanie said the Brainerd area lacks a support systemfor those affected by Huntington’s. “People are not aware ofit,” she said. “That hurts me.”

Dianna Nelson, Stephanie’s mother-in-law, said thatbefore she knew Stephanie, she may have been amongthose who judged based on assumption.

“You make fun of them because you don’t understand,”she said. “Stephanie has to be one of the strongest people Iknow.”

Missy said even with the need for education about HD,she is optimistic about the life she has lived thus far.

“You start feeling sorry for yourself and then you have tosay, no, I’ve had a pretty good life.”

Stephanie, Joe and Missy share the hope that as peoplelearn more about HD and how it changes the lives of thoseaffected by it, they will be more accepting and slower tomake an assumption about what they think is “wrong” withthem.

“My belief is we all have something, ours is justHuntington’s,” Stephanie said. “Just have some compas-sion.”

SSAARRAAHH NNEELLSSOONN may be reached at [email protected]

or 855-5879.


Stephanie Zappa (right) has found support from family and friendsas her Huntington’s disease symptoms have progressed. Amongthose who have provided a great deal of support is longtime familyfriend, Minna Wallin.

15

The Minnesota Department of Health announced the launch of MinnesotaPublic Health Data Access, an electronic gateway to Minnesota health and envi-ronment data. MNPH Data Access is part of a national initiative led by theCenters for Disease Control and Prevention to close the information gap in whatis known about the impact of environmental hazards on public health.

This Web-based information system provides a “one stop shop” for data abouthealth, the environment, and other risk factors that may affect public health inMinnesota. Local public health professionals, the public and others may useMNPH Data Access to gather information about health and environmenttrends over time, and to conduct queries of state and county-level data inMinnesota about diseases and conditions, such as asthma, cancer and heartattacks. This information will help improve efficiency through better dataaccess, and will help Minnesotans make healthy, informed decisions.

MNPH Data Access currently includes data on ten topic areas: air quality,asthma, heart attacks, childhood lead poisoning, carbon monoxide poisoning,reproductive outcomes, cancer, birth defects, drinking water quality, and chron-ic obstructive pulmonary disease. This summer, MNPH Data Access will addnew data and tools, including GIS maps.

Minnesota, along with 22 states and New York City, receives funding fromCDC to help improve what is known about the environment's impact on publichealth by building state tracking networks. With Minnesota's participation,CDC's environmental public health tracking efforts are informing public healthpolicies and actions.

MNPH Data Access is updated and maintained by the MinnesotaEnvironmental Public Health Tracking Program, a program within MDH,through a cooperative agreement with CDC's National Environmental PublicHealth Tracking Program. Data is collected in collaboration with several MDHprograms and other agencies, including the Minnesota Pollution ControlAgency.

MNPH Data Access is available at: https://apps.health.state.mn.us/mndata/.

For information about the Minnesota Environmental Public Health TrackingProgram, see: http://www.health.state.mn.us/tracking.

For more information about the CDC Tracking Program, seehttp://www.cdc.gov/nceh/tracking/.

The CDC Tracking Network is a nationwide network that integrates healthand environmental data from a variety of national, state and city sources; it islocated at

www.cdc.gov/ephtracking <http://ephtracking.cdc.gov/showHome.action> .

MDH LaunchesMinnesota PublicHealth Data Access: A Gateway toMinnesota Health andEnvironment Data

16

What lies beneath the UV raysBy JENNY HOLMESHealthWatchCorrespondent

It isn’t an uncommonstory — overzealousindoor tanning expo-

sure as a teen leads toskin cancer as an adult.

Now, as a 42-year-old moth-er of two, Gayle Wood looksback on her experience over 14years ago and thanks herlucky stars that her storyended on a positive note.

Wood, a 1987 graduate ofBrainerd High School and nowstylist at the Sharp EdgeSalon in Brainerd, was 28years old when she firstnoticed an unusual and unfa-miliar spot under her leftbreast.

“I’m typically a very moleyperson,” Wood noted, “but thiswas never there before.”

The suspicious spot in ques-tion was no bigger than aneraser head, dark brown in itscenter. While the “C word”crossed her mind, Wood saidneither she nor her familypractice physician were overlyconcerned. The mole wasremoved and sent in for biopsy.

“I really didn't think much ofit,” she said. “I was young andyou weren't seeing skin canceron young people at that point.But it came back asmelanoma.”

Wood underwent a processthat removed 30 percent of theskin and tissue around theoriginal spot to determine ifadditional cancer cells werepresent. Fortunately, it hadbeen contained to the immedi-ate area and was caught wellin advance of spreading tonearby tissues. She was put ona preventative schedule forblood work and chest X-raysevery few months until shewas considered out-of-the-woods, so to speak.

“That would be called high

school tanning beds,” Woodsaid of her believed source ofcancer.

“That’s what that was: thedangers of being in a tanningbed. You know in high school,you looked better and felt bet-ter when you were tan. Skincancer was unrealistic.”

Over the years, Wood hashad approximately 10 sepa-rate spots removed as a pre-caution, none of which havebeen declared melanoma. Butin an ironic twist of fate, skincancer revisited Wood’s familya little over one year ago.

Husband, Brian, had a moleon his back that Wood said hadbeen there “forever.” But thisparticular spot began growingdarker in color, raising her sus-picions.

“Brian’s skin fits more inprofiling someone who wouldbe more apt to get skin cancer,”Wood said. “He’s light com-plected, has red hair, burnseasily.”

Brian walked the same roadhis wife had several years ear-lier, undergoing the ‘punch’process, removing the area inquestion. And, once again,results were positive formelanoma. However, this timewhen 30 percent of the sur-rounding area was removedand tested, additional abnor-mal cells were detected.Brian's cancer was more sub-stantial than that of his wife’s.A much larger area of skin wasremoved by a surgeon toremove additional cancer cells.Fortunately, Brian was thencleared without need for radia-tion or additional invasivetreatment.

Because of her bout withskin cancer,Wood said her chil-dren were put at a high risk.Now with the addition of herspouse’s cancer incidence, thatrisk is even higher.

And for Wood, her concern issomewhat lessened in havingtwo sons.


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

17

“We still do allof our summeractivities, playout on thebeach. You'rejust morecareful, all of us.I use sunscreen alot....”

“Fortunately, they won’t be using tanning beds.”According to the American Cancer Society, skin

cancer is the most common of all cancer types, withmore than 2 million skin cancers diagnosed eachyear in the United States. It goes without saying,the real rays of the sun can be as dangerous, if notmore so, than the UVA and UVB rays emitted in anindoor tanning bed. Ultraviolet (UV) radiation isbelieved to be the major risk factor for most skincancers, and sunlight is the main source of UVrays, which can damage the genes in skin cells.

Becky White is a certified nurse practitionerwith Dermatology Professionals, PA in Baxter andsaid rates of all forms of skin cancer are certainlyon the rise.

“The increased rates may be due to increasedawareness,”White said. “People may be more apt toseek medical attention for suspicious lesions result-ing in better diagnosis. Ultraviolet rays, includingrays from the sun and tanning beds, are the lead-ing cause of skin cancer. Skin cancer, however, canoccur in areas that have never been exposed toultraviolet rays.”

White said there are many ways to keep your-self, and loved ones, safe while enjoying the sum-mer sun.

“Wearing sunscreen with protection factor of 30or greater that contains at least one of the follow-

ing active ingredients will provide the best protec-tion from both UVB and UVA rays: zinc oxide, tita-nium dioxide, avobenzone or mexoryl (ecamusol).Wear a wide brimmed hat and clothing with ultra-violet protection when exposed to sun. Choose to bein the shade as much as possible. And avoid thepeak hours of sun, generally between 10 a.m. and 2p.m.”

White urges individuals to see their doctor ifthey have a spot that won’t heal, a scaly spot thatwon’t go away or if they have a mole that is irregu-lar in color, irregular in shape, changes shape,becomes irritated, or bleeds.

Protection from skin cancer doesn’t necessarilymean avoiding the great outdoors through thesummer months. It just means stepping up yourskin safety smarts, Wood noted.

“We still do all of our summer activities, play outon the beach. You’re just more careful, all of us. Iuse sunscreen a lot. I’m good about applying sun-screen when I’m out and I think you become moreaware of it.And I make sure it's not just myself, butalso my kids. I’m really trying to get them into thehabit of using it. You can still get color even thoughyou're using sunscreen. Everybody loves a tan or toget color, but you don't have to get as dark as youcan.”

Essentia Health St.Joseph’s Medical Centerreceives DHS recognitionfor helping establishpaternity

The Minnesota Department of Human Services recognizedEssentia Health St. Joseph’s Medical Center among 21 Minnesotahospitals for their work in establishing children’s paternity. Therecognition was part of the Fourth Annual Excellence in BirthRegistration Training and Conference, hosted by the MinnesotaDepartment of Health, April 29 at the MDH Snelling Office Park,St. Paul, Minn.

“Establishing paternity is a critical step toward establishing life-long relationships between parents and children,” said DHSCommissioner Lucinda Jesson, who signed the awards for each ofthe hospitals. “We are very proud of what these hospitals haveachieved, and recognize their contribution toward building healthyfamilies.”

Essentia Health St. Joseph’s Medical Center was among 14 hos-pitals recognized for establishing paternity for at least 80 percentof children born to unmarried parents who signed the Recognitionof Parentage at the time of their children’s birth. These hospitalswill receive the Recognition of Parentage Excellence Award.

18

Cancer. It’s a word anyone wait-ing for biopsy results dreads tohear.

And that diagnosis is often just thebeginning of the questions. What type ofmedical option is best? Does it mean sur-gery? Is there a clinical trial that mayprovide a new treatment option? Facedwith economic struggles, how can a fami-ly handle this diagnosis and treatmentson top of a broken vehicle or a financialcrunch?

Early Tuesday morning, a group withexperienced specialists — from surgeonsto social services — meets at EssentiaHealth St. Joseph’s Medical Center forthe weekly cancer conference.

A patient’s case is presented — withbiopsy results, risk factors, overall health.The presentation includes images suchas X-rays and CT scans along with testresults. A radiologist attends to helpreview the images such as a mammo-gram. A pathologist provides biopsyresults. Patient care is reviewed, optionsdiscussed and a plan for patient caredeveloped based on the evidence — utiliz-ing the specialized knowledge of eachparticipant. They look at the individualpatient’s situation and what the bestcourse of action may be.

Beyond the tumor, the group considersthe entire patient and needs both socialand spiritual. The ultimate goal is toimprove quality of care.The group tries toreview all new breast cancer diagnosisperhaps even before surgery, along withother cancer cases. Each member of thecare team may ask for a patient’s careplan, or a particular part of it, be present-ed to the group.

It’s not revolutionary. Medical staff atthe Brainerd hospital have been collabo-rating for many years. But when themedical center sought national accredita-tion, a monthly conference was turnedinto a weekly event with a broad range ofspecialties included.

In March, Essentia Health achievedNational Accreditation for BreastCancers. Its cancer program was nomi-nated for an outstanding achievementaward.

Essentia Health St. Joseph’s MedicalCenter reports it was the fourth hospitalin Minnesota to achieve national accredi-tation. Essentia Health, which includesSt. Joseph’s Medical Center and St.Mary’s Medical Center in Duluth, report-ed it makes up 50 percent of NAPBCaccredited hospitals in Minnesota.

The group typically gathers each weekat 7 a.m. to discuss cancer cases. At leastone representative from each specialtyattends. Radiologist. Pathologist.Surgeon. Medical oncologist. Radiationoncologist. Clinical nurse navigator.Clinical research nurse. Lymphedema

Essentia Health cancerconferencecontributes to patientcare

By RENEE RICHARDSON |Senior Reporter

Brainerd Dispatch/Renee Richardson

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

19

Pastoral care representative. Cancer cen-ter manager. Cancer registrar.

Dr. James Dehen, surgeon, said the cancerconference is really a formalization of whathas always been done.

“Cancer treatment is never a single physi-cian disease,” Dehen said. Now with cancerclinical trials available to patients, Dehensaid the medical center needs to have a wayto help people through the process from diag-nosis to the right arms of treatment.

“We’ve been doing this all along, now weare doing it better, more efficiently and thepatient has a contact person to work directlywith in the form of a navigator.”

The ultimate goal of bringing the special-ists together is to increase the number ofbreast cancer survivors.

“Patients feel like their care can be veryfragmented, so especially with cancerpatients where they are seeing multiple spe-cialists,” said Dr. Laura Joque, medical oncol-ogist. “I think they can feel confident that allof their care team doctors and nurses havespoken together and are on the same page asfar as their treatment plan and goals. It’s allthese people coming together so it’s nice tohave that in a coordinated way. That to me isa big benefit of this formalized weekly meet-ing of the group.” Brainerd Dispatch/Renee Richardson

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

See CANCER Page 21

20

Diagnosingfrom the denCan surfing the Internet make yousick?

By SHEILA HELMBERGERHealthWatch Correspondent

Have you ever had a cough, a pain, a tinge or an acheand logged on to the Internet to figure out for your-self what the problem might be?

There’s no denying the value in a trip around the web toconnect with a long lost relative or as a tool to scan the dealsfor a new car and look for garage sales but is it the place tomake decisions about our health? It can be helpful. But I feara bit dangerous also. People use the Internet to diagnose med-ical ailments for the same reason they use it for most any-thing else. To save on cost, sometimes embarrassment, for itsconvenience and to save time.

If you were ever prone to becoming a hypochondriac it onlygets easier thanks to the Internet. In fact they’ve alreadygiven it a title — Cyberchondria: The unfounded escalation ofconcerns about common symptomology based on review ofsearch results and literature online.

There are many good sites that offer solid, informative helpon when and when not to go to the doctor and there are a mul-titude of tips on how to treat almost any ailment.

Knowing when to log off can be important.I took a stumble down the steps of my parent’s deck recent-

ly and landed on my left hand. It’s a little swollen and I’m sureI probably have a light sprain but I went to the Internet todiagnose my ailment. Since I already knew what happened Iwanted to see what my friends online had to say based on mysymptoms.

There were some serious contenders for what my ailmentmight be. The problem about the Internet is that it’s easy tostart wondering if you don’t actually have something.Anything. In fact — everything. I see where this could be aproblem. Some of the sites are merely discussion boardswhere you access other exchanges regarding similar symp-toms and anyone, including an everyday Joe like myself, candispel medical information and help determine a believablediagnosis.

Some of them thought maybe it was from too much salt(well… there actually was this whole bag of sunflower seedsat the campfire the night before ... but I needed to remembermy fall). I also started to get worried when terms like rheuma-toid arthritis and fibromyalgia started coming up frequently.A search for ‘why is my left hand swollen’ resulted in sugges-tions of a potassium deficiency, anxiety disorder and actually,pregnancy came up more than once. One person was con-cerned that the pain might move from my hand down mywrist and I swear ... when I started rubbing, it I really start-ed to think they could be right.

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

I already know I’m just the sort of person that shouldn’t use these websites.The hand wasn’t enough to worry about because when I decided to be evenmore honest my online friends started to question why I tumbled down thestairs in the first place and it became a topic of great concern. Even though Iknew the culprit was really a flip-flop that flipped when it should haveflopped, others were worried that I may have gotten a dizzy spell, which ledto an early determination of dementia, cerebral tumor, stroke or just poor eye-sight. Hypoglycemia was suggested, as was anemia. Pretty soon my fingerswere flying and I was second guessing the whole slip-on-the stairs incidentmyself. Was I noticing I was more clutzy these days? Tough one. But I did spilla cup of coffee in the morning. Actually, that happens pretty often but I’venever done it the ... same ... day I’ve fallen before. Coincidence? Some thoughtnot.That led to suggestions of nerve damage, more votes for arthritis, and alsolupus, gout, Lyme’s disease or some sort of severe infection.

If I had something really scary I’m not sure this would be the place for meto go. I’m way too easily convinced about things. But I have to admit I’ve usedthings like WebMD and MayoClinic.com and some other sites as a source togather information before taking my mother to the doctor or going myself.Only so we can go armed with some good, necessary questions to ask a realphysician. The truth is the good doctors at Mayo Clnic .com actually suggest-ed a sprain or break when I entered information on my swollen hand. Since asearch for information on a headache can run the gamut from caffeine with-drawal to a brain tumor it might be a good idea to let the experts do the realdiagnosing.

While I was pretty close to rushing to the nearest hospital and admittingmyself for a full battery of tests I stopped before I got too much information.My hand is already feeling better and I’m pretty sure I’m just your averageklutz. It really does seem that surfing the Internet for medical advice canmake you sick.

SSHHEEIILLAA HHEELLMMBBEERRGGEERR lives in Baxter and contribures to several publications. She has been married for

24 years to her husband, Kirk. They have three children and almost as many cats.

21

Inside a Cancer ConferenceAt Essentia Health St. Joseph’s Medical Centerin Brainerd, each week a cancer conference pullstogether a blend of specialities to discuss cancercases. All new breast cancer cases go before thegroup, along with other cases. Each group includes a specific skill set aimed atthe overall patient. They include: Radiologists — present any imaging on eachcase being presented. Radiologists read diag-nostic imaging, such as X-rays, and performbiopsies that lead to a cancer diagnosisPathologists — present any pathologic findingson each case being presented. Pathologists lookat tissue that is removed from the body eitherby biopsy or surgery and look at the cellularstructure under a microscope to determine if thecells are cancerous.Surgeons — treat cancer by removing cancerousorgans and tissue through surgical procedures. Medical oncologists — medical oncology is thespecialty that treats patients with systemic ther-apy such as chemotherapy and supportspatients through diagnosis and treatment andcontinues to follow patients after they havecompleted treatment.Radiation oncologists — plan and deliver highenergy radiation to cancer cells to treat and killthe cancer cells. Clinical nurse navigator — acts as a contactperson for breast cancer patients to help navi-gate through the health system during theirdiagnosis and treatment. The nurse navigatoranswers questions and gives patients educationon their cancer and treatment options.Clinical research nurse — screens cases for clin-ical trial eligibility and then enrolls willing eligi-ble patients into available clinical trials, whichgive patients access to treatments not widelyavailable.Lymphedema therapist — prevents and treatsconditions caused by the damage or removal oflymph nodes. Lymphedema is tissue swellingcaused by a buildup of protein fluid. Social services — provide support services topatients in need and links patients to hospitaland community resources, such as transporta-tion to and from medical appointments.Pastoral care — provides spiritual and grievancecounseling to patients.Cancer Center manager — oversees day-to-dayfunctions of oncology services and the infusioncenter to ensure patients are receiving the bestcare. The manager also processes changes thatarise through discussion at the cancer confer-ence.Cancer registrar — tracks cancer care data andprovides conference participants with data oncancer incidence and treatment when necessaryand keeps documentation of cancer conferencediscussions and attendance.

Source: Essentia Health St. Joseph’s MedicalCenter.

Patients are told their cases will be dis-cussed at the cancer conference. Joquesaid the discussion, which can be lively,also provides a second opinion.

“I think that’s all for the patient’s ben-efit,” Joque said.

Dehen and Joque said in their experi-ence, patients appreciate the group’sfeedback, whether it’s an affirmation ofthe care they are receiving or a variation.

“Cancer is a disease that scares peopleand the more you can do to just makethem feel the path they are on is theright one is a plus,” Dehen said.

Barbara Morris, clinical researchnurse, said attending the weekly confer-ences to talk about the plan of careallows her to have input on the clinicaltrials that are available in Brainerd. Bynetworking, the hospital in Brainerd isable to connect patients with existingclinical trials at other facilities such asthe Mayo Clinic.

Dr. Jonathan deHart said the discus-sions aren’t solely focused on treatment,but go into diagnosis as well and the for-mat allows the group to challenge eachother.

Beyond the obvious medical aspectsand gathering input from specialists inthose fields, the conferences look at thewhole patient. Participants in the confer-ence, from social services and pastoralcare, are there to see if other patientneeds are being met — be they spiritualor financial, or even as basic as whethera patient has transportation to get toappointments. Each of those areasimpact how a patient does in treatmentand thus is incorporated into the overallcare plan.

“I think it helps me give better care,”Joque said of the conferences and therelationships developed there betweenstaff. Joque said she thinks the groupsessions have helped in her daily workand not just in the specific cases dis-cussed at the cancer conference.

RENEE RICHARDSON may be reached at

[email protected] or 855-

5852.

CANCER/ Conferences a im atimprov ing hea l th care

22

Bariatric surgeryprogram offered atCRMC has assistedmore than 1,000people in their weightloss journey

CROSBY — Losing weight andkeeping it off usually warrantsmore than a fad diet or miracle-

working piece of exercise equipment —it requires a lifestyle change.

People struggling with obesity, the No. 1health problem in the United States, oftenhave a hard time making those lifestylechanges on their own, or, no matter how hardthey try, can't seem to lose weight.That’s whenthey turn to bariatric, or weight loss, surgery.

Within an 80-mile radius of Brainerd,bariatric surgery is only offered at CuyunaRegional Medical Center's MinnesotaInstitute for Minimally Invasive Surgery inCrosby. The bariatric program is amoung theoldest, most comprehensive in the state.

MIMIS has a team of four experienced sur-geons — Dr. Howard McCollister, Dr. PaulSeverson, Dr. Timothy LeMieur and Dr.Shawn Roberts — along with a dietician, psy-chologist and nurse coordinators dedicatedsolely to bariatric patients.

McCollister said he often hears stories fromhis patients about not being able to fly on anairplane, drive a car or actively participate inthe lives of their children or grandchildren. It'sthose stories that led him and Severson to cre-ate MIMIS's program 12 years ago.

“I've been a surgeon for a long time, andwhen someone gives you hug and says ‘yougave me my life back,’ I can’t even describehow gratifying that is,” said McCollister, co-director of MIMIS’s bariatric surgery program.

After being overweight for most of her life,Lani Hatrick decided to have bariatric surgeryat MIMIS after being diagnosed with diabetesand high blood pressure at age 35.

“I'd failed every diet,” she said. “I was sick ofit.”

Although she had an active lifestyle evenbefore the surgery, she now works out four

Committed tohelping patientsbattle obesity

Dr. Timothy LeMieur (left), surgeon at Cuyuna Regional Medical Center's Minnesota Institute forMinimally Invasive Surgery, chatted with Lani Hatrick following her Lap-Band procedure.See CROSBY Page 24

23

Q & A with...Speech Therapist Kari JohnsonCan you share a little bit about yourself?

I moved from North Dakota to Minnesota after highschool to attend college at the University ofMinnesota-Duluth. I got married the weekend after Igraduated from graduate school to my husband,Jeremy. We’ve now been married for six years andhave an almost 2 year old son, Carter. Besidesspending time with my family and friends, I also love tocook and to travel.

How long have you been a speech pathologist withEssentia Health St. Joseph’s Medical Center?

I have worked at Essentia Health St. Joseph’s MedicalCenter for six years now. I can't believe how time flies.

What kind of educational background and trainingwas required before entering your field?

To become a speech language pathologist, a master’sdegree is required and you must pass a national exam.The title of the degree will vary depending on theuniversity, but my master's degree is inCommunication Sciences and Disorders. I studied atthe University of Minnesota-Duluth.

What kind of treatments do your therapies provide?

It really depends whether you’re working with childrenor adults. I work primarily with adults, so commontreatments I provide are for swallowing, voice,cognitive-communication disorders, speech andlanguage.

What is the most common need for speech therapy?

For me, in the hospital inpatient setting, swallowingevaluation and treatment is definitely the mostcommon need. It’s crucial to identify what foods andliquids a patient can safely swallow and to providetherapy when disorders are present.

What do you like most about your job?

There’s a lot to like about my job. I love the varietyeach day and I have great co-workers, but what I lovemost is the great patients and families I get to workwith on a daily basis. They are definitely the highlightfor me.

— Health Watch Editor, Sarah Nelson


Kari Johnson works as a speechpathologist with Essentia HealthSt. Joseph’s Medical Center andBrainerd Medical Clinic.

24

days a week, inline skating and taking aerobics classes.“My stamina is much better … and I’m not thinking about food

the whole time I'm doing it anymore,” Hatrick said.Her diabetes and high blood pressure is gone too.“I feel (Dr. LeMieur) saved my life,” she said of the MIMIS doc-

tor who performed her surgery.MIMIS surgeons have performed more than 1,000 bariatric

surgeries through the years, using Roux-en-y gastric bypass, lapband and sleeve gastrectomy techniques to help patients feel fullsoon after they eat. Statistics show people who have completedMIMIS’s bariatric program exceed the national average for beingable to keep most of the weight off for at least two years followingsurgery.

Jill Wehseler, a registered nurse who works with MIMIS'sbariatric patients, said the high success rate is a testament totheir comprehensive program.

“We put a lot of emphasis on preparing patients for how theirlives will change after the surgery,” Wehseler said. “I believe thishas helped our patients succeed when it comes to keeping theweight off.”

The thorough program takes anywhere from four months to ayear to complete, and features psychological counseling andpreparation, dietary education, exercise plans and a variety ofhealth tests before and after the surgery.

“We teach people to use the surgery as a tool to lose weight,”said McCollister. “You can’t have a successful bariatric programthat revolves around just the surgery.”

The dramatic amount of weight loss that usually followsbariatric surgery often leads to better overall health. In mostcases, like Hatrick’s, health problems including diabetes, highblood pressure and cholesterol, sleep apnea and joint pain can beeliminated after returning to a healthy weight.

“We’ve committed ourselves to answer the call to try to helppeople with obesity,” said Severson. “After a decade of laproendo-scopic bariatric work, we're the most reliable bariatric program inthe state.”

So reliable, in fact, MIMIS is accredited by The FellowshipCouncil to teach other surgeons to preform bariatric surgeries.

“The pinnacle in bariatric education is available here, not any-where else in Minnesota,” said Severson. “Surgeons are comingfrom across the country to be trained here.”

MIMIS has the only accredited bariatric fellowship trainingprogram in Minnesota. There are only about 130 programs in theUnited States and Canada that are accredited by the FellowshipCouncil to teach minimally invasive surgery.

MIMIS is accredited by the American Society of Metabolic andBariatric Surgery as a Bariatric Center of Excellence. They arealso a Level 1a Center of Excellence through the AmericanCollege of Surgeons, as well as a designated Blue DistinctionCenter for Bariatric Surgery by Blue Cross and Blue Shield.

For more information on the bariatric program on the Medical Campus at Crosby,

call 888-546-4343.

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

“I feel (Dr. LeMieur)saved my life.”

25

There’s something, er, fishyabout the new Dietary Guidelinesfor Americans 2010. Unlike the2005 version, the newly updatededition of the federal govern-ment’s official guide to healthfuleating lists increasing seafoodintake among its key recommen-dations.

By “fishy,” I don’t mean suspi-cious. Besides being delicious, fishand shellfish, which together con-stitute “seafood,” can confer last-ing health benefits.

The benefitsLike red meat and poultry, fish

provides the protein essential formaintaining healthy muscles andother tissues. Most of us get morethan enough protein. What reallymakes fish worth eating are itsomega-3 fatty acids. New researchshows that these healthful fatsmay help prevent age-relatedmacular degeneration, a diseasethat impairs vision. But their ben-efits extend far beyond that.

➤Heart health. Omega-3 fattyacids, specifically eicosapen-taenoic acid (EPA) and docosa-hexaenoic acid (DHA), help pre-vent cardiovascular disease andsudden cardiac death. Penny Kris-Etherton, professor of nutrition atPenn State, says these healthfulfats can reduce heart arrhythmia,the leading cause of sudden car-diac death. The effect can takehold mere weeks after a personadds more fish to his diet, shesays. Omega-3s may also lowertriglycerides and blood pressureand prevent blood clots that cancause stroke.

➤Child development. Omega-3fatty acids contribute to fetalgrowth and brain development inearly infancy, says BethanyThayer, a spokeswoman for theAmerican Dietetic Association.When women consume omega-3s -

especially DHA - from at leasteight ounces of seafood per

week, the dietary guidelinessay, their babies may have height-ened visual and cognitive develop-ment.

Kris-Etherton adds thatresearch shows kids who eat morefish may have slightly higher IQsthan those who eat less. “A coupleof IQ points, you question whetherthat can make a big difference,”she says. “But it might have somebearing on test-score results.”

How to eat more:➤Can it. For convenience, you

can’t beat canned tuna andsalmon (which also are goodsources of Vitamin D and, if youbuy the bone-in kind, calcium,Kris-Etherton says). Keep inmind, though, that if you limityourself to these you’ll be gettingmore sodium than you need andmissing out on the wide range ofoptions in the fresh-seafood case.

➤Try milder fish. Don’t likefishy taste? Try

mild-flavored fish such as cod,flounder, sole and tilapia, whichtake well to baking, poaching orsteaming, Thayer says, more sothan grilling. But she notes thatthese don’t deliver as big a dose ofomega-3s as fattier fish.

➤Go beyond the fillet or steak.You can add fish to soups or sal-ads, Thayer suggests. Get kids toeat more fish with homemade fishstrips or fish tacos. Or simply coatstrips of cod or haddock in sea-soned bread crumbs and bakethem in the oven. Thayer herselfis partial to salmon topped withfruit salsa. (You’ll notice thatnobody suggests battering andfrying, which adds unneeded calo-ries and often unhealthful fat.)

Consumer concerns

The year of the fishNew dietary guidelines place fish at the top of the list for

health benefitsBy Jennifer LaRue Huget

Special to The Washington Post

➤Best for omega-3s. Someseafoods have more of thesethan others. The best are:salmon (wild and farmed)Pacific oysters, anchovies, her-ring, sardines, trout, andAtlantic and Pacific mackerel.

➤Mercury. Some people avoidfish for fear of consumingmethyl mercury, which mayharm the developing nervoussystem of an unborn baby oryoung child. Some fish containmore mercury than others,including large fish such as alba-core tuna that “are great big andhang around the ocean a longtime, eating smaller fish,” saysKris-Etherton.

Pregnant women in particu-lar should steer clear of the topfour mercury-containing fish:tilefish, shark, swordfish andking mackerel (also known asgolden bass). As for tuna, thedietary guidelines say womenwho are pregnant or breast-feed-ing can eat any kind of tuna theylike but should stick to no morethan six ounces of white tunaper week because it containsmore mercury.

➤Cholesterol. Shrimp is a“very lean source of protein,”Thayer says, but some peopleshy away because it is loadedwith cholesterol. (It’s also lowerin omega-3s than other seafood.)Thayer and Kris-Etherton agreethat the science is fuzzy on howeating shrimp affects cholesterollevels in your body. AmericanHeart Association guidelines callfor consuming less than 300 mgper day of cholesterol; fourounces of shrimp deliver about160 mg.

➤Safety and freshness. Cookfish until its internal tempera-ture measures 145 degrees on afood thermometer, Thayer advis-es. Just checking to see if it’sflaky isn’t good enough. And thebest way to tell whether fish isfresh is to give it a sniff. “If itsmells fishy, it’s probably notfresh,” she says. “It should havejust a faint smell of the sea.”

A diet rich in seafood provides lasting health benefits heart-healthboosting omega-3 fatty acids. Omega 3 also benefits eye health thatmay prevent age-related macular degeneration.

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HealthWatch Magazine - Summer 2011