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OCTOBER 2003 A day in the life of ... A flight medic Page 5 Lose weight fast Gastric Bypass surgery Page 10

UpNorth HealthWatch 10/2003

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ANNOUNCING ST. JOSEPH’S $25 MILLION MEDICAL CENTER EXPANSION.

It’s an exciting time to live in the Brainerd Lakesarea. Our community is growing and getting betterevery day. With that growth, of course, comes anincreased need for healthcare services.

At St. Joseph’s Medical Center, we’re responding to that need by expanding our medical campus—putting $25 million in construction services andmaterial costs into the local economy.And whenwe’re done, we’ll bring even more jobs to the community. Our 116,000-square-foot expansion and renovation project will bring us to our licensedcapacity of 162 beds and increase the number of private rooms, allowing patients and familiesgreater comfort. It will also increase the capacity of our intensive care and progressive care units,and allow us to bring to our area some of the mostadvanced medical technology available.

It’s better care for all of us, and it’s a sign that ourcommunity will continue to stay healthy as it grows.

Life is good. We’ll help keep it that way.

Construction scheduled for completion in 2005.

OCTOBER 2003

A day in the life of ...

A flight medicPage 5

Lose weight fast

Gastric Bypass surgeryPage 10

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They are also an outlet of faith and love for residents who seek spiritual as well as physical nourishment.

Bethany and Woodland Good Samaritan Villages offer a continuum of care, from independent living to

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Page 3: UpNorth HealthWatch 10/2003

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Mohan Jenkins, MD, F.R.C.S., SurgeonLakewood Health System401 Prairie Avenue NEStaples, MN 56479The scope of surgical services that Dr. Jenkins will perform atLakewood Health System are laparoscopic, breast, vascular,thoracic, as well as general surgery.

Dr. Jenkins completed his surgical training at Northwest RegionalHealth Authority, Manchester, England and is a Fellow of the RoyalCollege of Surgeons. He completed his surgical residencies atMayo Clinic, Rochester, MN and the University of Missouri,Kansas City, MO.

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Down syndrome

Irreversible Only for Now?Most people know Down syndrome is a genetic disorder that causes irre-

versible mental retardation. But that description may not be true in the future.Scientists have pounced on the revolutionary idea that Down syndrome —

the most common genetic cause of mental retardation — can be treated. First,they must understand the biological cause of the condition, down to the spe-cific genes responsible for the varied symptoms. Then, they hope, they’ll beable to reverse or eliminate related problems with cognitive function, memory,speech, sleep and even the neurological decline that occurs in older adultswith the disorder.

Scientists at Stanford University Medical Center already have identifiedabnormalities in the nerve cell structure of people with Down syndrome, dif-ferences that appear to be responsible for much of the brain damage that is thehallmark of the disorder. They’re now trying to home in on the genes that causethat particular abnormality.

“People thought that once you’re born with Down syndrome, that’s it; youcan’t make the brain better. But we know that is not true about brains,” says Dr.William Mobley, a pediatric neurologist at Lucile Packard Children’s Hospital atStanford. “Brains are plastic. We may not be able to cure this disease, but wemay be able to make people’s lives better.”

Several advances have paved the way for this hypothesis. Scientists under-stand the brain far better than they did even 15 years ago, because sophisticat-ed imaging devices have allowed them to better examine its structure, and themapping of the human genome provided detailed information on the 21stchromosome. Down syndrome is caused by a third, or extra, copy of this chro-mosome.

The mapping of chromosome 21 revealed that it is the smallest of the 24human chromosomes, containing about 225 genes. Now scientists such asMobley, director of the new center for Down syndrome research at Stanford,are working to identify what those genes do.

Experiments on Down syndrome mice have shown abnormalities in thesynapses, or circuits, between nerve cells. The abnormal structure and functionof the synapses lead to the kind of brain damage seen in Down syndrome andAlzheimer’s disease. People with Down syndrome typically developAlzheimer’s disease in adulthood, Mobley says.

Now researchers are trying to figure out which of the genes cause this prob-lem in Down syndrome. Fixing the defect may involve turning off the extracopy of certain genes.

“We definitely know that genes cause this,” Mobley says. “If we find anoffending gene, theoretically we can make things better by turning off thatthird copy.”

Treating a condition caused by an extra gene, he says, may prove easier thantreating other genetic diseases such as cystic fibrosis, in which genes are abnor-mal or missing. Drugs could be developed to turn off that extra gene andimprove cognitive ability in people with Down syndrome. Theoretically,Mobley says, the drugs could be given at any point in the lifespan to improvebrain function.

“What they’re doing is extremely exciting,” says Myra Madnick, executivedirector of the National Down Syndrome Society. “The whole research scenehas changed dramatically since the mapping of the 21st chromosome.”

Scientists caution, however, that potential treatments resulting from thisresearch are at least a decade away.

Story/Shari RoanLos Angeles Times

3

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Who we arePublisher — Terry McColloughAdvertising Director — Mary

PanzerEditor — Heidi LakeCopy Editors — Roy Miller, DeLynn

HowardGraphic Designer — Cindy Spilman

HealthWatch is a quarterly publica-tion of The Brainerd Daily Dispatch.

Read HealthWatch online atwww.upnorthhealthwatch.com

For advertising opportunities callMary Panzer at (218) 855-5844.

E-mail your comments [email protected] orwrite to:

Heidi LakePO Box 974Brainerd, MN 56401

Lawns are littered with dried, yellowleaves and the grass underneath is frostywhen the alarm goes off in the morning.Fall is here, ladies and gentlemen, andalong with the change in seasons comesanother issue of HealthWatch.

Judging by the feedback I received fromreaders, the first issue of HealthWatch wasa success. Thank you to everyone whowrote or e-mailed their comments. It’snice to know people are actually readingwhat we worked so hard on.

In this issue, free-lance writer JennyKringen-Holmes and I put our headstogether and came up with some great

stories that including ththe benefitseven addedwe discovecook and ea

Once agideas or coerddispatch

Happy re

Heidi LakEditor

From the Editor

Table of conten

Cover photo/Nels

510

34

32

26

24

22

18

16

14

COVER STORY:A day in the life of a flight medic

DISCan

PROCEDURE:Gastric bypass surgery

NUTRITION:Eating healthy

RECIPES:Cooking healthy

HEALTHCARE:New Pillager clinics

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EASE:cer doctor battles disease

ILY:ggling with infertility

ING:ping with prosthesis

DICINE:w birth control pill

EARCH:wn Syndrome

Synthetic marijuana compound shows promiseMarijuana can ease pain even for longtime suf-

ferers of disease, but the illegal herb’s mind-alter-ing properties make it less than ideal as a medica-tion.

German researchers now have found that a syn-thetic version of one of many marijuana com-pounds safely reduced chronic nerve pain withoutimpairing thinking and behavior. If the preliminaryfindings hold up in larger trials, capsules contain-ing this compound might one day be prescribedfor hard-to-treat pain.

The principal active ingredient in cannabis istetrahydrocannabinol, or THC. That compoundhas been the most studied, but researchers aroundthe world are also looking more closely at theplant’s other chemical compounds for potentialhealth benefits. Scores of them belong to a groupcalled cannabinoids; others include flavonoids,which are thought to have antioxidant properties.

“It’s not a surprise that these cannabinoids havemedical benefit,” said Dr. Donald I. Abrams, anAIDS specialist conducting clinical trials of mari-juana at San Francisco General Hospital.

People with cancer, AIDS and other chronic dis-

eases have long attested to the plant’s ability toprovide relief from nausea and pain. “That’s whywe’re investigating marijuana,” Abrams said.

Previous studies have shown some cannabi-noids have limited ability to blunt acute nerve pain,typically associated with an injury. But the Germanstudy found that a cannabinoid called CT-3 couldhelp sufferers of chronic neuropathy, who oftendon’t respond to standard medications.

CT-3 is related to THC. But the problem withTHC is that even at low doses, it can impair think-ing and coordination, and create anxiety, panicattacks, psychosis and paranoia, as well as drymouth, blurred vision, and a drop in blood pres-sure upon standing.

Despite these effects, scientists have remainedinterested in cannabinoids, because the body hasnatural cannabinoid receptors that offer potentialdrug targets.

CT-3 first showed promise in animals as an anti-inflammatory and as a reliever of two aspects ofneuropathy: pain and extreme sensitivity to ordi-nary sensations.

Researchers at Hannover Medical School in

Germany, working with an American colleague,gave various doses of CT-3 to 24 volunteer patientswith chronic neuropathic pain in places such asthe foot, arm, face and head. Many patients alsowere taking other pain-relieving medications suchas narcotics, muscle relaxants, antidepressants andsedatives.

The researchers found that CT-3 was moreeffective than a placebo at relieving pain; its effectswere greatest with milder pain. Increasing thedose brought no greater relief. The major sideeffects were dry mouth and fatigue.

“What’s promising is that there can be a productthat stimulates the cannabinoid receptors anddoes not have the emotional and hallucinatoryeffects otherwise known for THC,” said Dr. JoelSaper, a neurologist who directs the MichiganHead-Pain and Neurological Institute in AnnArbor. He’d like to see longer CT-3 studies usinglarger numbers of patients who aren’t taking otherpain medications: “We need to see how this wouldwork in patients not on all these drugs.”

Story/Jane E. AllenLos Angeles Times

ile photo

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FDA approves first birth control pilldesigned to help women skip periods

SAVANNAH, Ga. — Imagine being on combattour in Iraq and having monthly cramps,headaches, mood swings and heavy bleeding inextremely macho environs.

Skipping monthly periods sounds appealing.Especially for women in the military such as StaffSgt. Cheryl Williams.

But would Williams pop a daily birth control pillthat suppresses monthly periods?

Not a chance."It's a fabulous idea, but I have misgivings about

taking the body cycle out of its natural sync. That isspooky to me," said Williams, who spent abouteight months in Iraq this year. "Plus, when I sat in afive ton truck with a 22,000 pound trailer attached,the last thing on my mind is to pop a birth controlpill."

Stress of combat often causes women to misstheir periods naturally, without taking a pill, saidWilliams, based at Hunter Army Airfield.

While menstrual periods are inconvenient andsometimes painful, a new pill could bring an end towomen's monthly woes.

Seasonale, due out at the end of this month, isthe first FDA-approved birth control pill designedto help women skip periods – menstruating only

four times a year instead of 12.Seasonale's cost has yet to be determined. It will

be comparable to conventional birth control,about $30 a month. Some insurance plans may payfor it.

The trend of suppressing menstruation is noth-ing new.

But Seasonale has divided health expertsbetween those who cheer the new pill as anotherway for women to control their bodies vs. thosewho say that period suppression is dangerous.

Family nurse practitioner Dellarie Shilling inStatesboro plans to recommend Seasonale topatients, who are mostly college-aged women.

"As long as it works smoothly and there are noside effects, it will be popular," Shilling said. "A lotof women have painful periods which wouldn't bemissed at all."

But Savannah family nurse practitioner ValerieMcGowan sees the trend of menstrual suppres-sion as less healthy.

McGowan says the no-period pill might be risky,especially for teens and young women. She does-n't plan on recommending it to young patients atCurtis V. Cooper Health Care Center in Savannah,formerly Westside Clinic.

"The adolescent group is so fragile, you would-n't want to play around with their cycle too much,"McGowan said.

Women have already been suppressing theirperiods for years with standard 28-day birth controlpackages. They throw out the seven inactive pillsthat would have triggered their periods and start anew pack of regular pills to suppress menstruation.

But the FDA had not approved continuous useof the drugs until now.

Seasonale, produced by Barr Laboratories, isn'ta new chemical – just a repacking of the conven-tional oral contraceptives in a purple-and-pink box.

The packaging gives women 12 straight weeksof active pills, then a week of dummy pills for theirperiod.

Almost 39 million women in the United Statesuse some kind of birth control, according to theKaiser Family Foundation. Oral contraceptives arethe most common, reversible method.

Story/Anne HartMorris News Service

5

North Memorial Medical Center of Robbinsdale began its North Air Care divi-sion in 1985. Today there are permanent bases in Brainerd, Redwood Falls andthe Twin Cities.

A day in the life

of a flight medic

Story/Jenny Kringen-HolmesPhotos/Nels Norquist

Flying at about 180 miles per hour, North Air Careflight nurse April Aalto keeps a steady arm whilefilling a syringe with morphine to alleviate the dis-comfort of her patient. Flight medic John Davismonitors the man’s vital signs and keeps in contactwith medical officials on the ground regarding theman’s status. A heart monitor mounted within thehelicopter keeps tabs on the man’s heart rate, oxy-gen levels and blood pressure. Out the chopper’slarge side windows you can see the twinklinglights of life proceeding as usual in small townsbelow.

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SURGICAL WEIGHT LOSS??STOMACH STAPLING??

GASTRIC BYPASS??LAPAROSCOPIC??

Have you read the articles? Seen or heard the terms?Still confused? Let our team of medical professionals

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Rebecca Heimark, PA-C and Sharlene Johnson, LPN,will be conducting an informational seminar on

Monday, November 17at 6:30 P.M.

in the conference room atCuyuna Regional Medical Center

318 East Main Street, Crosby, Minnesota(Use the main clinic/hospital entrance and follow the signs.)

If you are at least 100 pounds overweight,have a body mass index of 35-50, or have other healthrelated conditions due to your weight and you wishto lose weight, you should plan on attending one of

these free informational seminars.Reservations are required.

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Support Group meetings are the 3rd Tuesday of every month at7:00 PM at Cuyuna Regional Medical Center

Big City Medicine, Hometown Care

In close quarters, this three-person flight crew istransporting a 52-year-old Wisconsin man withchest pains to Duluth for medical attention. It’s aflurry of activity in this emergency room in the skyas a trip which typically would take several hoursby ground is accomplished in little over a half hour.

In an emergency, every minute is critical. Thedifference between getting to a hospital by land orair can often be the difference between life anddeath.

The sky provides an open road. Little to no traf-fic. No stop signs. Rather than going around fields,you go over them. With speeds over 180 miles perhour, its no wonder the air ambulance industry has“taken off” over the last several years.

North Memorial Medical Center in Robbinsdalebegan its North Air Care division in 1985. Now, withthree bases, including one in Brainerd, communi-ties across the state and beyond have the opportu-nity to receive the best, most appropriate care atany hospital regardless of how far they are locatedfrom the facility.

With the approval of North Memorial, thisreporter was allowed to observe a flight crew dur-ing a regular Wednesday night shift earlier thismonth. This is just a glimpse into a day in the life ofan Air Care flight crew.

4 p.m. — North Air Care flight medic John Davisis going on the ninth hour of his 24-hour shift.Davis, 31, stands at the sink at the crew’s quarters ina hangar at the Crow Wing County Regional

Airport and finishes dish duty. “Don’t you dare tell my wife,” he says, laughing

about his domestic duties.A Brainerd High School graduate, Davis has

worked for North Ambulance in Brainerd since1996 where he worked as a paramedic on the road.When North Memorial Medical Center’s air ambu-lance program opened a permanent home inBrainerd in October of 2000, Davis was hired on asa flight medic. There’s no doubt in Davis’mind whyhe chose to make the switch from road to air.

“Because I got to do what I liked to do as a para-medic, but in a really cool ambulance,” he says,noting it’s virtually the same type of job but with it’sown set of differences and challenges.

4:30 p.m. — Davis and Air Care lead pilot PhilJames perform a safety briefing, required for anyride-along passenger of the helicopter. NorthMemorial owns and operates five Augusta C109s inits fleet. These helicopters are the fastest non-mili-tary chopper made.

Currently, North has three bases for its Air Careoperations: Brainerd, the Twin Cities and RedwoodFalls. On call at the hangar throughout their shift,the crew aims to be in the air within five minutes ofreceiving a call. Once arriving at the scene, theirgoal is to get the patient loaded up and en route totheir destination within 10 minutes.

5:45 p.m. — Pilot Ryan Sarvie arrives early forhis scheduled 12-hour shift.

Sarvie, 32, is one of four full time pilots servingthe Brainerd division of North Air Care. A new res-

ident of the Brainerd area, Sarvie previously livedin Buffalo. After graduation from high school, hejoined the United States Army where he served 81/2 years as a pilot flying Hueys and Black Hawkhelicopters. From August 1993 to January 1994, heserved in the conflict in Mogadishu, Somalia,which was portrayed in the movie Black HawkDown. Before coming to work for North Air Care,Sarvie flew the medical helicopter for St. Luke’sHospital in Duluth.

“I wanted to fly helicopters just because they’redifferent from airplanes,” Sarvie admits, adding heenjoys his current profession as he gets to helpsave lives “even though I couldn’t do it myself.”

Sarvie discusses the stringent training and eval-uation processes that go along with being a pilot.All of North Air Care’s pilots are required to beInstrument Flight Rules certified. Every six months,he and his fellow pilots must undergo an evalua-tion in order to maintain their pilot license wheretheir ability to use and understand the helicopter’sinstruments is tested.

“It’s kind of like taking a driver’s test every sixmonths,” he says.

6:30 p.m. — The Air Care crew receives a faxfrom their dispatch center operated out of NorthMemorial Medical Center in Robbinsdale. They arerequested for a “fly in”at Mercy Hospital in MooseLake where a group of firefighters, law enforce-ment, first responders and other emergency serv-ice providers are gathered to learn more about AirCare’s services as well as how to best work with

North Air Care pilot Ryan Sarvie took to the skiesduring his scheduled 12-hour shift. Sarvie, 32, ofBrainerd, is one of four full-time pilots serving theBrainerd division of North Air Care. Sarvie has beena licensed pilot for 13 years and served as a BlackHawk pilot during the Mogadishu, Somalia, conflictin the 1990s.

Apple Stuffed Tenderloin with Cinnamon Raisin Sauce

This hearty entrèe started out as stuffed pork chops. To make the dish lean-er and still keep its character, the recipe was switched to stuffing a pork ten-derloin. Calories, fat and cholesterol were reduced by:

• Using pork tenderloin (26% calories from fat) instead of rib chops (52%calories from fat);

• Using no-stick spray instead of butter to sautè the onions; • Eliminating the butter in the sauce.

Stuffed Pork Tenderloin:1 pork tenderloin (1 to 1 1/2 pounds) trimmed of all visible fat2 medium oranges1 medium apple, cored and chopped2 tablespoons finely chopped onions2/3 cup fine dry plain bread crumbs

Sauce: 1 cup unsweetened apple juice1 tablespoon cornstarch1/4 teaspoon ground cinnamon1/4 cup raisins

To make the stuffed pork tenderloin: Preheat the oven to 425 degrees. Cuta pocket in the side of the tenderloin by cutting a lengthwise slit from oneside to almost the other side and stopping about 1/2” from each of thetapered ends. Set the tenderloin aside.Finely shred the peelfrom the oranges and setaside. Then squeeze 3tablespoons ofjuice from theoranges. In a medi-um bowl, combinethe orange juice andapples. Set the applemixture aside. Spray anunheated small skillet withno-stick spray. Add the onions.Cook and stir over medium heatuntil tender. Then add the onions and bread crumbs to the apple mixture.Toss until combined. Spoon the bread mixture into the pocket of the tender-loin. Securely close the pocket with wooden toothpicks. Place the tenderloinon a rack in a shallow roasting pan. Insert a meat thermometer into the meatportion only. Bake for 25 to 30 minutes or until the thermometer registers 160degrees. Let stand about 5 minutes before slicing.

To make the sauce: In a small saucepan, use a wire whisk to stir togethertwo tablespoons of the apple juice and the cornstarch. Then stir in remainingapple juice. Cook and stir over medium heat until boiling. Stir in the reservedorange peel and cinnamon. Add the raisins and cook for five minutes, stirringoccasionally. To serve, slice the tenderloin. Spoon the sauce over the slices.Makes 4 to 6 servings.

Nutrition Scorecard (per serving)Calories – 245Fat (g) – 4% calories from fat – 16%Cholesterol (mg) – 74

Exchanges (per serving)3 meat1 fruit

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(Continued from Page 17)

• Replacing sour cream with fat-free yogurt; • Using evaporated skim milk instead of butter.

2 cups (8 ounces) finely shredded reduced-fat sharp cheddar cheese1 (10 3/4 ounce) can 99% fat-free condensed cream of chicken soup with 1/3

less salt1 cup fat-free plain yogurt3/4 cup evaporated skim milk1/2 cup very finely chopped onions2 cups cornflakes6 medium potatoes (2 pounds), peeled

Preheat the oven to 350 degrees. In a large bowl, stir together the cheese,condensed soup, yogurt, milk and onions. Set the soup mixture aside. In ablender or food processor, blend or process the cornflakes into coarsecrumbs (you should have about 1 cup). Set the cornflakes aside. Coarselyshred the potatoes. Immediately stir the potatoes into the soup mixture toprevent browning. Spray a 10”x9”x2”or 11”x7”x1 1/2”baking dish with no-stickspray. Transfer the potato mixture to the baking dish. Top with the cornflakes.Bake about 1 hour or until the potatoes are tender. Makes 8 servings.

Nutrition Scorecard (per serving)Calories – 230Fat (g) – 4% calories from fat – 21%Cholesterol (mg) – 35

Exchanges (per serving)2 starch1 lean meat

Harvest Apple StuffingThis fruit and walnut dressing is the perfect complement to roasted chick-

en. Calories, fat and cholesterol were reduced by:• Using apple juice instead of butter to sautè the vegetables.

2 cups finely chopped apples1 teaspoon lemon juice1 cup coarsely shredded carrots1 cup thinly sliced celery1/2 cup chopped onions1/2 cup apple juice1/4 teaspoon ground nutmeg8 cups dry plain bread cubes1/3 cup chopped walnuts1/4 cup toasted wheat germ1-1 1/2 cups chicken broth, defatted

Preheat the oven to 350 degrees. Place the apples in a small bowl. Sprinklewith the lemon juice, then toss until coated. Set aside. Spray a large skillet withno-stick spray. Add the carrots, celery, onions and apple juice. Cook overmedium heat until tender, stirring occasionally. Stir in the nutmeg. Lightlyspray a 3 to 4 quart casserole with no-stick spray. Add the bread cubes, apples,walnuts, wheat germ and the carrot mixture; toss to combine. Drizzle with onecup of the broth. If necessary, drizzle with enough of the remaining 1/2 cup ofbroth to moisten the bread; gently toss to mix well. Bake, uncovered, for 30 to40 minutes or until heated through. Makes 8 servings.

Nutrition Scorecard (per serving)Calories – 197Fat (g) – 5% calories from fat – 21%Cholesterol (mg) – 0

Exchanges (per serving)2 starch1/2 fruit

7

Nurse April Aalto (left),medic John Davis andpilot Ryan Sarvie madeup this North Air Careflight crew.

them in the event they would be called toMoose Lake.

“A big part of our job is safety,”notes flight nurseApril Aalto of Monticello. Aalto, a nurse with NorthMemorial since 1986, commutes to Brainerd towork 24-hour shifts on the helicopter crew.

7:27 p.m. — The Air Care crew leaves thehangar for their 30 minute flight to Moose Lake.Each member of the crew wears a headset with amicrophone in order to allow open communica-tion. Along the way, Sarvie points out the city ofAitkin to the left and Lake Mille Lacs out the right.He also notes the helicopter is currently travelingat a speed of 170 miles per hour with a bit of aheadwind.

7:55 p.m. — The crew arrives at Mercy Hospitalin Moose Lake, greeted by a large gathering ofemergency personnel. Aalto is the first to exit theaircraft, as she meets the group. After all threecrew members are out of the helicopter they intro-duce themselves and answer questions regardingthe helicopter, their experience and optimal land-ing situations.

As the Moose Lake group walks around the hel-icopter, looking inside and asking questions, awoman approaches Sarvie questioning how longhe’s been a pilot.

“Thirteen years,” he tells her. “Oh my,” she replies, obviously surprised. 8:40 p.m. — After giving rides to four individu-

als from the Moose Lake group and participating ina stretcher-loading exercise, the Air Care crewtakes to the skies and heads back to Brainerd. Theclear night provides visibility for miles and miles.Sarvie once again comes over the headsets point-ing out the cities below and beyond, including

McGregor, Aitkin and the distant lights of St. Cloudand even the Twin Cities area.

9:13 p.m. — The helicopter reaches its hangar atthe Brainerd airport. Sarvie calls to request fuel.The Augusta C109 holds 73 gallons on each side, or146 gallons total which provides for two hours and20 minutes of flight time. An auxiliary tank can holdan additional 40 gallons, Sarvie points out. With fullauxiliary and side tanks, the helicopter has a threehour endurance. At normal cruise, Air Care burnsone gallon of fuel per minute.

9:25 p.m. — Davis begins a run sheet, the nec-essary paperwork, required for the trip to and fromMoose Lake.

9:26 p.m. — The North dispatch center callswith a possible flight to Redwood County, but callsback almost immediately to disregard.

9:45 p.m. — In true leader fashion, Sarvie servesup hot chocolate to the crew and starts a batch ofchocolate chip cookies in the oven. The hangarwhere Air Care is stationed provides each memberof the scheduled crew with a private bedroom.There’s also a bathroom, shower room, office, liv-ing area and kitchen as well as the garage areawhere the helicopter is stored.

10 p.m. — The cookies are done and the crewsits down to a late dinner of pizza while catchingup with the 10 o’clock news.

“We’re one big happy family,” Sarvie jokes. 10:55 p.m. — The crew receives a call to transfer

a patient from Grantsburg, Wisconsin to Duluth.Details of the call are sketchy, but everyone is upon their feet and heading for the door.

11 p.m. — In the air and heading east, Davisbegins more paperwork. A message via his alpha-numeric pager tells the pertinent patient informa-

tion. This patient has a potential cardiac situationand is requesting to be transferred to St. Mary’sHospital in downtown Duluth.

The crew explains they provide a service thatwill take patients to any hospital. In the event of anaccident or critical situation, the crew will decidewhere the patient will be taken. Usually, that meansthe closest Level 1 trauma center. If the patient iscurrently at a hospital and being transferred to adifferent facility for additional treatment, thepatient and his/her family as well as the medicalstaff will determine where that person will be sentto receive the best care for their particular situa-tion.

Typically the Air Care base closest to the origi-nating city will respond to the call, but Davis saysboth the metro and Redwood Falls divisions areout on calls leaving the Brainerd crew up-to-bat.

North Air Care isn’t the only show in town, so tospeak. Both St. Mary’s and St. Luke’s in Duluth havetheir own air ambulance service, as well as othermedical centers in and around the Twin Cities area.But, the physician requesting the transfer has thediscretion of which company they would like totransport their patient. And in this case, they’vecalled North Memorial.

11:15 p.m. — Traveling at a speed of 184 milesper hour, Sarvie radios in to say he’s 16 minutesfrom Grantsburg.

Ground ambulances have a set service territory,Davis notes, but the same doesn’t hold true for theair service. Their job can take them anywhere inthe state as well as North Dakota, Wisconsin andmore. And for that reason, both Davis and Aaltohave respective paramedic and nurse licensure inthe state of Wisconsin.

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Aalto comments the furthest she’s traveled topick-up a patient came just a few days ago whenshe traveled with the Air Care crew to Devils Lake,N.D. to take a patient to Abbott Northwesternhospital in Minneapolis – about a 2 1/2 hour flight.

11:31 p.m. — An ambulance with flashinglights signals the chopper onto the landing pad atthe Burnett Medical Center in Grantsburg. Anemergency medical technician with NorthAmbulance’s service in Grantsburg meets thecrew at the emergency room entrance and escortsthem in to meet their awaiting patient.

Davis introduces his fellow crew members tothe patient and begins asking him a series ofhealth history questions as well as his current sta-tus.

“Our primary objective is to keep you as com-fortable as possible,” Davis tells the 52-year-oldman. As the man rates his pain as a 5 or 6 on a scaleof 1 to 10, Davis listens to his chest and Aalto pre-pares the heart monitor which will accompanyhim on the flight. The ER physician informs thecrew the man has an extensive cardiac history,including two heart attacks and bypass surgery.

“This is nothing new,” the man tells them.As Aalto starts an IV, the man jokes with her. “Can we land at my house so I can pick up my

checkbook?”

“Well,”Aalto chides back. “We’ll have to ask thepilot.”

11:45 p.m. — After the necessary paperworkhas been signed, the patient is wheeled out to theawaiting helicopter for his trip to Minnesota. It’s ateam effort as the stretcher is loaded into the air-craft. Aalto and Davis lift the man and slide thestretcher onto the stainless steel platform insidethe helicopter while Sarvie stands inside thechopper’s front door and pulls the foot end of thestretcher forward. Once he’s adjusted and com-fortable the crew situates themselves and pre-pares to lift off. The man is also given a headset sohe too can communicate with the crew. A curtainis drawn to separate the crew and patient from thepilot and cockpit area.

11:55 p.m. — Off the ground and en route toDuluth, a flurry of activity takes place inside this,now tight, quarters. While Sarvie navigates tonorthern Minnesota, Davis and Aalto monitor thepatient’s heart rate and oxygen levels in his blood,administer medications through his IV and keepin close contact with the man to ensure his com-fort.

The patient is an inquisitive one as he removeshis headset from time to time, touches the IV bagscontaining saline and medication, pokes at theceiling of the helicopter and watches out the win-

dow during his, approxi-mately, half hour flight toDuluth.

12:10 a.m. — Sarviecalls in to say the crew is15 minutes from St.Mary’s and is given clear-ance to land on the hos-pital’s rooftop helipadupon arrival.

The patient notes hispain level has decreasedsomewhat and is com-fortable, although hesays he’s having some dif-ficulty taking deepbreaths. He asks the pilothow high they’re flying.

“Three thousandfeet,” Sarvie repliesthrough the headset.

12:26 a.m. — After fly-ing over Lake Superiorand the infamous AerialLift Bridge, the chopperlands at St. Mary’s and ismet by security guards atthe rooftop entrance tothe hospital. Since thepatient’s condition is sta-ble, the crew waits for thehelicopter’s rotors tostop completely beforeexiting the helicopter.

“It was a good ride,”the man tells the crew, ashe’s unloaded and givena North Air Care baseballcap. “But I thought it’d bemore exciting.”

12:34 a.m. — The crewarrives in the coronary care unit and wheels theirpatient directly to a room where they brief staff onthe patient’s status and history.

12:57 a.m. — With their patient passed on to St.Mary’s staff and their job complete, the crewreturns to the helicopter for take off.

1:04 a.m. — Sarvie makes a stop at the SuperiorAirport. While he remains in the aircraft, Davisand Aalto perform a “hot refuel,” or refueling thehelicopter while it’s still running.

1:14 a.m. —Everyone is back in the helicopterfor the ride back to Brainerd, which Sarvie esti-mates will take a little over 30 minutes.

It’s a quiet ride home as the crew reflects ontheir shift so far and watches below as the worldwhizzes by.

1:58 a.m. — The “after flight paperwork”begins as the helicopter is pulled back into thehangar until its next call.

“It was a quiet day,” Davis reflects. But there’s still another five hours to go in the

day in the life of this flight crew and what’s tocome on any given Air Care shift is always “up inthe air.”

North Air Care is virtually an emergency room in the sky. Flight nurse April Aalto and flight medic John Davis ran throughtheir equipment and supplies, ensuring everything is ready before their next call comes in.

Educating others

While there is no formal support group forthose facing amputation or those who’ve experi-enced it, Taylor said Fabian has become a goodambulator in the community. Fabian said he has,on several occasions, talked to those who are con-templating a prosthesis.

“When you have someone who’s been there...It’s just a much more supportive means of encour-agement,” Taylor said. “There are so many referralsources who feel patients who’ve had an amputa-tion at the hip level can’t have a prosthesis. It’sgood to shed light on the patients who’ve had anamputation at this level and show that it can bedone.”

Fabian said, of his contacts, he has reassured ayounger boy that, yes, you can still ride a four-wheeler after receiving a prosthetic and a womanwho worried about the way a prosthetic leg wouldlook when wearing shorts.

But in keeping with his optimistic attitude,Fabian, a grandfather of two, has turned a tragicevent into a learning opportunity and a chance tohelp others by sharing his experience.

“I try to be very encouraging,”he said. “You canmake this work. If you have the right attitude andthe will, you can make it work.”

Socket — Upper portion of the prosthetic, made of carbon fiber with aflexible thermo-plastic interior.

Hip Joint — A single axis hip joint with an extension mechanism thathelps hold the limb straight and allows for safe alignment while standingand walking.

Leg — An aircraft aluminum structure with a carbon fiber knee unit. Hasa multi axis for sitting ability and ease of swinging when the patient takeseach step.

Foot — A dynamic multi axis foot allows patient to walk on uneven sur-faces. The more energy exerted into the foot, the faster the patient can taketheir next step.

Cover — A cosmetic foam cover with a skin tone, nylon-like exterior pro-vides for improved aesthetic appeal.

Taking a look at a prosthetic leg

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Lakeland PsychiatryWelcomes New Physicians

CLINIC

lakelandpsychiatry

St. Joseph’s Medical Center523 North Third Street

Brainerd, Minnesota 56401

Dr. Peter Neifert attended Colorado College inColorado Springs where he earned a Bachelor ofArts degree in Chemistry in 1990. He received hismedical degree from the Mayo Medical School in 1995 and completed his residency in psychiatryin June of 1998. He has been practicing as a psychiatrist with the Air Force for the past 5 years.

Dr. Twila Germanson received a Bachelor of Artsdegree in Chemistry from Arizona State Universityin 1994. She received her medical degree in 1999from the University of Minnesota and completedher residency in psychiatry in June of 2003.

Dr. Paul Erickson completed his undergraduatedegrees in Religion and Psychology at ConcordiaCollege in Moorhead. He received his medicaldegree from the University of Minnesota MedicalSchool in 1999 and completed his residency inpsychiatry in June of 2003.

St. Joseph’s Medical Center is pleased toannounce the addition of three

psychiatrists to Lakeland Psychiatry Clinic.■ Doctor Peter Neifert began seeing patients at

Lakeland Psychiatry July 1, 2003.

■ Doctor Twila Germanson will begin seeing patients on August 1, 2003.

■ Doctor Paul Erickson will begin seeing patients on September 1, 2003.

Lakeland Psychiatry is located on the fourth floor of St. Joseph’s Medical Center.

To Schedule an Appointment Call:(218) 828-7394

Getting a prosthetic

Each prosthetic is custom made. An impres-sion, or a blueprint for the prosthetic socket, ismade for each individual, Taylor describes,then the mechanics are added below that. Thetechnology for prosthetics has advanced great-ly in the last 20 years, he said. Titanium and air-craft aluminum are now used to allow for amuch lighter and stronger device. Taylor notesthat Fabian’s particular prosthesis weighsabout 11 pounds, compared to his entire legwhich likely weighed about 30 pounds or morebefore amputation.

“But any prosthetic always feels heavierthan it really is,”Taylor said, explaining it is basi-cally a foreign object suspended from thepatient.

Taylor, who has worked in the prostheticsfield since 1988, said the average prosthesis hasa life span anywhere between three and fiveyears.

“Like most mechanical devices, the (pros-thesis) parts need to be serviced,” he said.

In fact, Fabian joked that he already neededwork done on his leg when the knee unithousing cracked.

“I left my leg here for a total knee replace-ment,” he laughed, adding that it was covered“under warranty.”

Taylor also comes to Staples to make adjust-ments to the prosthesis during Fabian’s physi-cal therapy sessions.

“It’s kind of like fine tuning,” Taylor said.“The patient is constantly changing physically.For that reason we have to accommodate forthose changes.”

Living with prosthesis

Living with a prosthesis comes with manychallenges and discomforts.

“There are days where I don’t feel like put-ting it on,” Fabian concedes. “But I don’t wantto spend my life in a wheelchair.”

Fabian has had to relearn how to walk as aprosthesis requires its user to swing their hipsforward and use their lower back muscleswhen taking each step.

“You use different muscles and differentparts of the body that aren’t necessarily intend-ed to be used for walking,” Taylor notes. “So itcan be exhausting.”

“This is different, but this is something thatI can do,” Fabian said. “It gives me the oppor-tunity to be more mobile. There’s a learningcurve with it, obviously. I’ve spent many ses-sions learning to swing my hips. It didn’t takeme very long to know I wasn’t going to be oneof the 75 percent who wouldn’t make it work.”

Fabian is almost back to full time at his job asa certified registered nurse anesthetist atLakewood Health System in Staples.

“Its gone pretty well,” he said. “The biggestobstacle at work is endurance at this point, butit’s getting better.

“I get really tired. But I guess I was tiredbefore,” Fabian said with a chuckle.

Despite the things a prosthesis has enabledFabian to continue doing, he said he doesn’twant to paint too rosy of a picture. After all, hislife has changed drastically over the last year.

Fabian said the loss of his leg has forced himto make adjustments from simple daily ritualsto chores around the house.

“I can’t pick up a tree after a storm,” he said.“I can’t wash windows. Everything isn’t hunky-dory. There’s just too many things to enumer-ate on. It’s a struggle.”

The Fabians have had to add grab bars intheir Staples home. Fabian must buy larger-sized pants to accommodate for the prosthe-sis. He also must wear special undergarmentsbecause of the sweat produced from the artifi-cial limb.

But with the constant support and care fromhis wife, Beth, Fabian said he takes each day asit comes — one step at a time. He intends tocontinue raising and training labrador retriev-ers and is looking forward to hunting this fall.

9

www.lakewoodhealthsystem.comLakewood Health System Pillager Clinic 631 State Hwy 210W, Pillager, MN 56473

Open HouseNovember 2, 2003

Cool, crisp air is the first indication that fall is on its way. Soon after, leaves turn red and gold. Geese begin to fly south. Change is seen everywhere.

But, this fall is unique for the Pillager community— because more than leaves are changing in the area. Lakewood Health System is pleased to announce the opening of our newest clinic in Pillager.

The Pillager Clinic will offer you a choice of three physicians: Dr. Arden Beachy, Dr. Renee Nydegger, Dr. Mike Hudulla, as well as physician assistant Becky Bennett and nurse practitioner Kelly Thompson.

You also have the option of convenient health care with an on-site pharmacy with drive thru window, three-day-a-week physical therapy services, extended clinic hours and occupational health and educational services.

To celebrate, Lakewood Health System invites you to an Open House at the new Pillager location. Stop by on Sunday, November 2 between 1:00 – 3:00 p.m. to see our new facility, meet our staff, enjoy refreshments and receive a free gift. Mark your calendar today!

With Lakewood Health System you don’t have to go far, it’s right here.

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The incredible

CROSBY—Sharon Osbourne has done it. Sohave Al Roker, Carnie Wilson and Roseanne.Bariatric surgery. Not only is it a weight loss regi-men to some of Hollywood’s finest stars, but theprocedure can be done right here in theBrainerd lakes area to everyday people.

Unlike most Minnesota hospitals thatperform bariatric surgeries, theMinnesota Institute for MinimallyInvasive Surgery at Cuyuna RegionalMedical Center in Crosby does themlaparoscopically, leaving six one-quar-ter inch incisions on the abdomen.

Dr. Howard McCollister, chief ofsurgery at CRMC, said less than adozen surgeons do bariatric surger-ies laparoscopically in Minnesota andfour of them are at Crosby’s MIMIS.

“It’s a very hard operation to do,”McCollister said of performing surgeryby using cameras and watching a TVscreen. “You’re looking at a two-dimen-sional image and you have to make it 3-Din your head – kind of like a videogame.”

The MIMIS surgical team has donemore than 120 bariatric surgeries in theyear and a half they’ve been perform-ing them.

There are two types of bariatric sur-geries, Roux-en-Y bypass, and Lap-Band.

In Roux-en-Y, the stomach is sewninto two parts. The upper part forms asmall pouch that receives food. Thepouch can hold about one fluidounce.

A section of the small intestine isattached to the pouch to allow food tobypass the lower stomach and thefirst portion of the small intestine.Although food does not go throughthis bypassed segment, it still functionsby secreting gastric and digestive juicesfrom the liver and pancreas and emp-ties into this area.

The Roux-en-Y bypass is considereda more complicated surgery thatrequires spending one or twodays in the hospital following theprocedure, whereas Lap-Band canbe done on an outpatient basis.

Lap-Band uses an adjustable sil-icone band, separating the stom-ach into two pouches. The bandhas an inflatable inner surface,

allowing the surgeon to adjust thesize of the band depending

on how much weightthe patient

wants

to lose.“Not every patient is a suitable candidate for

one operation or the other,”McCollister said. “Eachpatient is different and we need to be able to rec-ommend the operation that is safest, and likely togive the best results.”

Lap-Band is considered less complicated thanRoux-en-Y bypass because neither the stomachnor the intestine is cut during the procedure, butthe weight loss results are the same.

By shrinking the stomach from thesize of a football to the size of alemon, patients lose an average of100-120 pounds one year after thesurgery, McCollister said. Initiallypatients can eat a shot glass full offood, and eventually their stomachstretches depending on how muchthey eat.

Bariatric surgery is limited topatients who are morbidly obese,with a body mass index greater than40, or have a BMI of more than 35and have associated health prob-lems such as high blood pressure,diabetes, acid reflux or arthritis.

BMI is a measurement related tothe patient’s body surface area andis used to determine a patient’s levelof obesity. It is calculated by a stan-dard chart that correlates a patient’sheight and weight. A BMI chart canbe found at www.cdc.gov/nccd-php/dnpa/bmi/calc-bmi.htm.

“Diet and exercise is fine forsome people,” McCollister said, butmany people with health problemscan’t exercise.

McCollister restated the signifi-cant dangers of being obese, sayingobesity-related illnesses are the No.2 cause of death in the UnitedStates, second only to smoking-related illnesses.

Tom Bonar of Pine River was dia-betic, had his left leg amputatedbelow the knee and had extremely

high blood pressure, heart prob-lems and gastroesophagealreflux disease, a condition Bonardescribes as having constantheartburn.

Surgery provides weight lossalternative to obese Story/Heidi Lake

Photos/Steve Kohls

Tom Bonar of Pine River demonstrated his 120-pound weight loss by holding upa pair of pants he wore before he had gastric bypass surgery. Then a size 52,today, one year after surgery, Bonar wears a size 40. (Photo by Nels Norquist)

stomachA healthy, middle-aged man from Staples, Fabian never imagined living without

a leg.But when cancer forced the amputation of his entire left leg, there was no

question whether he’d try a prosthetic leg.“I have cancer,” Fabian recalls. “I lost my leg. (A prosthetic leg) was one of the

positives of the whole thing. I’m going to have a leg and be able to get around.”

Cancer takes legIn October of 2002, Fabian, 51, began to experience pain in his left leg. Doctors

investigated for the source of the pain but had no answers until later that monthwhen a lump surfaced on Fabian’s upper left thigh. Doctors told Fabian the growthwas likely benign. But his symptoms worsened and when a biopsy was done atFairview-University Medical Center, Fabian’s worst fears came true. The lump wasa malignant tumor and a form of sarcoma cancer.

“I was devastated,” Fabian said. “But I have this real positive attitude. My familyand I decided ‘we’re gonna beat this thing.’”

Doctors gave Fabian two options — total amputation of the left leg; or a proce-dure to attempt to remove the tumor which would include a series of skin, nerveand bone grafts, something that came with its own set of complications.

So, in December of 2002, Fabian’s left leg was amputated from the hip jointdown. He spent eight days recovering at Fairview-University then returned hometo begin his drastically new life. While visiting with his physical therapist inStaples, Fabian learned of the possibility to walk again with the help of a prostheticleg. In February, he was introduced to Chip Taylor, a certified prosthetist andorthotist with Prosthetic Laboratories in Baxter.

Fabian’s doctors had told him half of the individuals who have this type ofamputation don’t receive a prosthesis and of the half that do only 25 percent stickwith it. Fabian said that statistic was his carrot and gave him the motivation to beone of the 25 percent who successfully use a prosthetic leg on a daily basis.

In March, a plaster impression was taken of Fabian’s remaining pelvic area anda “trial” prosthesis was made to utilize full function, comfort and also to accom-modate the small tissue shrinkage that follows an amputation. As the area shrunk,padding was added to the hip socket of the prosthesis to ensure a proper fit.

In June, the tissue shrinkage stabilized and Fabian was once again cast foranother prosthesis — the one he still wears today.

Chip Taylor of Prosthetic Laboratories in Baxterinspected the knee housing unit of Dave Fabian’s legprosthesis.

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Welcome Home Health Care

Artificial leg doesn’tslow down Staples man

Looking at Dave Fabian, you’d never knowhe has an artificial leg. It’s not until hechanges into shorts and pulls down the fab-ric cover of his prosthesis do you see themechanics that have made it possible for thiscancer survivor to continue doing what heloves best — living a normal life.Story/Jenny Kringen-Holmes

Photo/Steve Kohls

11

Dr. Howard McCollister, chief of surgery at the Minnesota Institute for Minimally Invasive Surgery at Cuyuna Regional Medical Center in Crosby, stoodin one of three operating rooms outfitted for laparoscopic surgery. The high-tech rooms have digital video equipment and cameras, along with voice-controlled lighting and swinging flat screen TV monitors.

A computer in the operating room at the Minnesota Institutefor Minimally Invasive Surgery at Cuyuna Regional MedicalCenter works as a control center for the room’s video cam-eras, monitors and other digital equipment.

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He was 6-foot-4 and 342 pounds. “I was a physical mess,” he said. ‘I didn’t

have energy, I didn’t have will and I was justwaiting to have a massive coronary or heartattack and die.”

He was a 44 year old husband and father offour who was spending an increasing amountof time in the hospital for various weight-relat-ed health problems.

Bonar tried everything to lose weight, to noavail. He was overweight his whole life. Heremembers taking diet pills in sixth-grade andplaying high school football at 300 pounds.

“I tried TOPS and Weight Watchers ... I’dlose weight for the first five days, then get frus-trated and give up,” he said.

Bonar first heard about gastric bypass sur-gery in January 2002. He spoke with his doc-tors who he came to know all too well afterspending so much time in the Crosby hospi-

tal. They decided he should have Roux-en-Ybypass.

“I knew this was my last chance,” he said.Before the surgery, Bonar took part in the

mandatory preparation program that includ-ed a bariatric seminar, giving an overview ofthe Roux-en-Y and Lap-Band surgeries, andsaw a dietitian, physical therapist and psychol-ogist to be sure he was mentally ready for theprocedure.

On Sept. 6, 2002, Bonar had Roux-en-Ybypass, a surgery that changed his life forever– not without a few bumps along the way.

The surgery, which normally causes little orno pain, was giving Bonar severe abdominalpain three days after the surgery.

After a CAT scan, doctors found his oldstomach was filled with blood caused by aleak from where his intestine was sewn to hisstomach.

“If it had burst it would’ve killed me,”Bonarsaid.

McCollister said Bonar is one of twopatients who had complications out of the 120gastric bypass surgeries the MIMIS surgicalteam has done.

By the end of September, Bonar was feelingbetter and started losing weight. So far he haslost 120 pounds, “And there’s no way I’m goingto get it back,” he said.

Today Bonar eats about two-thirds of aplate of food every meal and tries to avoid eat-ing carbohydrates and sugars.

Along with the weight, Bonar has shed allof his health problems, even diabetes. Hetakes no medications and for the first time in along time, he can ride a bike and go campingwith his family.

“This surgery has given me another chanceto live,” Bonar said. “I was going to die.”

In Roux-en-Y bypass, the stomach is sewn into two parts. The upperpart forms a small pouch that receives food. Also, a section of thesmall intestine is attached to the pouch to allow food to bypass thelower stomach and the first portion of the small intestine.

Lap-Band uses an adjustable silicone band, separating thestomach into two pouches.

In the winter of 1998 two 20-year-olds, Jason andDarcy Walkowiak, thought they had the world bythe tail. They were newly married, had good jobs,and were thrilled by the thought of buying a homeand starting a family together.

By fall, they bought a three-bedroom house in aquaint Brainerd neighborhood, hoping to soonuse one of the spare bedrooms as a baby’s room.

After a year of unsuccessfully trying to get preg-nant the Walkowiaks decided it was time to see adoctor.

Jason and Darcy both were tested to see whythey couldn’t seem to conceive. Darcy said manypeople assume reproduction problems are due tothe female, but statistics say males and femaleshave an equal chance of having reproductionproblems.

Darcy’s ovulation cycle, tubes and uterus weretested, and the results showed her body was capa-ble of producing a child and carrying itthroughout a pregnancy.

Jason’s sperm count was tested, andthe results showed he had low motili-ty. After further testing, it was foundthat Jason had a varicocele, a clump ofvaricose veins in his scrotum that pro-duced too much heat, killing thesperm.

Jason had surgery to correct theproblem and doctors were 60 percentsure the Walkowiaks would be able toconceive naturally.

In February 2001, Jason went back tothe doctor and heard words he neverexpected to hear. The surgery wasunsuccessful and he could never havebiological children.

“It was pretty devastating to find outthere’s no chance,” Darcy said.

“It was an issue for me at first,”Jasonsaid of finding out he was the reasonthey couldn’t conceive. “But it’s notlike if Darcy couldn’t hold a baby. Thenwe would have had no choice but toadopt.”

The doctor gave the couple theiroptions — they could do in vitro fertil-ization, donor insemination or adopt.

The Walkowiaks, then 23, spokewith an adoption agency and foundout until they turn 25, the chances ofthem receiving an infant without spe-cial needs were slim. That narrowedtheir choices to IVF or donor insemi-nation, procedures that are not donein Brainerd or anywhere in the area.

Dr. Carol Uhlman, a mild fertilityspecialist and obstetrician/gynecolo-gist at Brainerd Medical Center, saidBMC can do initial evaluations andhormonal studies on infertile couples,and even prescribe fertility drugs, butanything more involved, such as IVF, isreferred to hospitals and clinics in theTwin Cities.

The Minnesota Fertility ClinicReport describes IVF as a procedurewhere the woman’s ovaries are stimu-lated with drugs to release eggs, whichare retrieved using a needle guidedthrough the vagina with ultrasound.

The eggs are fertilized with semen, incubated in alaboratory dish, and transferred to the woman’suterus through the cervix at the appropriate time.

The report says IVF is the most common assist-ed reproductive treatment done in the UnitedStates, with less than a 30 percent success rate,about the same chance healthy couples have ofconceiving naturally each menstrual cycle.

“IVF is very common (among infertile couples),”said Uhlman. “IVF has really changed things on theforefront (of infertility).”

After much research and consideration, theWalkowiaks decided to try donor insemination.

“We didn’t feel comfortable with in vitrobecause it was so expensive and the chances ofgetting pregnant weren’t that good,” Darcy said,adding their insurance doesn’t cover infertility pro-cedures.

Through Cryogenics Laboratories, a sperm

bank in Roseville, the Walkowiaks went online insearch of a sperm donor. The Web site, www.cry-olab.com, makes shopping for sperm as easy asbrowsing the clothing racks at the mall. The Website allows people to identify the race, blood type,ethnic background, hair color, eye color andheight of the sperm donor. After inputting thecharacteristics, Cryogenics provides a list ofdonors who meet the qualifications. The listincludes detailed information about each donor,including education, health history and even theshape of their eyes, nose and mouth.

“It’s a completely anonymous program,” Darcysaid. “(The donor) will never know if his sperm wasused and he has kids.”

The Walkowiaks found their donor, boughtevery vile of his sperm available, costing $230 pervile, and started the process.

When Darcy was ovulating, Cryogenics wouldsend two viles to West Health inPlymouth, to be inserted in Darcy’suterus.

After five attempts, Darcy still wasn’tpregnant. They were down to the lastthree viles of their supply.

“We couldn’t afford any more andthere was no more sperm,”Darcy said. “Itwas our last chance.”

During this time of trying and continu-ously failing to get pregnant, Jason andDarcy said they’d never felt so alienatedand alone.

“We kept asking ourselves, ‘Why isGod punishing us?’ and thinking weweren’t made to be parents,” Darcy said.

Darcy joined an infertility supportgroup in Crosby, where she could speakto other women dealing with infertility.

“It helps to know there’s a lot of peo-ple out there dealing with (infertility),”Jason said.

Three weeks after the final attempt,Darcy hadn’t gotten her period. The cou-ple tried not to get their hopes up, pro-tecting themselves from getting theirdreams dashed again, like so many othertimes after finding out Darcy wasn’t preg-nant. She took a home pregnancy test. Itwas negative.

By the fourth week, Darcy still didn’thave her period and she said somethingdidn’t feel right. She took another preg-nancy test. It was positive. After aboutthree other home pregnancy tests and ablood test at the hospital, it was con-firmed. The Walkowiaks were going tohave a baby.

On July 4, 2002, Cameron JohnPeterson Walkowiak entered the worldand his two adoring parents couldn’t behappier.

“The joy we get from him is so great,”Darcy said.

Today, Cameron is walking, feedinghimself and even saying a few words.Jason and Darcy have recently started asupport group to help other couples dealwith the struggles infertility brings. Formore information on Brainerd’s supportgroup, e-mail Darcy at [email protected] or call 651-659-0333.

Jason and Darcy Walkowiak watched as their son, Cameron, played ata park near their home.

Page 13: UpNorth HealthWatch 10/2003

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One-year-old Cameron Walkowiak doesn’t know it yet, but his parents consider him a miracle. Jason and Darcy Walkowiak suffered through thebumps and bruises of infertility and Darcy finally got pregnant with Cameron after three years of trying.

Infertility

The struggles, the options, thedreams coming true

Story/Heidi LakePhotos/Nels Norquist

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In a generation obsessedwith fad diets and quickfixes for weight loss, goodeating habits sometimes getlost in the shuffle.

Mary Lange, a registereddietitian at BrainerdMedical Center, points outthat cutting back on saturat-ed and trans fats, as well asmaking sure to includeenough of the basic foodgroups on a daily basis, canmake a world of differencewhen striving for a healthierlifestyle.

A guide tohealthy eating

Ward Hernandez got a hand sittingup for an exam from his oncologist,Dr. David Squires, and Hernandez’sfiancee, Dorothy Glisson, atUniversity Hospital, where Squirestreats cancer patients with the knowl-edge of what it’s like to be one ofthem.

Page 15: UpNorth HealthWatch 10/2003

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AUGUSTA, Ga. — Ward Hernandez gets a handfrom Dr. David Squires, literally, as Squires helpshim lean forward in the bed at University Hospitaland then slips a stethoscope around to his back.

"OK, lungs sound good," Squires says with aquick smile.

There is an almost tangible bond between lym-phoma patient Hernandez and his oncologist.

"They have a lot in common," said Hernandez'sfiancee, Dorothy Glisson. They have both facedcancer.

It was a fluke that Squires ended up diagnosinghis own acute lymphoblastic leukemia six monthsbefore he entered medical school. He was in a his-tology class at Brigham Young University, and theassignment called for students to examine theirown blood with a microscope.

"I noticed that I was anemic and had an abnor-mally high number of lymphocytes (white bloodcells) in my peripheral count," Squires said.

As luck would have it, the next day he was grad-ing papers for another class, and one dealt withleukemia. When he looked it up, the pieces fell

into place.A week later, he was starting chemotherapy,

which would last for three years. Despite that, hegraduated as valedictorian of his undergraduateclass and would later be inducted into a medicalhonor society. When it came time to choose a spe-

cialty, he was naturally interested in cancer andwould eventually land a three-year fellowship atthe National Cancer Institute.

As the fellowship was coming to an end lastyear, however, he decided not to continue his workwith clinical trials. Instead, he wanted to see

patients full time. He joined Augusta OncologyAssociates in August.

"Many people can be in academics and do a finejob. What I really have to offer people is the expe-rience I had," he said.

The cancer shaped not only his communicationwith patients but also his view of life and his abilityto share that with them. The key is coping withwhat he calls "the tentativeness of cancer."

"This is part of life," he said. "Everyone is livingtentatively. Most people just don't realize it untilthey get some kind of acute, life-threatening ill-ness."

Faith has a lot to do with that, he said."I spend time with them and their families and

find out what kind of support they have," he said."And our discussions inevitably turn to God."

Squires can even see a positive in the cancerthat invaded his body. His original goal was tobecome a surgeon.

"I actually think it is somewhat of a blessing," hesaid, "because I don't think I would have enjoyedsurgery as much as I enjoy oncology."

"Many people can be inacademics and do a finejob. What I really have tooffer people is the experi-ence I had."

It’s 3 a.m. Good

G

“Celebratingour 20th

Anniversary.”

That nasty “F” wordOften times, the “F”word is given a bad rap, but

Lange stresses that fats aren’t all bad. Lange suggests when preparing meals, people

use more healthy oils and nuts. Monounsaturatedfats lower the risk of heart disease as well as LDL,or bad cholesterol, without lowering the HDL, orgood cholesterol. Products with monounsaturatedfats include olive and canola oils, olives, avocadosand most nuts, including almonds, filberts,macadamias, peanuts, pecans, cashews and pista-chios. Lange encourages people to try olive oil orcanola oil in place of other vegetable oils, butter ormargarine.

Another fat to include in your diet is Omega-3fatty acid, found in high-fat fishes such as salmon,herring, tuna, anchovies and sardines, as well as ingreen leafy vegetables, and soybean and canolaoils. This type of fat has been shown to reduce therisk of heart disease as well as stroke and also low-ers LDL cholesterol and raises the HDL cholesterol.

Snack attackWhen striving to lose weight, Lange says many

people will starve themselves between meals. Butthis can, in fact, backfire.

“I often recommend people include an after-noon snack,” Lange said, noting often times whenpeople don’t eat between lunch and dinner they’remuch more likely to overeat during their eveningmeal. Fruit and nuts, herring on whole wheatcrackers and yogurt are good, healthy choices,

Lange says, adding each of thedaily requirements from the va

Serving it upIt used to be recommended

five servings a day of fruits andis changing. Lange says the pservings a day for proper nutri

A common misconceptiowatchers, is that dairy is tabLange said she recommendsweight management and hiissues still get in three servineach day. Calcium is a critical sing many cells know what to help lead to satiety or a feelingeach meal.

As far as protein, working short in getting their requireWomen should consume two ounces, of protein each day. Pmeats, chicken, fish, eggs, cottfat cheese. Men need approximof protein per day.

Cutting those carbsThe infamous Atkins diet h

good thing for the public at-larIt’s helped people recognize wcarbohydrates. Lange agrees “bad carbs” found in white brsugary low-fiber cereals. Thes

15

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se foods helps meetrious food groups.

that individuals eat vegetables, but thatush now is for ninetion. n among weight

oo and high in fat. her patients with

gh blood pressuregs of low-fat dairy

ignaling agent, help-do, and dairy foods of satisfaction after

women seem to fallments, Lange says.

servings, or at least 5roteins include leanage cheese and low-

ately 5 to 8 ounces

as done at least onege, Lange concedes.hich foods contain

it’s best to limit theead, white rice ande foods have been

found to create an excessive insulin responsewhere the body secretes more insulin upon con-sumption of these items leading to early hunger.Rather than cutting carbs completely, Lange sug-gests the healthier ones, including brown rice, wildrice, baked potatoes, whole grain breads andcrackers and high-fiber cereals.

Washing it downLange said she has had patients who consume

up to 2,000 calories a day from drinking high sugarsodas alone. She suggests avoiding “regular” popaltogether. If you must get your soda fix, Lange saysto switch to diet pop. Other healthier alternativesinclude non-caffeinated beverages such as DietSnapple, sugar-free Kool Aid or Crystal Light.

Without a doubt, Lange says the best beverageis plain ol’ water. She recommends people drinkbetween 6 and 8 cups a day.

“I tell people to fill a mug, with at least 2 cups ofwater, and keep it on their desk at work during theday.” She says to force yourself to finish it beforelunch, then refill it after lunch and finish it beforeleaving for the day to ensure you get at least 4 cupsof water while at the office. Then fill a water bottleto take with you in the evening to sporting events,church functions or anywhere you travel.

Getting enough water may help to wash awayseveral health problems, including urinary tractinfections, kidney stones, bladder cancer, coloncancer, obesity and constipation.

Page 16: UpNorth HealthWatch 10/2003

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ur Layer Salad’s a salad you can prepare the day before and the lettuce will stay crispu’re ready to serve it. Calories, fat and cholesterol were reduced by: lacing bacon with turkey bacon and reducing the total amount;ucing the amount of cheddar cheese and using its reduced-fat alter-ess than 5 grams of fat per ounce of cheese);ng a reduced-fat parmesan dressing instead of mayonnaise;ng only the egg white portion of the hard cooked eggs.

s torn lettuce sliced fresh mushroomsounce) package frozen peas coarsely shredded carrotsd-cooked egg whites, chopped; discard yolkses turkey bacon, cooked, drained and crumbledp (2 ounces) finely shredded reduced-fat cheddar cheese

cups Creamy Parmesan Dressing (see recipe below)lespoons snipped fresh chives

the lettuce in a large clear-glass bowl with straight sides. In the fol-order, layer the mushrooms, frozen peas, carrots, egg whites andacon on top. Sprinkle with 1/4 cup of cheddar cheese. Then carefullyhe dressing over the top, sealing the dressing to the edge of the bowl. with the remaining 1/4 cup of cheddar cheese and the chives. Coverigerate for 24 hours. To serve, toss the salad until the lettuce and veg-are coated. Makes 8 side-dish servings.

althy cooking St. Joseph’s Medical CenterPillager Family Clinic

Dr. Kathy Wimmer, a family practitioner atBrainerd Medical Center, will soon be transferringher practice to St. Joseph’s Medical Center PillagerFamily Clinic.

Wimmer has practiced at BMC five and one-half years.

“I thought it’d be nice to have a small townatmosphere,” Wimmer said. “It’ll be more relaxedand not so hectic.”

Wimmer expects to serve 20-25 patients eachday.

Three nurses will be cross-trained as reception-ists and will join Wimmer at the Pillager clinic.Tracy Schmidt, Wimmer’s current nurse, LindaJohnson, of St. Joe’s Pine River clinic and SonjaEndreson, who currently works at SJMC, will jointhe Pillager team.

The clinic is scheduled to open Nov. 17. Hourswill be 8 a.m. to 4:30 p.m. Monday through Friday.

The 3,500 square-foot clinic has five examrooms and a procedure room.

An open house is scheduled 2:30-6 p.m. Nov. 17,which will include tours of the new facility and adedication ceremony.

St. Joseph Medical Center’s Pillager Family Clinic is scheduled to open Nov. 17. The clinic will behome to Dr. Kathy Wimmer, a family practitioner who currently works at Brainerd Medical Center.(Photo by Heidi Lake)

Nutrition Scorecard (per serving)Calories – 123Fat (g) – 4% calories from fat – 29%Cholesterol (mg) – 12

Exchanges (per serving)2 vegetables1 lean meat1/2 fat

Creamy Parmesan DressingNo one will ever guess that this rich, creamy dressing is virtually fat free.

Use it on the 24-Hour Layer Salad or with plain lettuce, fresh tomatoes, or asa dip with raw vegetables. Calories, fat and cholesterol were reduced by:

• Replacing regular sour cream with a combination of fat-free yogurt andfat-free sour cream;

• Using reduced-fat parmesan cheese (3 grams of fat per ounce of cheese)

1/2 cup fat-free plain yogurt1/2 cup fat-free sour cream1/4 cup grated reduced-fat parmesan cheese 2 tablespoons fresh lemon juice (see note below)1 clove garlic, minced

In a small bowl, use a wire whisk to stir together the yogurt, sour cream,parmesan cheese, lemon juice and garlic. Cover and chill in the refrigeratorfor at least 30 minutes to blend the flavors. Makes 1 1/4 cups or 10 servings.Note: This is a tangy dressing. If you prefer a less sour dressing, replace someof the lemon juice with skim milk.

Nutrition Scorecard (per serving)Calories – 29Fat (g) – <1% calories from fat – 19%Cholesterol (mg) – 0

Exchanges (per serving)1/2 fat

Romanoff Bow TiesAlthough egg noodles are fairly low in fat, they still contain much more fat

than other types of dried pasta. For this dish, the noodles are replaced withbow tie noodles (but almost any pasta will do). Calories, fat and cholesterolwere reduced by:

• Replacing egg noodles with bow tie pasta; • Using fat-free cottage cheese; • Replacing sour cream with fat-free plain yogurt;• Using no-stick spray instead of butter to sautè the onions; • Replacing whole milk with a combination of regular skim milk and evap-

orated skim milk; • Using reduced-fat cheddar cheese (less than 5 grams of fat per ounce of

cheese)

8 ounces bow tie pasta1 cup fat-free cottage cheese1 cup fat-free plain yogurt1/4 cup chopped onions 1/2 cup skim milk 1 tablespoon cornstarch1/2 cup evaporated skim milk1/2 teaspoon dry mustard1/2 teaspoon Worcestershire sauceDash ground red pepperDash of hot pepper sauce1/4 cup (1 ounce) finely shredded reduced-fat sharp cheddar cheese3 tablespoons fine dry seasoned bread crumbs

Cook the pasta according to the directions on the package. Drain and setaside. Meanwhile, lightly spray a 2-quart casserole with no-stick spray and set

Page 17: UpNorth HealthWatch 10/2003

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A construction workerput finishing touchesaround the door framesand windows at theLakewood HealthSystem Pillager Clinic.

Construction workers worked on finishing the waitingroom of the Lakewood Health System Pillager Clinic.(Photos by Mindy Niemela)

You don’t have to drive hours for outstanding cancer care. Brainerd Medica

St. Joseph’s Medical Center offer comprehensive cancer diagnosis and treatme

certified hematologists and oncologists will provide a full range of care, from co

planning the most effective treatment options. You’ll find certified oncology nurs

to compassionate and supportive care in our spacious new chemotherapy tre

For an appointment, call (218) 855-5471 or 800-277-8262.

CANCER CARE. COMPASSIONATE C

Front Row: Renee Pearl, RN, OCN • Marian Foehrenbacher, RN, OCN • LBack Row: Ann Maresch-Solseth, LPN • Dr. Ronald Ha

aside. Press the cottage cheese through a strainer or sieve into a large bowl.Add the yogurt and stir until well combined. Set the yogurt mixture aside.Preheat the oven to 350 degrees. Lightly spray a medium saucepan with no-stick spray. Add the onions. Cook and stir over medium heat about three min-utes or until tender. In a custard cup, stir together 2 tablespoons of the skimmilk and the cornstarch until smooth. Stir the remaining skim milk, evaporat-ed milk and cornstarch mixture into the onions. Cook and stir over mediumheat until thickened and bubbly. Then stir in the dry mustard, Worcestershiresauce, red pepper and hot pepper sauce. Cook and stir for one minute more.Stir in the cheddar cheese and cook until melted. Slowly stir the cheese mix-ture into the yogurt mixture. Fold in the pasta. Transfer to the prepared casse-role. Sprinkle the bread crumbs on top. Bake about 15 minutes or until bub-bly. Makes 6 servings.

Nutrition Scorecard (per serving)Calories – 245Fat (g) – 2% calories from fat – 7%Cholesterol (mg) – 7

Exchanges (per serving)1 1/2 starch1 lean meat1/2 milk

Glazed CarrotsDon’t be alarmed by seeing butter instead of margarine in this recipe. It’s

used only a tiny amount to give these carrots a rich, buttery taste. It makes abig difference! Calories, fat and cholesterol were reduced by:

• Replacing some of the butter with apple juice.

1 pound carrots4 teaspoons apple juice1 tablespoon brown sugar1 teaspoon butter1/4 teaspoon ground nutmeg (optional)

Cut the large saucecarrots in athe basket sutes or untcup or cusCook in a until the bra serving bdesired, sp

Note: Sinin this recipbles. You cdifference.

NutritionCaloriesFat (g) – % caloriCholeste

Exchang2 vegeta

Classy PoServe th

for dinner. leaves you doing last-m

• Using ounce of ch

• Using

17

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carrots into 2” long pieces. Then cut lengthwise into quarters. In apan with a tight-fitting lid, bring about 1” of water to a boil. Place steamer basket and set the basket in the saucepan, making sureits above the water. Cover the saucepan and steam for 8 to 10 min-il crisp-tender. Meanwhile, in a 1-cup microwave-safe measuringtard cup, stir together the apple juice, brown sugar and butter.microwave oven on high power (100%) about 25 seconds or justown sugar and butter are melted. To serve, transfer the carrots toowl. Drizzle with the apple juice mixture and toss until coated. Ifrinkle with the nutmeg and toss again. Makes 4 servings. ce sodium is a concern for many people, the amount is reducede by omitting the salt that’s usually sprinkled on cooked vegeta-

an do that with virtually any vegetable and you’ll never notice the

Scorecard (per serving) – 741es from fat – 1%rol (mg) – 3

es (per serving)ble

tatoesis delicious cheese and potato casserole when company’s comingIt’s ideal because you can prepare it before your guests arrive. Thismore time to spend with them instead of being in the kitcheninute preparations. Calories, fat and cholesterol were reduced by:

reduced-fat sharp cheddar cheese (less than 5 grams of fat pereese);

reduced-fat cream of chicken soup;

(Continued on Page 30)

Page 18: UpNorth HealthWatch 10/2003

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These are the surgeons who practice theirart at the Cuyuna Regional Medical Center in Crosby. Each brings a rare and unique setof skills to the job. Together, they’re helpingto shape the future of surgery inthis region.

They bring the region new procedures and new technologies.They work withcomputers, scopesand lasers, not simplywith scalpels. In many procedures, theirincisions are less thanthree millimeters long,

and T

wor

Su

A town about 15 miles westtwo bars, two restaurants and

Although the green sign outulation 420,” administrators o

System and Brainerd-baseconfident the small to

“Just look around thTim Rice, Lakew

“There is a lot oThe clini

near Highware both schedu

Plenty of pills in Pillager

Story/Heidi Lake

Two clinics, pharmacy opening

19

closed with a band-aid, not with a stitch.heir training has taken them around theld. Their resumes include some of the

most prestigious schools, internships andresidency programs in America.

They’re teachers, too. No less than four of

our surgeons are actively involved in trainingother surgeons around the region. Four areon the faculties of regional medical colleges.

They’re experts in joint repair and jointreplacement. In cataract and laser vision correction. In a multitude of procedures thatcan improve the quality of your life. If you

(or someone you know) is in need ofsurgery (or considering some form of

elective surgery), ask your doctor (orcall 1-218-546-2300 and ask) aboutthe surgeons who practice at theCuyuna Regional Medical Centerin Crosby today.

rgery Is An Art. Meet Our Picassos.

of Brainerd has two gas stations, now two clinics.side the city of Pillager says, “pop-f Staples-based Lakewood Healthd St. Joseph’s Medical Center arewn can support two clinics.e area surrounding Pillager,” saidood Health System president.f growth in that area.”cs, located practically side-by-side

ay 210 and Cass County Road 1,led to open in November.

Lakewood Health System Pillager Clinic isscheduled to open Nov. 3.

The primary care clinic will have three rotatingdoctors on staff, Dr. Arden Beachy, Dr. MichaelHudalla and Dr. Renee Nydegger. The doctors cur-rently work at the Staples clinic and will rotatebetween the Pillager and Staples clinics as needed.A physician’s assistant, Rebecca Bennett, and anurse practitioner, Kelly Thompson, will also staffthe Pillager clinic.

“(A rotating staff) will give people a choice,”Rice said. “It gives them accessibility to options.”

The 7,000 square-foot clinic has six exam rooms,a laboratory, a nurses’ station and an X-ray andminor procedure room.

A physical therapist from Lakewood Hospital inStaples will offer physical therapy at the clinicthree days a week.

Craig Wolhowe, division director of clinic serv-ices at Lakewood, said he expects the clinic toserve 18 to 22 patients each day.

The clinic will also house Pillager’s only phar-macy, Longbella Drug.

An open house is scheduled 1-3 p.m. Nov. 2.

Lakewood Health SystemPillager Clinic

Lakewood Health System Pillager Clinic plans to open Nov. 3. The 7,000 square-foot clinicwill include a pharmacy and will be located near Highway 210 and Cass County Road 1.(Photo by Mindy Niemela)

soon

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These are the surgeons who practice theirart at the Cuyuna Regional Medical Center in Crosby. Each brings a rare and unique setof skills to the job. Together, they’re helpingto shape the future of surgery inthis region.

They bring the region new procedures and new technologies.They work withcomputers, scopesand lasers, not simplywith scalpels. In many procedures, theirincisions are less thanthree millimeters long,

and closed with a band-aid, not with a stitch.Their training has taken them around the

world. Their resumes include some of the

most prestigious schools, internships andresidency programs in America.

They’re teachers, too. No less than four of

our surgeons are actively involved in trainingother surgeons around the region. Four areon the faculties of regional medical colleges.

They’re experts in joint repair and jointreplacement. In cataract and laser vision correction. In a multitude of procedures thatcan improve the quality of your life. If you

(or someone you know) is in need ofsurgery (or considering some form of

elective surgery), ask your doctor (orcall 1-218-546-2300 and ask) aboutthe surgeons who practice at theCuyuna Regional Medical Centerin Crosby today.

Surgery Is An Art. Meet Our Picassos.

A town about 15 miles west of Brainerd has two gas stations,two bars, two restaurants and now two clinics.

Although the green sign outside the city of Pillager says, “pop-ulation 420,” administrators of Staples-based Lakewood Health

System and Brainerd-based St. Joseph’s Medical Center areconfident the small town can support two clinics.

“Just look around the area surrounding Pillager,” saidTim Rice, Lakewood Health System president.

“There is a lot of growth in that area.”The clinics, located practically side-by-side

near Highway 210 and Cass County Road 1,are both scheduled to open in November.

Lakewood Health System Pillager Clinic isscheduled to open Nov. 3.

The primary care clinic will have three rotatingdoctors on staff, Dr. Arden Beachy, Dr. MichaelHudalla and Dr. Renee Nydegger. The doctors cur-rently work at the Staples clinic and will rotatebetween the Pillager and Staples clinics as needed.A physician’s assistant, Rebecca Bennett, and anurse practitioner, Kelly Thompson, will also staffthe Pillager clinic.

“(A rotating staff) will give people a choice,”Rice said. “It gives them accessibility to options.”

The 7,000 square-foot clinic has six exam rooms,a laboratory, a nurses’ station and an X-ray andminor procedure room.

A physical therapist from Lakewood Hospital inStaples will offer physical therapy at the clinicthree days a week.

Craig Wolhowe, division director of clinic serv-ices at Lakewood, said he expects the clinic toserve 18 to 22 patients each day.

The clinic will also house Pillager’s only phar-macy, Longbella Drug.

An open house is scheduled 1-3 p.m. Nov. 2.

Lakewood Health SystemPillager Clinic

Plenty of pills in Pillager

Lakewood Health System Pillager Clinic plans to open Nov. 3. The 7,000 square-foot clinicwill include a pharmacy and will be located near Highway 210 and Cass County Road 1.(Photo by Mindy Niemela)

Story/Heidi Lake

Two clinics, pharmacy opening soon

19

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You don’t have to drive hours for outstanding cancer care. Brainerd Medical Center and

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planning the most effective treatment options. You’ll find certified oncology nurses committed

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For an appointment, call (218) 855-5471 or 800-277-8262.

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Front Row: Renee Pearl, RN, OCN • Marian Foehrenbacher, RN, OCN • Lori Nistler, MA • Deborah Tabbert, RN, OCNBack Row: Ann Maresch-Solseth, LPN • Dr. Ronald Halvorson • Dr. Timothy Yeh

A construction workerput finishing touchesaround the door framesand windows at theLakewood HealthSystem Pillager Clinic.

Construction workers worked on finishing the waitingroom of the Lakewood Health System Pillager Clinic.(Photos by Mindy Niemela)

aside. Press the cottage cheese through a strainer or sieve into a large bowl.Add the yogurt and stir until well combined. Set the yogurt mixture aside.Preheat the oven to 350 degrees. Lightly spray a medium saucepan with no-stick spray. Add the onions. Cook and stir over medium heat about three min-utes or until tender. In a custard cup, stir together 2 tablespoons of the skimmilk and the cornstarch until smooth. Stir the remaining skim milk, evaporat-ed milk and cornstarch mixture into the onions. Cook and stir over mediumheat until thickened and bubbly. Then stir in the dry mustard, Worcestershiresauce, red pepper and hot pepper sauce. Cook and stir for one minute more.Stir in the cheddar cheese and cook until melted. Slowly stir the cheese mix-ture into the yogurt mixture. Fold in the pasta. Transfer to the prepared casse-role. Sprinkle the bread crumbs on top. Bake about 15 minutes or until bub-bly. Makes 6 servings.

Nutrition Scorecard (per serving)Calories – 245Fat (g) – 2% calories from fat – 7%Cholesterol (mg) – 7

Exchanges (per serving)1 1/2 starch1 lean meat1/2 milk

Glazed CarrotsDon’t be alarmed by seeing butter instead of margarine in this recipe. It’s

used only a tiny amount to give these carrots a rich, buttery taste. It makes abig difference! Calories, fat and cholesterol were reduced by:

• Replacing some of the butter with apple juice.

1 pound carrots4 teaspoons apple juice1 tablespoon brown sugar1 teaspoon butter1/4 teaspoon ground nutmeg (optional)

Cut the carrots into 2” long pieces. Then cut lengthwise into quarters. In alarge saucepan with a tight-fitting lid, bring about 1” of water to a boil. Placecarrots in a steamer basket and set the basket in the saucepan, making surethe basket sits above the water. Cover the saucepan and steam for 8 to 10 min-utes or until crisp-tender. Meanwhile, in a 1-cup microwave-safe measuringcup or custard cup, stir together the apple juice, brown sugar and butter.Cook in a microwave oven on high power (100%) about 25 seconds or justuntil the brown sugar and butter are melted. To serve, transfer the carrots toa serving bowl. Drizzle with the apple juice mixture and toss until coated. Ifdesired, sprinkle with the nutmeg and toss again. Makes 4 servings.

Note: Since sodium is a concern for many people, the amount is reducedin this recipe by omitting the salt that’s usually sprinkled on cooked vegeta-bles. You can do that with virtually any vegetable and you’ll never notice thedifference.

Nutrition Scorecard (per serving)Calories – 74Fat (g) – 1% calories from fat – 1%Cholesterol (mg) – 3

Exchanges (per serving)2 vegetable

Classy PotatoesServe this delicious cheese and potato casserole when company’s coming

for dinner. It’s ideal because you can prepare it before your guests arrive. Thisleaves you more time to spend with them instead of being in the kitchendoing last-minute preparations. Calories, fat and cholesterol were reduced by:

• Using reduced-fat sharp cheddar cheese (less than 5 grams of fat perounce of cheese);

• Using reduced-fat cream of chicken soup;

(Continued on Page 30)

20218-829-1470 • Hwy. 3/25 N.

rainerd
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Conveniently located just off 371 N in Baxter.Call us at 218-824-5027

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24-Hour Layer SaladHere’s a salad you can prepare the day before and the lettuce will stay crisp

until you’re ready to serve it. Calories, fat and cholesterol were reduced by: • Replacing bacon with turkey bacon and reducing the total amount;• Reducing the amount of cheddar cheese and using its reduced-fat alter-

native (less than 5 grams of fat per ounce of cheese);• Using a reduced-fat parmesan dressing instead of mayonnaise;• Using only the egg white portion of the hard cooked eggs.

4 cups torn lettuce1 cup sliced fresh mushrooms1 (10 ounce) package frozen peas1 cup coarsely shredded carrots4 hard-cooked egg whites, chopped; discard yolks5 slices turkey bacon, cooked, drained and crumbled1/2 cup (2 ounces) finely shredded reduced-fat cheddar cheese1 1/4 cups Creamy Parmesan Dressing (see recipe below)2 tablespoons snipped fresh chives

Place the lettuce in a large clear-glass bowl with straight sides. In the fol-lowing order, layer the mushrooms, frozen peas, carrots, egg whites andturkey bacon on top. Sprinkle with 1/4 cup of cheddar cheese. Then carefullyspread the dressing over the top, sealing the dressing to the edge of the bowl.Sprinkle with the remaining 1/4 cup of cheddar cheese and the chives. Coverand refrigerate for 24 hours. To serve, toss the salad until the lettuce and veg-etables are coated. Makes 8 side-dish servings.

Healthy cooking St. Joseph’s Medical CenterPillager Family Clinic

Dr. Kathy Wimmer, a family practitioner atBrainerd Medical Center, will soon be transferringher practice to St. Joseph’s Medical Center PillagerFamily Clinic.

Wimmer has practiced at BMC five and one-half years.

“I thought it’d be nice to have a small townatmosphere,” Wimmer said. “It’ll be more relaxedand not so hectic.”

Wimmer expects to serve 20-25 patients eachday.

Three nurses will be cross-trained as reception-ists and will join Wimmer at the Pillager clinic.Tracy Schmidt, Wimmer’s current nurse, LindaJohnson, of St. Joe’s Pine River clinic and SonjaEndreson, who currently works at SJMC, will jointhe Pillager team.

The clinic is scheduled to open Nov. 17. Hourswill be 8 a.m. to 4:30 p.m. Monday through Friday.

The 3,500 square-foot clinic has five examrooms and a procedure room.

An open house is scheduled 2:30-6 p.m. Nov. 17,which will include tours of the new facility and adedication ceremony.

St. Joseph Medical Center’s Pillager Family Clinic is scheduled to open Nov. 17. The clinic will behome to Dr. Kathy Wimmer, a family practitioner who currently works at Brainerd Medical Center.(Photo by Heidi Lake)

Nutrition Scorecard (per serving)Calories – 123Fat (g) – 4% calories from fat – 29%Cholesterol (mg) – 12

Exchanges (per serving)2 vegetables1 lean meat1/2 fat

Creamy Parmesan DressingNo one will ever guess that this rich, creamy dressing is virtually fat free.

Use it on the 24-Hour Layer Salad or with plain lettuce, fresh tomatoes, or asa dip with raw vegetables. Calories, fat and cholesterol were reduced by:

• Replacing regular sour cream with a combination of fat-free yogurt andfat-free sour cream;

• Using reduced-fat parmesan cheese (3 grams of fat per ounce of cheese)

1/2 cup fat-free plain yogurt1/2 cup fat-free sour cream1/4 cup grated reduced-fat parmesan cheese 2 tablespoons fresh lemon juice (see note below)1 clove garlic, minced

In a small bowl, use a wire whisk to stir together the yogurt, sour cream,parmesan cheese, lemon juice and garlic. Cover and chill in the refrigeratorfor at least 30 minutes to blend the flavors. Makes 1 1/4 cups or 10 servings.Note: This is a tangy dressing. If you prefer a less sour dressing, replace someof the lemon juice with skim milk.

Nutrition Scorecard (per serving)Calories – 29Fat (g) – <1% calories from fat – 19%Cholesterol (mg) – 0

Exchanges (per serving)1/2 fat

Romanoff Bow TiesAlthough egg noodles are fairly low in fat, they still contain much more fat

than other types of dried pasta. For this dish, the noodles are replaced withbow tie noodles (but almost any pasta will do). Calories, fat and cholesterolwere reduced by:

• Replacing egg noodles with bow tie pasta; • Using fat-free cottage cheese; • Replacing sour cream with fat-free plain yogurt;• Using no-stick spray instead of butter to sautè the onions; • Replacing whole milk with a combination of regular skim milk and evap-

orated skim milk; • Using reduced-fat cheddar cheese (less than 5 grams of fat per ounce of

cheese)

8 ounces bow tie pasta1 cup fat-free cottage cheese1 cup fat-free plain yogurt1/4 cup chopped onions 1/2 cup skim milk 1 tablespoon cornstarch1/2 cup evaporated skim milk1/2 teaspoon dry mustard1/2 teaspoon Worcestershire sauceDash ground red pepperDash of hot pepper sauce1/4 cup (1 ounce) finely shredded reduced-fat sharp cheddar cheese3 tablespoons fine dry seasoned bread crumbs

Cook the pasta according to the directions on the package. Drain and setaside. Meanwhile, lightly spray a 2-quart casserole with no-stick spray and set

21Baxter, MN 56401

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Brainerd Office 218.828.9545 • 877.338.3957

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• Treatment of eye infections and injuries

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For Referral Call (218) 829-92381-888-221-5785 Baxter

“Celebratingour 20th

Anniversary.”

That nasty “F” wordOften times, the “F”word is given a bad rap, but

Lange stresses that fats aren’t all bad. Lange suggests when preparing meals, people

use more healthy oils and nuts. Monounsaturatedfats lower the risk of heart disease as well as LDL,or bad cholesterol, without lowering the HDL, orgood cholesterol. Products with monounsaturatedfats include olive and canola oils, olives, avocadosand most nuts, including almonds, filberts,macadamias, peanuts, pecans, cashews and pista-chios. Lange encourages people to try olive oil orcanola oil in place of other vegetable oils, butter ormargarine.

Another fat to include in your diet is Omega-3fatty acid, found in high-fat fishes such as salmon,herring, tuna, anchovies and sardines, as well as ingreen leafy vegetables, and soybean and canolaoils. This type of fat has been shown to reduce therisk of heart disease as well as stroke and also low-ers LDL cholesterol and raises the HDL cholesterol.

Snack attackWhen striving to lose weight, Lange says many

people will starve themselves between meals. Butthis can, in fact, backfire.

“I often recommend people include an after-noon snack,” Lange said, noting often times whenpeople don’t eat between lunch and dinner they’remuch more likely to overeat during their eveningmeal. Fruit and nuts, herring on whole wheatcrackers and yogurt are good, healthy choices,

Lange says, adding each of these foods helps meetdaily requirements from the various food groups.

Serving it upIt used to be recommended that individuals eat

five servings a day of fruits and vegetables, but thatis changing. Lange says the push now is for nineservings a day for proper nutrition.

A common misconception among weightwatchers, is that dairy is taboo and high in fat.Lange said she recommends her patients withweight management and high blood pressureissues still get in three servings of low-fat dairyeach day. Calcium is a critical signaling agent, help-ing many cells know what to do, and dairy foodshelp lead to satiety or a feeling of satisfaction aftereach meal.

As far as protein, working women seem to fallshort in getting their requirements, Lange says.Women should consume two servings, or at least 5ounces, of protein each day. Proteins include leanmeats, chicken, fish, eggs, cottage cheese and low-fat cheese. Men need approximately 5 to 8 ouncesof protein per day.

Cutting those carbsThe infamous Atkins diet has done at least one

good thing for the public at-large, Lange concedes.It’s helped people recognize which foods containcarbohydrates. Lange agrees it’s best to limit the“bad carbs” found in white bread, white rice andsugary low-fiber cereals. These foods have been

found to create an excessive insulin responsewhere the body secretes more insulin upon con-sumption of these items leading to early hunger.Rather than cutting carbs completely, Lange sug-gests the healthier ones, including brown rice, wildrice, baked potatoes, whole grain breads andcrackers and high-fiber cereals.

Washing it downLange said she has had patients who consume

up to 2,000 calories a day from drinking high sugarsodas alone. She suggests avoiding “regular” popaltogether. If you must get your soda fix, Lange saysto switch to diet pop. Other healthier alternativesinclude non-caffeinated beverages such as DietSnapple, sugar-free Kool Aid or Crystal Light.

Without a doubt, Lange says the best beverageis plain ol’ water. She recommends people drinkbetween 6 and 8 cups a day.

“I tell people to fill a mug, with at least 2 cups ofwater, and keep it on their desk at work during theday.” She says to force yourself to finish it beforelunch, then refill it after lunch and finish it beforeleaving for the day to ensure you get at least 4 cupsof water while at the office. Then fill a water bottleto take with you in the evening to sporting events,church functions or anywhere you travel.

Getting enough water may help to wash awayseveral health problems, including urinary tractinfections, kidney stones, bladder cancer, coloncancer, obesity and constipation.

Cancer doctor finds out whatdisease is like first hand

Story/Tom Corwin

Photo/Jonathan Ernst

(Morris News Service)

AUGUSTA, Ga. — Ward Hernandez gets a handfrom Dr. David Squires, literally, as Squires helpshim lean forward in the bed at University Hospitaland then slips a stethoscope around to his back.

"OK, lungs sound good," Squires says with aquick smile.

There is an almost tangible bond between lym-phoma patient Hernandez and his oncologist.

"They have a lot in common," said Hernandez'sfiancee, Dorothy Glisson. They have both facedcancer.

It was a fluke that Squires ended up diagnosinghis own acute lymphoblastic leukemia six monthsbefore he entered medical school. He was in a his-tology class at Brigham Young University, and theassignment called for students to examine theirown blood with a microscope.

"I noticed that I was anemic and had an abnor-mally high number of lymphocytes (white bloodcells) in my peripheral count," Squires said.

As luck would have it, the next day he was grad-ing papers for another class, and one dealt withleukemia. When he looked it up, the pieces fell

into place.A week later, he was starting chemotherapy,

which would last for three years. Despite that, hegraduated as valedictorian of his undergraduateclass and would later be inducted into a medicalhonor society. When it came time to choose a spe-

cialty, he was naturally interested in cancer andwould eventually land a three-year fellowship atthe National Cancer Institute.

As the fellowship was coming to an end lastyear, however, he decided not to continue his workwith clinical trials. Instead, he wanted to see

patients full time. He joined Augusta OncologyAssociates in August.

"Many people can be in academics and do a finejob. What I really have to offer people is the expe-rience I had," he said.

The cancer shaped not only his communicationwith patients but also his view of life and his abilityto share that with them. The key is coping withwhat he calls "the tentativeness of cancer."

"This is part of life," he said. "Everyone is livingtentatively. Most people just don't realize it untilthey get some kind of acute, life-threatening ill-ness."

Faith has a lot to do with that, he said."I spend time with them and their families and

find out what kind of support they have," he said."And our discussions inevitably turn to God."

Squires can even see a positive in the cancerthat invaded his body. His original goal was tobecome a surgeon.

"I actually think it is somewhat of a blessing," hesaid, "because I don't think I would have enjoyedsurgery as much as I enjoy oncology."

"Many people can be inacademics and do a finejob. What I really have tooffer people is the experi-ence I had."

22Dr. Jackie McCall 218.894.5480 • 866-894-5455

[email protected]

Page 23: UpNorth HealthWatch 10/2003

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Story/Jenny Kringen-Holmes

In a generation obsessedwith fad diets and quickfixes for weight loss, goodeating habits sometimes getlost in the shuffle.

Mary Lange, a registereddietitian at BrainerdMedical Center, points outthat cutting back on saturat-ed and trans fats, as well asmaking sure to includeenough of the basic foodgroups on a daily basis, canmake a world of differencewhen striving for a healthierlifestyle.

A guide tohealthy eating

Ward Hernandez got a hand sittingup for an exam from his oncologist,Dr. David Squires, and Hernandez’sfiancee, Dorothy Glisson, atUniversity Hospital, where Squirestreats cancer patients with the knowl-edge of what it’s like to be one ofthem.

23on.-Fri. 8:30-5:00, Sat. 9:00-12:00 Noon

Page 24: UpNorth HealthWatch 10/2003

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Thank You

One-year-old Cameron Walkowiak doesn’t know it yet, but his parents consider him a miracle. Jason and Darcy Walkowiak suffered through thebumps and bruises of infertility and Darcy finally got pregnant with Cameron after three years of trying.

Infertility

The struggles, the options, thedreams coming true

Story/Heidi LakePhotos/Nels Norquist

4

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He was 6-foot-4 and 342 pounds. “I was a physical mess,” he said. ‘I didn’t

have energy, I didn’t have will and I was justwaiting to have a massive coronary or heartattack and die.”

He was a 44 year old husband and father offour who was spending an increasing amountof time in the hospital for various weight-relat-ed health problems.

Bonar tried everything to lose weight, to noavail. He was overweight his whole life. Heremembers taking diet pills in sixth-grade andplaying high school football at 300 pounds.

“I tried TOPS and Weight Watchers ... I’dlose weight for the first five days, then get frus-trated and give up,” he said.

Bonar first heard about gastric bypass sur-gery in January 2002. He spoke with his doc-tors who he came to know all too well afterspending so much time in the Crosby hospi-

tal. They decided he should have Roux-en-Ybypass.

“I knew this was my last chance,” he said.Before the surgery, Bonar took part in the

mandatory preparation program that includ-ed a bariatric seminar, giving an overview ofthe Roux-en-Y and Lap-Band surgeries, andsaw a dietitian, physical therapist and psychol-ogist to be sure he was mentally ready for theprocedure.

On Sept. 6, 2002, Bonar had Roux-en-Ybypass, a surgery that changed his life forever– not without a few bumps along the way.

The surgery, which normally causes little orno pain, was giving Bonar severe abdominalpain three days after the surgery.

After a CAT scan, doctors found his oldstomach was filled with blood caused by aleak from where his intestine was sewn to hisstomach.

“If it had burst it would’ve killed me,”Bonarsaid.

McCollister said Bonar is one of twopatients who had complications out of the 120gastric bypass surgeries the MIMIS surgicalteam has done.

By the end of September, Bonar was feelingbetter and started losing weight. So far he haslost 120 pounds, “And there’s no way I’m goingto get it back,” he said.

Today Bonar eats about two-thirds of aplate of food every meal and tries to avoid eat-ing carbohydrates and sugars.

Along with the weight, Bonar has shed allof his health problems, even diabetes. Hetakes no medications and for the first time in along time, he can ride a bike and go campingwith his family.

“This surgery has given me another chanceto live,” Bonar said. “I was going to die.”

In Roux-en-Y bypass, the stomach is sewn into two parts. The upperpart forms a small pouch that receives food. Also, a section of thesmall intestine is attached to the pouch to allow food to bypass thelower stomach and the first portion of the small intestine.

Lap-Band uses an adjustable silicone band, separating thestomach into two pouches.

In the winter of 1998 two 20-year-olds, Jason andDarcy Walkowiak, thought they had the world bythe tail. They were newly married, had good jobs,and were thrilled by the thought of buying a homeand starting a family together.

By fall, they bought a three-bedroom house in aquaint Brainerd neighborhood, hoping to soonuse one of the spare bedrooms as a baby’s room.

After a year of unsuccessfully trying to get preg-nant the Walkowiaks decided it was time to see adoctor.

Jason and Darcy both were tested to see whythey couldn’t seem to conceive. Darcy said manypeople assume reproduction problems are due tothe female, but statistics say males and femaleshave an equal chance of having reproductionproblems.

Darcy’s ovulation cycle, tubes and uterus weretested, and the results showed her body was capa-ble of producing a child and carrying itthroughout a pregnancy.

Jason’s sperm count was tested, andthe results showed he had low motili-ty. After further testing, it was foundthat Jason had a varicocele, a clump ofvaricose veins in his scrotum that pro-duced too much heat, killing thesperm.

Jason had surgery to correct theproblem and doctors were 60 percentsure the Walkowiaks would be able toconceive naturally.

In February 2001, Jason went back tothe doctor and heard words he neverexpected to hear. The surgery wasunsuccessful and he could never havebiological children.

“It was pretty devastating to find outthere’s no chance,” Darcy said.

“It was an issue for me at first,”Jasonsaid of finding out he was the reasonthey couldn’t conceive. “But it’s notlike if Darcy couldn’t hold a baby. Thenwe would have had no choice but toadopt.”

The doctor gave the couple theiroptions — they could do in vitro fertil-ization, donor insemination or adopt.

The Walkowiaks, then 23, spokewith an adoption agency and foundout until they turn 25, the chances ofthem receiving an infant without spe-cial needs were slim. That narrowedtheir choices to IVF or donor insemi-nation, procedures that are not donein Brainerd or anywhere in the area.

Dr. Carol Uhlman, a mild fertilityspecialist and obstetrician/gynecolo-gist at Brainerd Medical Center, saidBMC can do initial evaluations andhormonal studies on infertile couples,and even prescribe fertility drugs, butanything more involved, such as IVF, isreferred to hospitals and clinics in theTwin Cities.

The Minnesota Fertility ClinicReport describes IVF as a procedurewhere the woman’s ovaries are stimu-lated with drugs to release eggs, whichare retrieved using a needle guidedthrough the vagina with ultrasound.

The eggs are fertilized with semen, incubated in alaboratory dish, and transferred to the woman’suterus through the cervix at the appropriate time.

The report says IVF is the most common assist-ed reproductive treatment done in the UnitedStates, with less than a 30 percent success rate,about the same chance healthy couples have ofconceiving naturally each menstrual cycle.

“IVF is very common (among infertile couples),”said Uhlman. “IVF has really changed things on theforefront (of infertility).”

After much research and consideration, theWalkowiaks decided to try donor insemination.

“We didn’t feel comfortable with in vitrobecause it was so expensive and the chances ofgetting pregnant weren’t that good,” Darcy said,adding their insurance doesn’t cover infertility pro-cedures.

Through Cryogenics Laboratories, a sperm

bank in Roseville, the Walkowiaks went online insearch of a sperm donor. The Web site, www.cry-olab.com, makes shopping for sperm as easy asbrowsing the clothing racks at the mall. The Website allows people to identify the race, blood type,ethnic background, hair color, eye color andheight of the sperm donor. After inputting thecharacteristics, Cryogenics provides a list ofdonors who meet the qualifications. The listincludes detailed information about each donor,including education, health history and even theshape of their eyes, nose and mouth.

“It’s a completely anonymous program,” Darcysaid. “(The donor) will never know if his sperm wasused and he has kids.”

The Walkowiaks found their donor, boughtevery vile of his sperm available, costing $230 pervile, and started the process.

When Darcy was ovulating, Cryogenics wouldsend two viles to West Health inPlymouth, to be inserted in Darcy’suterus.

After five attempts, Darcy still wasn’tpregnant. They were down to the lastthree viles of their supply.

“We couldn’t afford any more andthere was no more sperm,”Darcy said. “Itwas our last chance.”

During this time of trying and continu-ously failing to get pregnant, Jason andDarcy said they’d never felt so alienatedand alone.

“We kept asking ourselves, ‘Why isGod punishing us?’ and thinking weweren’t made to be parents,” Darcy said.

Darcy joined an infertility supportgroup in Crosby, where she could speakto other women dealing with infertility.

“It helps to know there’s a lot of peo-ple out there dealing with (infertility),”Jason said.

Three weeks after the final attempt,Darcy hadn’t gotten her period. The cou-ple tried not to get their hopes up, pro-tecting themselves from getting theirdreams dashed again, like so many othertimes after finding out Darcy wasn’t preg-nant. She took a home pregnancy test. Itwas negative.

By the fourth week, Darcy still didn’thave her period and she said somethingdidn’t feel right. She took another preg-nancy test. It was positive. After aboutthree other home pregnancy tests and ablood test at the hospital, it was con-firmed. The Walkowiaks were going tohave a baby.

On July 4, 2002, Cameron JohnPeterson Walkowiak entered the worldand his two adoring parents couldn’t behappier.

“The joy we get from him is so great,”Darcy said.

Today, Cameron is walking, feedinghimself and even saying a few words.Jason and Darcy have recently started asupport group to help other couples dealwith the struggles infertility brings. Formore information on Brainerd’s supportgroup, e-mail Darcy at [email protected] or call 651-659-0333.

Jason and Darcy Walkowiak watched as their son, Cameron, played ata park near their home.

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Dr. Howard McCollister, chief of surgery at the Minnesota Institute for Minimally Invasive Surgery at Cuyuna Regional Medical Center in Crosby, stoodin one of three operating rooms outfitted for laparoscopic surgery. The high-tech rooms have digital video equipment and cameras, along with voice-controlled lighting and swinging flat screen TV monitors.

A computer in the operating room at the Minnesota Institutefor Minimally Invasive Surgery at Cuyuna Regional MedicalCenter works as a control center for the room’s video cam-eras, monitors and other digital equipment.

Artificial leg doesn’tslow down Staples man

Looking at Dave Fabian, you’d never knowhe has an artificial leg. It’s not until hechanges into shorts and pulls down the fab-ric cover of his prosthesis do you see themechanics that have made it possible for thiscancer survivor to continue doing what heloves best — living a normal life.Story/Jenny Kringen-Holmes

Photo/Steve Kohls

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CROSBY—Sharon Osbourne has done it. Sohave Al Roker, Carnie Wilson and Roseanne.Bariatric surgery. Not only is it a weight loss regi-men to some of Hollywood’s finest stars, but theprocedure can be done right here in theBrainerd lakes area to everyday people.

Unlike most Minnesota hospitals thatperform bariatric surgeries, theMinnesota Institute for MinimallyInvasive Surgery at Cuyuna RegionalMedical Center in Crosby does themlaparoscopically, leaving six one-quar-ter inch incisions on the abdomen.

Dr. Howard McCollister, chief ofsurgery at CRMC, said less than adozen surgeons do bariatric surger-ies laparoscopically in Minnesota andfour of them are at Crosby’s MIMIS.

“It’s a very hard operation to do,”McCollister said of performing surgeryby using cameras and watching a TVscreen. “You’re looking at a two-dimen-sional image and you have to make it 3-Din your head – kind of like a videogame.”

The MIMIS surgical team has donemore than 120 bariatric surgeries in theyear and a half they’ve been perform-ing them.

There are two types of bariatric sur-geries, Roux-en-Y bypass, and Lap-Band.

In Roux-en-Y, the stomach is sewninto two parts. The upper part forms asmall pouch that receives food. Thepouch can hold about one fluidounce.

A section of the small intestine isattached to the pouch to allow food tobypass the lower stomach and thefirst portion of the small intestine.Although food does not go throughthis bypassed segment, it still functionsby secreting gastric and digestive juicesfrom the liver and pancreas and emp-ties into this area.

The Roux-en-Y bypass is considereda more complicated surgery thatrequires spending one or twodays in the hospital following theprocedure, whereas Lap-Band canbe done on an outpatient basis.

Lap-Band uses an adjustable sil-icone band, separating the stom-ach into two pouches. The bandhas an inflatable inner surface,

allowing the surgeon to adjust thesize of the band depending

on how much weightthe patient

wants

to lose.“Not every patient is a suitable candidate for

one operation or the other,”McCollister said. “Eachpatient is different and we need to be able to rec-ommend the operation that is safest, and likely togive the best results.”

Lap-Band is considered less complicated thanRoux-en-Y bypass because neither the stomachnor the intestine is cut during the procedure, butthe weight loss results are the same.

By shrinking the stomach from thesize of a football to the size of alemon, patients lose an average of100-120 pounds one year after thesurgery, McCollister said. Initiallypatients can eat a shot glass full offood, and eventually their stomachstretches depending on how muchthey eat.

Bariatric surgery is limited topatients who are morbidly obese,with a body mass index greater than40, or have a BMI of more than 35and have associated health prob-lems such as high blood pressure,diabetes, acid reflux or arthritis.

BMI is a measurement related tothe patient’s body surface area andis used to determine a patient’s levelof obesity. It is calculated by a stan-dard chart that correlates a patient’sheight and weight. A BMI chart canbe found at www.cdc.gov/nccd-php/dnpa/bmi/calc-bmi.htm.

“Diet and exercise is fine forsome people,” McCollister said, butmany people with health problemscan’t exercise.

McCollister restated the signifi-cant dangers of being obese, sayingobesity-related illnesses are the No.2 cause of death in the UnitedStates, second only to smoking-related illnesses.

Tom Bonar of Pine River was dia-betic, had his left leg amputatedbelow the knee and had extremely

high blood pressure, heart prob-lems and gastroesophagealreflux disease, a condition Bonardescribes as having constantheartburn.

Surgery provides weight lossalternative to obese Story/Heidi Lake

Photos/Steve Kohls

Tom Bonar of Pine River demonstrated his 120-pound weight loss by holding upa pair of pants he wore before he had gastric bypass surgery. Then a size 52,today, one year after surgery, Bonar wears a size 40. (Photo by Nels Norquist)

stomachA healthy, middle-aged man from Staples, Fabian never imagined living without

a leg.But when cancer forced the amputation of his entire left leg, there was no

question whether he’d try a prosthetic leg.“I have cancer,” Fabian recalls. “I lost my leg. (A prosthetic leg) was one of the

positives of the whole thing. I’m going to have a leg and be able to get around.”

Cancer takes legIn October of 2002, Fabian, 51, began to experience pain in his left leg. Doctors

investigated for the source of the pain but had no answers until later that monthwhen a lump surfaced on Fabian’s upper left thigh. Doctors told Fabian the growthwas likely benign. But his symptoms worsened and when a biopsy was done atFairview-University Medical Center, Fabian’s worst fears came true. The lump wasa malignant tumor and a form of sarcoma cancer.

“I was devastated,” Fabian said. “But I have this real positive attitude. My familyand I decided ‘we’re gonna beat this thing.’”

Doctors gave Fabian two options — total amputation of the left leg; or a proce-dure to attempt to remove the tumor which would include a series of skin, nerveand bone grafts, something that came with its own set of complications.

So, in December of 2002, Fabian’s left leg was amputated from the hip jointdown. He spent eight days recovering at Fairview-University then returned hometo begin his drastically new life. While visiting with his physical therapist inStaples, Fabian learned of the possibility to walk again with the help of a prostheticleg. In February, he was introduced to Chip Taylor, a certified prosthetist andorthotist with Prosthetic Laboratories in Baxter.

Fabian’s doctors had told him half of the individuals who have this type ofamputation don’t receive a prosthesis and of the half that do only 25 percent stickwith it. Fabian said that statistic was his carrot and gave him the motivation to beone of the 25 percent who successfully use a prosthetic leg on a daily basis.

In March, a plaster impression was taken of Fabian’s remaining pelvic area anda “trial” prosthesis was made to utilize full function, comfort and also to accom-modate the small tissue shrinkage that follows an amputation. As the area shrunk,padding was added to the hip socket of the prosthesis to ensure a proper fit.

In June, the tissue shrinkage stabilized and Fabian was once again cast foranother prosthesis — the one he still wears today.

Chip Taylor of Prosthetic Laboratories in Baxterinspected the knee housing unit of Dave Fabian’s legprosthesis.

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Lakeland PsychiatryWelcomes New Physicians

CLINIC

lakelandpsychiatry

St. Joseph’s Medical Center523 North Third Street

Brainerd, Minnesota 56401

Dr. Peter Neifert attended Colorado College inColorado Springs where he earned a Bachelor ofArts degree in Chemistry in 1990. He received hismedical degree from the Mayo Medical School in 1995 and completed his residency in psychiatryin June of 1998. He has been practicing as a psychiatrist with the Air Force for the past 5 years.

Dr. Twila Germanson received a Bachelor of Artsdegree in Chemistry from Arizona State Universityin 1994. She received her medical degree in 1999from the University of Minnesota and completedher residency in psychiatry in June of 2003.

Dr. Paul Erickson completed his undergraduatedegrees in Religion and Psychology at ConcordiaCollege in Moorhead. He received his medicaldegree from the University of Minnesota MedicalSchool in 1999 and completed his residency inpsychiatry in June of 2003.

St. Joseph’s Medical Center is pleased toannounce the addition of three

psychiatrists to Lakeland Psychiatry Clinic.■ Doctor Peter Neifert began seeing patients at

Lakeland Psychiatry July 1, 2003.

■ Doctor Twila Germanson will begin seeing patients on August 1, 2003.

■ Doctor Paul Erickson will begin seeing patients on September 1, 2003.

Lakeland Psychiatry is located on the fourth floor of St. Joseph’s Medical Center.

To Schedule an Appointment Call:(218) 828-7394

www.lakewoodhealthsystem.comLakewood Health System Pillager Clinic 631 State Hwy 210W, Pillager, MN 56473

Open HouseNovember 2, 2003

Cool, crisp air is the first indication that fall is on its way. Soon after, leaves turn red and gold. Geese begin to fly south. Change is seen everywhere.

But, this fall is unique for the Pillager community— because more than leaves are changing in the area. Lakewood Health System is pleased to announce the opening of our newest clinic in Pillager.

The Pillager Clinic will offer you a choice of three physicians: Dr. Arden Beachy, Dr. Renee Nydegger, Dr. Mike Hudulla, as well as physician assistant Becky Bennett and nurse practitioner Kelly Thompson.

You also have the option of convenient health care with an on-site pharmacy with drive thru window, three-day-a-week physical therapy services, extended clinic hours and occupational health and educational services.

To celebrate, Lakewood Health System invites you to an Open House at the new Pillager location. Stop by on Sunday, November 2 between 1:00 – 3:00 p.m. to see our new facility, meet our staff, enjoy refreshments and receive a free gift. Mark your calendar today!

With Lakewood Health System you don’t have to go far, it’s right here.

Getting a prosthetic

Each prosthetic is custom made. An impres-sion, or a blueprint for the prosthetic socket, ismade for each individual, Taylor describes,then the mechanics are added below that. Thetechnology for prosthetics has advanced great-ly in the last 20 years, he said. Titanium and air-craft aluminum are now used to allow for amuch lighter and stronger device. Taylor notesthat Fabian’s particular prosthesis weighsabout 11 pounds, compared to his entire legwhich likely weighed about 30 pounds or morebefore amputation.

“But any prosthetic always feels heavierthan it really is,”Taylor said, explaining it is basi-cally a foreign object suspended from thepatient.

Taylor, who has worked in the prostheticsfield since 1988, said the average prosthesis hasa life span anywhere between three and fiveyears.

“Like most mechanical devices, the (pros-thesis) parts need to be serviced,” he said.

In fact, Fabian joked that he already neededwork done on his leg when the knee unithousing cracked.

“I left my leg here for a total knee replace-ment,” he laughed, adding that it was covered“under warranty.”

Taylor also comes to Staples to make adjust-ments to the prosthesis during Fabian’s physi-cal therapy sessions.

“It’s kind of like fine tuning,” Taylor said.“The patient is constantly changing physically.For that reason we have to accommodate forthose changes.”

Living with prosthesis

Living with a prosthesis comes with manychallenges and discomforts.

“There are days where I don’t feel like put-ting it on,” Fabian concedes. “But I don’t wantto spend my life in a wheelchair.”

Fabian has had to relearn how to walk as aprosthesis requires its user to swing their hipsforward and use their lower back muscleswhen taking each step.

“You use different muscles and differentparts of the body that aren’t necessarily intend-ed to be used for walking,” Taylor notes. “So itcan be exhausting.”

“This is different, but this is something thatI can do,” Fabian said. “It gives me the oppor-tunity to be more mobile. There’s a learningcurve with it, obviously. I’ve spent many ses-sions learning to swing my hips. It didn’t takeme very long to know I wasn’t going to be oneof the 75 percent who wouldn’t make it work.”

Fabian is almost back to full time at his job asa certified registered nurse anesthetist atLakewood Health System in Staples.

“Its gone pretty well,” he said. “The biggestobstacle at work is endurance at this point, butit’s getting better.

“I get really tired. But I guess I was tiredbefore,” Fabian said with a chuckle.

Despite the things a prosthesis has enabledFabian to continue doing, he said he doesn’twant to paint too rosy of a picture. After all, hislife has changed drastically over the last year.

Fabian said the loss of his leg has forced himto make adjustments from simple daily ritualsto chores around the house.

“I can’t pick up a tree after a storm,” he said.“I can’t wash windows. Everything isn’t hunky-dory. There’s just too many things to enumer-ate on. It’s a struggle.”

The Fabians have had to add grab bars intheir Staples home. Fabian must buy larger-sized pants to accommodate for the prosthe-sis. He also must wear special undergarmentsbecause of the sweat produced from the artifi-cial limb.

But with the constant support and care fromhis wife, Beth, Fabian said he takes each day asit comes — one step at a time. He intends tocontinue raising and training labrador retriev-ers and is looking forward to hunting this fall.

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Aalto comments the furthest she’s traveled topick-up a patient came just a few days ago whenshe traveled with the Air Care crew to Devils Lake,N.D. to take a patient to Abbott Northwesternhospital in Minneapolis – about a 2 1/2 hour flight.

11:31 p.m. — An ambulance with flashinglights signals the chopper onto the landing pad atthe Burnett Medical Center in Grantsburg. Anemergency medical technician with NorthAmbulance’s service in Grantsburg meets thecrew at the emergency room entrance and escortsthem in to meet their awaiting patient.

Davis introduces his fellow crew members tothe patient and begins asking him a series ofhealth history questions as well as his current sta-tus.

“Our primary objective is to keep you as com-fortable as possible,” Davis tells the 52-year-oldman. As the man rates his pain as a 5 or 6 on a scaleof 1 to 10, Davis listens to his chest and Aalto pre-pares the heart monitor which will accompanyhim on the flight. The ER physician informs thecrew the man has an extensive cardiac history,including two heart attacks and bypass surgery.

“This is nothing new,” the man tells them.As Aalto starts an IV, the man jokes with her. “Can we land at my house so I can pick up my

checkbook?”

“Well,”Aalto chides back. “We’ll have to ask thepilot.”

11:45 p.m. — After the necessary paperworkhas been signed, the patient is wheeled out to theawaiting helicopter for his trip to Minnesota. It’s ateam effort as the stretcher is loaded into the air-craft. Aalto and Davis lift the man and slide thestretcher onto the stainless steel platform insidethe helicopter while Sarvie stands inside thechopper’s front door and pulls the foot end of thestretcher forward. Once he’s adjusted and com-fortable the crew situates themselves and pre-pares to lift off. The man is also given a headset sohe too can communicate with the crew. A curtainis drawn to separate the crew and patient from thepilot and cockpit area.

11:55 p.m. — Off the ground and en route toDuluth, a flurry of activity takes place inside this,now tight, quarters. While Sarvie navigates tonorthern Minnesota, Davis and Aalto monitor thepatient’s heart rate and oxygen levels in his blood,administer medications through his IV and keepin close contact with the man to ensure his com-fort.

The patient is an inquisitive one as he removeshis headset from time to time, touches the IV bagscontaining saline and medication, pokes at theceiling of the helicopter and watches out the win-

dow during his, approxi-mately, half hour flight toDuluth.

12:10 a.m. — Sarviecalls in to say the crew is15 minutes from St.Mary’s and is given clear-ance to land on the hos-pital’s rooftop helipadupon arrival.

The patient notes hispain level has decreasedsomewhat and is com-fortable, although hesays he’s having some dif-ficulty taking deepbreaths. He asks the pilothow high they’re flying.

“Three thousandfeet,” Sarvie repliesthrough the headset.

12:26 a.m. — After fly-ing over Lake Superiorand the infamous AerialLift Bridge, the chopperlands at St. Mary’s and ismet by security guards atthe rooftop entrance tothe hospital. Since thepatient’s condition is sta-ble, the crew waits for thehelicopter’s rotors tostop completely beforeexiting the helicopter.

“It was a good ride,”the man tells the crew, ashe’s unloaded and givena North Air Care baseballcap. “But I thought it’d bemore exciting.”

12:34 a.m. — The crewarrives in the coronary care unit and wheels theirpatient directly to a room where they brief staff onthe patient’s status and history.

12:57 a.m. — With their patient passed on to St.Mary’s staff and their job complete, the crewreturns to the helicopter for take off.

1:04 a.m. — Sarvie makes a stop at the SuperiorAirport. While he remains in the aircraft, Davisand Aalto perform a “hot refuel,” or refueling thehelicopter while it’s still running.

1:14 a.m. —Everyone is back in the helicopterfor the ride back to Brainerd, which Sarvie esti-mates will take a little over 30 minutes.

It’s a quiet ride home as the crew reflects ontheir shift so far and watches below as the worldwhizzes by.

1:58 a.m. — The “after flight paperwork”begins as the helicopter is pulled back into thehangar until its next call.

“It was a quiet day,” Davis reflects. But there’s still another five hours to go in the

day in the life of this flight crew and what’s tocome on any given Air Care shift is always “up inthe air.”

North Air Care is virtually an emergency room in the sky. Flight nurse April Aalto and flight medic John Davis ran throughtheir equipment and supplies, ensuring everything is ready before their next call comes in.

Educating others

While there is no formal support group forthose facing amputation or those who’ve experi-enced it, Taylor said Fabian has become a goodambulator in the community. Fabian said he has,on several occasions, talked to those who are con-templating a prosthesis.

“When you have someone who’s been there...It’s just a much more supportive means of encour-agement,” Taylor said. “There are so many referralsources who feel patients who’ve had an amputa-tion at the hip level can’t have a prosthesis. It’sgood to shed light on the patients who’ve had anamputation at this level and show that it can bedone.”

Fabian said, of his contacts, he has reassured ayounger boy that, yes, you can still ride a four-wheeler after receiving a prosthetic and a womanwho worried about the way a prosthetic leg wouldlook when wearing shorts.

But in keeping with his optimistic attitude,Fabian, a grandfather of two, has turned a tragicevent into a learning opportunity and a chance tohelp others by sharing his experience.

“I try to be very encouraging,”he said. “You canmake this work. If you have the right attitude andthe will, you can make it work.”

Socket — Upper portion of the prosthetic, made of carbon fiber with aflexible thermo-plastic interior.

Hip Joint — A single axis hip joint with an extension mechanism thathelps hold the limb straight and allows for safe alignment while standingand walking.

Leg — An aircraft aluminum structure with a carbon fiber knee unit. Hasa multi axis for sitting ability and ease of swinging when the patient takeseach step.

Foot — A dynamic multi axis foot allows patient to walk on uneven sur-faces. The more energy exerted into the foot, the faster the patient can taketheir next step.

Cover — A cosmetic foam cover with a skin tone, nylon-like exterior pro-vides for improved aesthetic appeal.

Taking a look at a prosthetic leg

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Nurse April Aalto (left),medic John Davis andpilot Ryan Sarvie madeup this North Air Careflight crew.

them in the event they would be called toMoose Lake.

“A big part of our job is safety,”notes flight nurseApril Aalto of Monticello. Aalto, a nurse with NorthMemorial since 1986, commutes to Brainerd towork 24-hour shifts on the helicopter crew.

7:27 p.m. — The Air Care crew leaves thehangar for their 30 minute flight to Moose Lake.Each member of the crew wears a headset with amicrophone in order to allow open communica-tion. Along the way, Sarvie points out the city ofAitkin to the left and Lake Mille Lacs out the right.He also notes the helicopter is currently travelingat a speed of 170 miles per hour with a bit of aheadwind.

7:55 p.m. — The crew arrives at Mercy Hospitalin Moose Lake, greeted by a large gathering ofemergency personnel. Aalto is the first to exit theaircraft, as she meets the group. After all threecrew members are out of the helicopter they intro-duce themselves and answer questions regardingthe helicopter, their experience and optimal land-ing situations.

As the Moose Lake group walks around the hel-icopter, looking inside and asking questions, awoman approaches Sarvie questioning how longhe’s been a pilot.

“Thirteen years,” he tells her. “Oh my,” she replies, obviously surprised. 8:40 p.m. — After giving rides to four individu-

als from the Moose Lake group and participating ina stretcher-loading exercise, the Air Care crewtakes to the skies and heads back to Brainerd. Theclear night provides visibility for miles and miles.Sarvie once again comes over the headsets point-ing out the cities below and beyond, including

McGregor, Aitkin and the distant lights of St. Cloudand even the Twin Cities area.

9:13 p.m. — The helicopter reaches its hangar atthe Brainerd airport. Sarvie calls to request fuel.The Augusta C109 holds 73 gallons on each side, or146 gallons total which provides for two hours and20 minutes of flight time. An auxiliary tank can holdan additional 40 gallons, Sarvie points out. With fullauxiliary and side tanks, the helicopter has a threehour endurance. At normal cruise, Air Care burnsone gallon of fuel per minute.

9:25 p.m. — Davis begins a run sheet, the nec-essary paperwork, required for the trip to and fromMoose Lake.

9:26 p.m. — The North dispatch center callswith a possible flight to Redwood County, but callsback almost immediately to disregard.

9:45 p.m. — In true leader fashion, Sarvie servesup hot chocolate to the crew and starts a batch ofchocolate chip cookies in the oven. The hangarwhere Air Care is stationed provides each memberof the scheduled crew with a private bedroom.There’s also a bathroom, shower room, office, liv-ing area and kitchen as well as the garage areawhere the helicopter is stored.

10 p.m. — The cookies are done and the crewsits down to a late dinner of pizza while catchingup with the 10 o’clock news.

“We’re one big happy family,” Sarvie jokes. 10:55 p.m. — The crew receives a call to transfer

a patient from Grantsburg, Wisconsin to Duluth.Details of the call are sketchy, but everyone is upon their feet and heading for the door.

11 p.m. — In the air and heading east, Davisbegins more paperwork. A message via his alpha-numeric pager tells the pertinent patient informa-

tion. This patient has a potential cardiac situationand is requesting to be transferred to St. Mary’sHospital in downtown Duluth.

The crew explains they provide a service thatwill take patients to any hospital. In the event of anaccident or critical situation, the crew will decidewhere the patient will be taken. Usually, that meansthe closest Level 1 trauma center. If the patient iscurrently at a hospital and being transferred to adifferent facility for additional treatment, thepatient and his/her family as well as the medicalstaff will determine where that person will be sentto receive the best care for their particular situa-tion.

Typically the Air Care base closest to the origi-nating city will respond to the call, but Davis saysboth the metro and Redwood Falls divisions areout on calls leaving the Brainerd crew up-to-bat.

North Air Care isn’t the only show in town, so tospeak. Both St. Mary’s and St. Luke’s in Duluth havetheir own air ambulance service, as well as othermedical centers in and around the Twin Cities area.But, the physician requesting the transfer has thediscretion of which company they would like totransport their patient. And in this case, they’vecalled North Memorial.

11:15 p.m. — Traveling at a speed of 184 milesper hour, Sarvie radios in to say he’s 16 minutesfrom Grantsburg.

Ground ambulances have a set service territory,Davis notes, but the same doesn’t hold true for theair service. Their job can take them anywhere inthe state as well as North Dakota, Wisconsin andmore. And for that reason, both Davis and Aaltohave respective paramedic and nurse licensure inthe state of Wisconsin.

(Continued from Page 17)

• Replacing sour cream with fat-free yogurt; • Using evaporated skim milk instead of butter.

2 cups (8 ounces) finely shredded reduced-fat sharp cheddar cheese1 (10 3/4 ounce) can 99% fat-free condensed cream of chicken soup with 1/3

less salt1 cup fat-free plain yogurt3/4 cup evaporated skim milk1/2 cup very finely chopped onions2 cups cornflakes6 medium potatoes (2 pounds), peeled

Preheat the oven to 350 degrees. In a large bowl, stir together the cheese,condensed soup, yogurt, milk and onions. Set the soup mixture aside. In ablender or food processor, blend or process the cornflakes into coarsecrumbs (you should have about 1 cup). Set the cornflakes aside. Coarselyshred the potatoes. Immediately stir the potatoes into the soup mixture toprevent browning. Spray a 10”x9”x2”or 11”x7”x1 1/2”baking dish with no-stickspray. Transfer the potato mixture to the baking dish. Top with the cornflakes.Bake about 1 hour or until the potatoes are tender. Makes 8 servings.

Nutrition Scorecard (per serving)Calories – 230Fat (g) – 4% calories from fat – 21%Cholesterol (mg) – 35

Exchanges (per serving)2 starch1 lean meat

Harvest Apple StuffingThis fruit and walnut dressing is the perfect complement to roasted chick-

en. Calories, fat and cholesterol were reduced by:• Using apple juice instead of butter to sautè the vegetables.

2 cups finely chopped apples1 teaspoon lemon juice1 cup coarsely shredded carrots1 cup thinly sliced celery1/2 cup chopped onions1/2 cup apple juice1/4 teaspoon ground nutmeg8 cups dry plain bread cubes1/3 cup chopped walnuts1/4 cup toasted wheat germ1-1 1/2 cups chicken broth, defatted

Preheat the oven to 350 degrees. Place the apples in a small bowl. Sprinklewith the lemon juice, then toss until coated. Set aside. Spray a large skillet withno-stick spray. Add the carrots, celery, onions and apple juice. Cook overmedium heat until tender, stirring occasionally. Stir in the nutmeg. Lightlyspray a 3 to 4 quart casserole with no-stick spray. Add the bread cubes, apples,walnuts, wheat germ and the carrot mixture; toss to combine. Drizzle with onecup of the broth. If necessary, drizzle with enough of the remaining 1/2 cup ofbroth to moisten the bread; gently toss to mix well. Bake, uncovered, for 30 to40 minutes or until heated through. Makes 8 servings.

Nutrition Scorecard (per serving)Calories – 197Fat (g) – 5% calories from fat – 21%Cholesterol (mg) – 0

Exchanges (per serving)2 starch1/2 fruit

30www.crosbyeyeclinic.com

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In close quarters, this three-person flight crew istransporting a 52-year-old Wisconsin man withchest pains to Duluth for medical attention. It’s aflurry of activity in this emergency room in the skyas a trip which typically would take several hoursby ground is accomplished in little over a half hour.

In an emergency, every minute is critical. Thedifference between getting to a hospital by land orair can often be the difference between life anddeath.

The sky provides an open road. Little to no traf-fic. No stop signs. Rather than going around fields,you go over them. With speeds over 180 miles perhour, its no wonder the air ambulance industry has“taken off” over the last several years.

North Memorial Medical Center in Robbinsdalebegan its North Air Care division in 1985. Now, withthree bases, including one in Brainerd, communi-ties across the state and beyond have the opportu-nity to receive the best, most appropriate care atany hospital regardless of how far they are locatedfrom the facility.

With the approval of North Memorial, thisreporter was allowed to observe a flight crew dur-ing a regular Wednesday night shift earlier thismonth. This is just a glimpse into a day in the life ofan Air Care flight crew.

4 p.m. — North Air Care flight medic John Davisis going on the ninth hour of his 24-hour shift.Davis, 31, stands at the sink at the crew’s quarters ina hangar at the Crow Wing County Regional

Airport and finishes dish duty. “Don’t you dare tell my wife,” he says, laughing

about his domestic duties.A Brainerd High School graduate, Davis has

worked for North Ambulance in Brainerd since1996 where he worked as a paramedic on the road.When North Memorial Medical Center’s air ambu-lance program opened a permanent home inBrainerd in October of 2000, Davis was hired on asa flight medic. There’s no doubt in Davis’mind whyhe chose to make the switch from road to air.

“Because I got to do what I liked to do as a para-medic, but in a really cool ambulance,” he says,noting it’s virtually the same type of job but with it’sown set of differences and challenges.

4:30 p.m. — Davis and Air Care lead pilot PhilJames perform a safety briefing, required for anyride-along passenger of the helicopter. NorthMemorial owns and operates five Augusta C109s inits fleet. These helicopters are the fastest non-mili-tary chopper made.

Currently, North has three bases for its Air Careoperations: Brainerd, the Twin Cities and RedwoodFalls. On call at the hangar throughout their shift,the crew aims to be in the air within five minutes ofreceiving a call. Once arriving at the scene, theirgoal is to get the patient loaded up and en route totheir destination within 10 minutes.

5:45 p.m. — Pilot Ryan Sarvie arrives early forhis scheduled 12-hour shift.

Sarvie, 32, is one of four full time pilots servingthe Brainerd division of North Air Care. A new res-

ident of the Brainerd area, Sarvie previously livedin Buffalo. After graduation from high school, hejoined the United States Army where he served 81/2 years as a pilot flying Hueys and Black Hawkhelicopters. From August 1993 to January 1994, heserved in the conflict in Mogadishu, Somalia,which was portrayed in the movie Black HawkDown. Before coming to work for North Air Care,Sarvie flew the medical helicopter for St. Luke’sHospital in Duluth.

“I wanted to fly helicopters just because they’redifferent from airplanes,” Sarvie admits, adding heenjoys his current profession as he gets to helpsave lives “even though I couldn’t do it myself.”

Sarvie discusses the stringent training and eval-uation processes that go along with being a pilot.All of North Air Care’s pilots are required to beInstrument Flight Rules certified. Every six months,he and his fellow pilots must undergo an evalua-tion in order to maintain their pilot license wheretheir ability to use and understand the helicopter’sinstruments is tested.

“It’s kind of like taking a driver’s test every sixmonths,” he says.

6:30 p.m. — The Air Care crew receives a faxfrom their dispatch center operated out of NorthMemorial Medical Center in Robbinsdale. They arerequested for a “fly in”at Mercy Hospital in MooseLake where a group of firefighters, law enforce-ment, first responders and other emergency serv-ice providers are gathered to learn more about AirCare’s services as well as how to best work with

North Air Care pilot Ryan Sarvie took to the skiesduring his scheduled 12-hour shift. Sarvie, 32, ofBrainerd, is one of four full-time pilots serving theBrainerd division of North Air Care. Sarvie has beena licensed pilot for 13 years and served as a BlackHawk pilot during the Mogadishu, Somalia, conflictin the 1990s.

Apple Stuffed Tenderloin with Cinnamon Raisin Sauce

This hearty entrèe started out as stuffed pork chops. To make the dish lean-er and still keep its character, the recipe was switched to stuffing a pork ten-derloin. Calories, fat and cholesterol were reduced by:

• Using pork tenderloin (26% calories from fat) instead of rib chops (52%calories from fat);

• Using no-stick spray instead of butter to sautè the onions; • Eliminating the butter in the sauce.

Stuffed Pork Tenderloin:1 pork tenderloin (1 to 1 1/2 pounds) trimmed of all visible fat2 medium oranges1 medium apple, cored and chopped2 tablespoons finely chopped onions2/3 cup fine dry plain bread crumbs

Sauce: 1 cup unsweetened apple juice1 tablespoon cornstarch1/4 teaspoon ground cinnamon1/4 cup raisins

To make the stuffed pork tenderloin: Preheat the oven to 425 degrees. Cuta pocket in the side of the tenderloin by cutting a lengthwise slit from oneside to almost the other side and stopping about 1/2” from each of thetapered ends. Set the tenderloin aside.Finely shred the peelfrom the oranges and setaside. Then squeeze 3tablespoons ofjuice from theoranges. In a medi-um bowl, combinethe orange juice andapples. Set the applemixture aside. Spray anunheated small skillet withno-stick spray. Add the onions.Cook and stir over medium heatuntil tender. Then add the onions and bread crumbs to the apple mixture.Toss until combined. Spoon the bread mixture into the pocket of the tender-loin. Securely close the pocket with wooden toothpicks. Place the tenderloinon a rack in a shallow roasting pan. Insert a meat thermometer into the meatportion only. Bake for 25 to 30 minutes or until the thermometer registers 160degrees. Let stand about 5 minutes before slicing.

To make the sauce: In a small saucepan, use a wire whisk to stir togethertwo tablespoons of the apple juice and the cornstarch. Then stir in remainingapple juice. Cook and stir over medium heat until boiling. Stir in the reservedorange peel and cinnamon. Add the raisins and cook for five minutes, stirringoccasionally. To serve, slice the tenderloin. Spoon the sauce over the slices.Makes 4 to 6 servings.

Nutrition Scorecard (per serving)Calories – 245Fat (g) – 4% calories from fat – 16%Cholesterol (mg) – 74

Exchanges (per serving)3 meat1 fruit

31Big City Medicine, Hometown Care

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North Memorial Medical Center of Robbinsdale began its North Air Care divi-sion in 1985. Today there are permanent bases in Brainerd, Redwood Falls andthe Twin Cities.

A day in the life

of a flight medic

Story/Jenny Kringen-HolmesPhotos/Nels Norquist

Flying at about 180 miles per hour, North Air Careflight nurse April Aalto keeps a steady arm whilefilling a syringe with morphine to alleviate the dis-comfort of her patient. Flight medic John Davismonitors the man’s vital signs and keeps in contactwith medical officials on the ground regarding theman’s status. A heart monitor mounted within thehelicopter keeps tabs on the man’s heart rate, oxy-gen levels and blood pressure. Out the chopper’slarge side windows you can see the twinklinglights of life proceeding as usual in small townsbelow.

FDA approves first birth control pilldesigned to help women skip periods

SAVANNAH, Ga. — Imagine being on combattour in Iraq and having monthly cramps,headaches, mood swings and heavy bleeding inextremely macho environs.

Skipping monthly periods sounds appealing.Especially for women in the military such as StaffSgt. Cheryl Williams.

But would Williams pop a daily birth control pillthat suppresses monthly periods?

Not a chance."It's a fabulous idea, but I have misgivings about

taking the body cycle out of its natural sync. That isspooky to me," said Williams, who spent abouteight months in Iraq this year. "Plus, when I sat in afive ton truck with a 22,000 pound trailer attached,the last thing on my mind is to pop a birth controlpill."

Stress of combat often causes women to misstheir periods naturally, without taking a pill, saidWilliams, based at Hunter Army Airfield.

While menstrual periods are inconvenient andsometimes painful, a new pill could bring an end towomen's monthly woes.

Seasonale, due out at the end of this month, isthe first FDA-approved birth control pill designedto help women skip periods – menstruating only

four times a year instead of 12.Seasonale's cost has yet to be determined. It will

be comparable to conventional birth control,about $30 a month. Some insurance plans may payfor it.

The trend of suppressing menstruation is noth-ing new.

But Seasonale has divided health expertsbetween those who cheer the new pill as anotherway for women to control their bodies vs. thosewho say that period suppression is dangerous.

Family nurse practitioner Dellarie Shilling inStatesboro plans to recommend Seasonale topatients, who are mostly college-aged women.

"As long as it works smoothly and there are noside effects, it will be popular," Shilling said. "A lotof women have painful periods which wouldn't bemissed at all."

But Savannah family nurse practitioner ValerieMcGowan sees the trend of menstrual suppres-sion as less healthy.

McGowan says the no-period pill might be risky,especially for teens and young women. She does-n't plan on recommending it to young patients atCurtis V. Cooper Health Care Center in Savannah,formerly Westside Clinic.

"The adolescent group is so fragile, you would-n't want to play around with their cycle too much,"McGowan said.

Women have already been suppressing theirperiods for years with standard 28-day birth controlpackages. They throw out the seven inactive pillsthat would have triggered their periods and start anew pack of regular pills to suppress menstruation.

But the FDA had not approved continuous useof the drugs until now.

Seasonale, produced by Barr Laboratories, isn'ta new chemical – just a repacking of the conven-tional oral contraceptives in a purple-and-pink box.

The packaging gives women 12 straight weeksof active pills, then a week of dummy pills for theirperiod.

Almost 39 million women in the United Statesuse some kind of birth control, according to theKaiser Family Foundation. Oral contraceptives arethe most common, reversible method.

Story/Anne HartMorris News Service

32

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Lawns are littered with dried, yellowleaves and the grass underneath is frostywhen the alarm goes off in the morning.Fall is here, ladies and gentlemen, andalong with the change in seasons comesanother issue of HealthWatch.

Judging by the feedback I received fromreaders, the first issue of HealthWatch wasa success. Thank you to everyone whowrote or e-mailed their comments. It’snice to know people are actually readingwhat we worked so hard on.

In this issue, free-lance writer JennyKringen-Holmes and I put our headstogether and came up with some great

stories that we hope you’ll find interesting,including the new clinics in Pillager andthe benefits of gastric bypass surgery. Weeven added a low-fat recipe section wherewe discovered some fun new ways tocook and eat healthy.

Once again, feel free to e-mail storyideas or comments to [email protected].

Happy reading and happy fall,

Heidi LakeEditor

From the Editor

Table of contents

Cover photo/Nels Norquist

510

34

32

26

24

22

18

16

14

COVER STORY:A day in the life of a flight medic

DISEASE:Cancer doctor battles disease

PROCEDURE:Gastric bypass surgery

NUTRITION:Eating healthy

RECIPES:Cooking healthy

HEALTHCARE:New Pillager clinics

FAMILY:Struggling with infertility

LIVING:Coping with prosthesis

MEDICINE:New birth control pill

RESEARCH:Down Syndrome

Synthetic marijuana compound shows promiseMarijuana can ease pain even for longtime suf-

ferers of disease, but the illegal herb’s mind-alter-ing properties make it less than ideal as a medica-tion.

German researchers now have found that a syn-thetic version of one of many marijuana com-pounds safely reduced chronic nerve pain withoutimpairing thinking and behavior. If the preliminaryfindings hold up in larger trials, capsules contain-ing this compound might one day be prescribedfor hard-to-treat pain.

The principal active ingredient in cannabis istetrahydrocannabinol, or THC. That compoundhas been the most studied, but researchers aroundthe world are also looking more closely at theplant’s other chemical compounds for potentialhealth benefits. Scores of them belong to a groupcalled cannabinoids; others include flavonoids,which are thought to have antioxidant properties.

“It’s not a surprise that these cannabinoids havemedical benefit,” said Dr. Donald I. Abrams, anAIDS specialist conducting clinical trials of mari-juana at San Francisco General Hospital.

People with cancer, AIDS and other chronic dis-

eases have long attested to the plant’s ability toprovide relief from nausea and pain. “That’s whywe’re investigating marijuana,” Abrams said.

Previous studies have shown some cannabi-noids have limited ability to blunt acute nerve pain,typically associated with an injury. But the Germanstudy found that a cannabinoid called CT-3 couldhelp sufferers of chronic neuropathy, who oftendon’t respond to standard medications.

CT-3 is related to THC. But the problem withTHC is that even at low doses, it can impair think-ing and coordination, and create anxiety, panicattacks, psychosis and paranoia, as well as drymouth, blurred vision, and a drop in blood pres-sure upon standing.

Despite these effects, scientists have remainedinterested in cannabinoids, because the body hasnatural cannabinoid receptors that offer potentialdrug targets.

CT-3 first showed promise in animals as an anti-inflammatory and as a reliever of two aspects ofneuropathy: pain and extreme sensitivity to ordi-nary sensations.

Researchers at Hannover Medical School in

Germany, working with an American colleague,gave various doses of CT-3 to 24 volunteer patientswith chronic neuropathic pain in places such asthe foot, arm, face and head. Many patients alsowere taking other pain-relieving medications suchas narcotics, muscle relaxants, antidepressants andsedatives.

The researchers found that CT-3 was moreeffective than a placebo at relieving pain; its effectswere greatest with milder pain. Increasing thedose brought no greater relief. The major sideeffects were dry mouth and fatigue.

“What’s promising is that there can be a productthat stimulates the cannabinoid receptors anddoes not have the emotional and hallucinatoryeffects otherwise known for THC,” said Dr. JoelSaper, a neurologist who directs the MichiganHead-Pain and Neurological Institute in AnnArbor. He’d like to see longer CT-3 studies usinglarger numbers of patients who aren’t taking otherpain medications: “We need to see how this wouldwork in patients not on all these drugs.”

Story/Jane E. AllenLos Angeles Times

Dispatch file photo

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Irreversible Only for Now?Most people know Down syndrome is a genetic disorder that causes irre-

versible mental retardation. But that description may not be true in the future.Scientists have pounced on the revolutionary idea that Down syndrome —

the most common genetic cause of mental retardation — can be treated. First,they must understand the biological cause of the condition, down to the spe-cific genes responsible for the varied symptoms. Then, they hope, they’ll beable to reverse or eliminate related problems with cognitive function, memory,speech, sleep and even the neurological decline that occurs in older adultswith the disorder.

Scientists at Stanford University Medical Center already have identifiedabnormalities in the nerve cell structure of people with Down syndrome, dif-ferences that appear to be responsible for much of the brain damage that is thehallmark of the disorder. They’re now trying to home in on the genes that causethat particular abnormality.

“People thought that once you’re born with Down syndrome, that’s it; youcan’t make the brain better. But we know that is not true about brains,” says Dr.William Mobley, a pediatric neurologist at Lucile Packard Children’s Hospital atStanford. “Brains are plastic. We may not be able to cure this disease, but wemay be able to make people’s lives better.”

Several advances have paved the way for this hypothesis. Scientists under-stand the brain far better than they did even 15 years ago, because sophisticat-ed imaging devices have allowed them to better examine its structure, and themapping of the human genome provided detailed information on the 21stchromosome. Down syndrome is caused by a third, or extra, copy of this chro-mosome.

The mapping of chromosome 21 revealed that it is the smallest of the 24human chromosomes, containing about 225 genes. Now scientists such asMobley, director of the new center for Down syndrome research at Stanford,are working to identify what those genes do.

Experiments on Down syndrome mice have shown abnormalities in thesynapses, or circuits, between nerve cells. The abnormal structure and functionof the synapses lead to the kind of brain damage seen in Down syndrome andAlzheimer’s disease. People with Down syndrome typically developAlzheimer’s disease in adulthood, Mobley says.

Now researchers are trying to figure out which of the genes cause this prob-lem in Down syndrome. Fixing the defect may involve turning off the extracopy of certain genes.

“We definitely know that genes cause this,” Mobley says. “If we find anoffending gene, theoretically we can make things better by turning off thatthird copy.”

Treating a condition caused by an extra gene, he says, may prove easier thantreating other genetic diseases such as cystic fibrosis, in which genes are abnor-mal or missing. Drugs could be developed to turn off that extra gene andimprove cognitive ability in people with Down syndrome. Theoretically,Mobley says, the drugs could be given at any point in the lifespan to improvebrain function.

“What they’re doing is extremely exciting,” says Myra Madnick, executivedirector of the National Down Syndrome Society. “The whole research scenehas changed dramatically since the mapping of the 21st chromosome.”

Scientists caution, however, that potential treatments resulting from thisresearch are at least a decade away.

Story/Shari RoanLos Angeles Times

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WOODLANDGood SamaritanVillage

804 Wright StreetBrainerd, MN 56401(218) 829-1407

100 Buffalo Hills LaneBrainerd, MN 56401(218) 829-1429

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Page 36: UpNorth HealthWatch 10/2003

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ANNOUNCING ST. JOSEPH’S $25 MILLION MEDICAL CENTER EXPANSION.

It’s an exciting time to live in the Brainerd Lakesarea. Our community is growing and getting betterevery day. With that growth, of course, comes anincreased need for healthcare services.

At St. Joseph’s Medical Center, we’re responding to that need by expanding our medical campus—putting $25 million in construction services andmaterial costs into the local economy.And whenwe’re done, we’ll bring even more jobs to the community. Our 116,000-square-foot expansion and renovation project will bring us to our licensedcapacity of 162 beds and increase the number of private rooms, allowing patients and familiesgreater comfort. It will also increase the capacity of our intensive care and progressive care units,and allow us to bring to our area some of the mostadvanced medical technology available.

It’s better care for all of us, and it’s a sign that ourcommunity will continue to stay healthy as it grows.

Life is good. We’ll help keep it that way.

Construction scheduled for completion in 2005.

OCTOBER 2003

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