healthwatch magazine: august 2015

3

Table of ContentsPublisher • Tim Bogenschutz

Advertising • Susie Alters and Phil Seibel

Editor • Sarah Nelson Katzenberger

Art Direction/Design • Jan Finger

Contributing Writers

Sheila Helmberger • Jodie Tweed • Dr. Ben Robertson • Sarah Nelson Katzenberger • Dr. Marie Nelson • Marino Eccher • Jenny Holmes • John Lundy • Patrick Springer

Health Watch is a quarterly publication of the Brainerd Dispatch.

Read Health Watch online at www.brainerddispatch.com

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

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

Knitted Knockers 4Making a difference for women battling breast cancer. . . . . . . . . By Jenny Holmes

What are my joints telling me? 6Insights from an orthopedic surgeon. . . . . . . . . . . . . . . . By Dr. Ben Robertson

Coming Home 7Native of the Brainerd lakes area returns to practice medicine. . . . By Dr. Marie Nelson

Brushing up on good dental care 8Myths, facts and when to see a dentist. . . . . . . . . . . . . . . By Sheila Helmberger

First steps on a new journey 9Dr. Jessica Tabbatt launches career in podiatric surgery . . By Sarah Nelson Katzenberger

Ready to roll in Cuyuna Country 10Cuyuna Lakes Mountain Bike Patrol is there to help . . . . . . . . . . . . By Jodie Tweed

Chiropractor helps patients find best approach 12Dr. Thea Feierabend promotes nature’s healing . . . . . . By Sarah Nelson Katzenberger

Easy Listening 14New technology enhances hearing aid experience . . . . By Sarah Nelson Katzenberger

Motorized exoskeleton provides life-changing help 16Paraplegic patients stand & walk. . . . . . . . . . . . . . . . . . . . By Marino Eccher

Meditation technique improves quality of life 18Enthusiasts see improvements in stress levels and general health . . . . . By John Lundy

Targeted drugs take aim at specific cancers 20Kidney cancer victim, Dale Thornton shares his experience . . . . . . By Patrick Springer

Springsteen in the operating room 21Many surgeons turn up the music . . . . . . . . . . . . . . . . . . . . . By John Lundy

THE End 22It’s hard to talk about, but it’s best to be prepared . . . . . . . . . . . . . By John Lundy

Kelly Humphrey • [email protected]

4

When dealing with the seriousness of

breast cancer, a little humor is certainly a

welcome friend.

Perhaps that was the motivation when a group of women formed, and named, the “Knitted Knock-ers” organization in 2007. While started by a single woman in Maine, the concept and initiative spread

like wildfire. Today, Knitted Knockers has collected over 5,000 Knockers from volunteer knitters and dis-tributed them, for free, to mastectomy patients in all 50 states. There are now groups in Arizona, Arkan-sas, California, Florida, Georgia, Illinois, Indiana, Maryland, Michigan, Minnesota, Ohio, Pennsylva-nia, Texas, Washington and Wisconsin making and distributing Knitted Knockers.

Marty Peisch of Nisswa first read about it in an online blog. Having been a knitter since she was very young, Peisch said the concept soon became her personal calling.

“Both of my grandmothers and a cousin had breast cancer,” Peisch said, noting she saw a unique niche that needed to be filled on a local level. In April she began her own group of the Knitted Knockers in the

By JENNY HOLMES Contributing Writer

Knitted KNOCKERSmaking a DIFFERENCE for women battling breast cancer

800-525-1033 I 218-894-1515 I lakewoodhealthsystem.com

HELPING YOU LIVE WELL.YOUR CARE TEAM.

SEEING PATIENTS AT OUR PILLAGER & STAPLES CLINICS:Becky Bennett, PA-C; Arden Beachy, MD; Jody Giza, PA-C; Christine Albrecht, MD; Neil Bratney, Pediatrician

YOUR PILLAGER-STAPLES CARE TEAM

Your care team is dedicated to your overall health and well-being. That means they know the ins and outs of your game plan—working alongside their partners to ensure you receive the care you deserve. So, regardless of which team member you see, you can rest assured, your health is in good hands.

Brainerd area.Knitted Knockers are a lightweight, knitted

prosthetic breast alternative for women who have had a mastectomy. When placed inside a bra, the knockers take the shape and feel of a real breast. Made with cotton-based yarn and polyfill, Knitted Knockers are said to be lighter and more comfort-able than silicone prosthetic breasts. The knitted fabric breathes and prevents the heat rash and discomfort often experienced by women wearing other types of prosthesis.

The Knockers are made in a variety of cup sizes for women to choose from, ranging from an A cup all the way up to DD. Each piece has a small hole on the side so women can remove or add polyfill, as well as a knitted nipple on front for a realistic effect.

Peisch brought the idea to the Utrinkets store on Laurel Street in Brainerd where she often meets with other knitters to work on projects.

“When I brought it up to everyone here, it was kind of like ‘Huh?,’” said Utrinkets owner Kevin Yutrzenka. “But it’s a great concept. And, definitely, we know there’s a need out there.”

Yutrzenka and his wife, Kristy, host annual ‘Knit-In’ events at their store every July. They invite knitters of all ages and genders to sit and knit, uninterrupted. The date of the event is the weekend after the week of the Fourth of July. The event times are from noon on Friday to noon on Saturday.

Everyone is welcome to attend for an hour or two or stay for the whole 24 hours. The group dedicates that time to making chemo hats for individuals un-dergoing chemotherapy, as well as prayer shawls and lap blankets for those going through chemo and their families. Collectively, the group of knitters has distributed their labors of love not only locally, but also to the Mayo Clinic, metro-area hospitals and fa-

cilities, St. Cloud, Aitkin, Fargo, and a multitude of hospice organizations.

Kristy and Kevin said they have participated in cancer-supportive gifts for the eight years they’ve owned their store. What was started as fun time to gather together has evolved into something that has created emotional and personal connections with people battling cancer.

“There were just so many times that first year that I cried,” Kristy said. “It’s a really personal thing that everybody is impacted by. And if making something so simple makes someone happy, why not?”

The Yutrzenkas and Peisch have witnessed wom-en pay it forward after receiving a knitted gift by coming back to knit for others.

“It is a fun time to get together to knit and visit, but it’s also really personal,” Kristy said.

Knit-In events continue to grow and gather steam at the Utrinkets store. However, Peisch is really looking for more knitters who want to devote time to exclusively making Knitted Knockers. Dependent on the knitter, the average Knocker takes about two hours to make. Each is tagged with the cup size and the name of the knitter who created the piece. Peisch, herself, said she has easily made over 30 since she started a few months ago, but simply can’t keep up with the demand.

“I’d really like to find other knitters to help. May-

be there’s another weirdo out there that has more time than good sense,” she laughed.

“It’s just so therapeutic to sit and knit. And you make good friends real fast, too.”

Even Kevin Yutrzenka has gotten in on the action and made a Knocker at a recent Open Knitting Day where Marty presented the idea to knitters and cro-cheters at Utrinkets.

“It’s really a nice, small project that’s quick and easy,” he said. “You don’t have to stress about a pat-tern. It all just falls into place. It’s a quick grab-and-go thing to do.”

In 2015, the Knitted Knockers effort morphed into a worldwide program and became Knitted Knockers Charities — a 501(c)3 organization. A website was established to provide information to cancer survi-vors to connect them to local organizations involved in the initiative. Worldwide, Knitted Knockers has affiliates in the United Kingdom, Australia, South Af-rica, Mexico, Germany and Finland.

Peisch said her local organization is not a 501(c)3 at this point, and all Knockers are made with donat-ed time and materials. There is no charge for Knitted Knockers, and they can be picked up at many local hospitals and through breast cancer survivor groups.

To get involved or to learn more about the Knitted Knockers, contact Marty Peisch at 218-820-7149 or email [email protected]. ■

I’d really like to find other knitters to help. Maybe there’s another weirdo out there that has more time than good sense.

Marty Peisch

6

In normal joints, a smooth material called cartilage covers the ends of each bone. This provides a gliding surface for joint motion and acts as a cushion as well. The term arthritis refers to joint pain. In OA, this joint pain is the result of the super-smooth cartilage break-ing down. As a result, the bones begin to rub together. This causes pain and swelling and difficulty moving the af-fected joint.

Symptoms of osteoarthritis often develop gradually. Many times, peo-ple with OA notice pain and stiffness, which is often more noticeable first thing in the morning, or after sitting for a prolonged period of time. Some ac-tivities can increase the pain. However, many patients notice that when they are active, their joints actually feel better.

OA can lead to other health problems as well. Chronic pain from the arthritis can affect mood and contribute to de-pression. In addition, knee or hip pain often leads to inactivity, which promotes weight gain and obesity. This, in turn, can worsen heart disease, diabetes and high blood pressure. People with OA also have a 30 percent greater risk of falling and 20 percent greater risk of fracture.

Your doctor can commonly diagnose knee and hip arthritis. Your medical his-tory is very important in helping diag-nose. Your doctor may ask for a descrip-tion of your symptoms, including where you feel your joint pain and when your symptoms began. Other important fac-tors include how rapidly your symptoms began and how your symptoms affect your normal daily activities. Physical examination is also very helpful. Your doctor will be examining how well your joint moves.

They will also be looking for areas that are painful or swollen. Imaging is also very useful. Often times an X-ray

is enough to make the diagnosis. Other times an MRI scan can be very helpful. Blood work can be done to rule out oth-er causes of joint pain such as rheuma-toid arthritis or Lyme disease. Joint aspi-ration can also rule out gout or infection as a possible source of pain.

Osteoarthritis (OA) is a long-term (chronic) disease. There is not a cure, but there are many ways to manage the symptoms. The goal in treating OA is to control the pain and allow patients to participate in the activities they desire. Sometimes this requires surgery, such as joint replacement. However, many times these goals can be accomplished without surgery.

Physical activity is one of the most important ways to manage OA. Low impact aerobic activity is especially

important. Activities such as walking, using the elliptical trainer, biking, swim-ming and cross-country skiing reduce pain in knee and hip joints. They also improve flexibility, help maintain prop-er body weight and can improve mood. Strengthening exercises help to build muscle around affected joints. Stretch-ing also improves flexibility and lessens stiffness. Yoga and tai chi can also be very helpful.

Weight loss is also an important treatment for OA. Excess weight adds additional stress to weight bearing joints such as the hip and knee. This leads to increased pain and swelling, and can increase the rate at which the joint is damaged. Weight loss can be achieved through diet and exercise. When diet and exercise are not sufficient, there

are other alternatives; which can be dis-cussed with your doctor.

Medications can also help manage OA pain. Pain relievers such as Tylenol can help with joint pain. Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen can help to manage the pain and inflammation. These are avail-able over the counter or with a prescrip-tion. Injections can also be very helpful.Corticosteroid injections are powerful pain and anti-inflammatory medica-tions that can be injected directly into the joint. They often provide three to four months of pain relief, and can be repeated. Hyaluronic acid is a protein which naturally occurs in joint fluid. This acts as a lubricant and breaks down in OA. This can be injected and can also provide very good pain relief.

When OA of the knee or hip con-tinues to cause pain, despite these in-terventions, joint replacement is a very good option. Joint replacement involves covering the ends of the bone with metal and plastic (polyethylene) to prevent the bones from rubbing on each other. This eliminates the pain and allows patients to return to their activities. Surgery is now done with only a very short hospi-tal stay. Physical therapy is begun shortly after surgery and continued as an outpa-tient. Hip replacement can now be done through an anterior approach, which al-lows us to perform the hip replacement without cutting any muscle. This allows for a faster recovery and less pain.

Osteoarthritis is a very common dis-ease. It causes pain and affects people in myriad ways. However, there are many treatments available. It is impor-tant to talk with your doctor and work through these treatments so that the symptoms are controlled and you can continue with all of your activities. ■

NORTHERN ORTHOPEDICS AND ESSENTIA HEALTH are working together to bring experts to the communities of Crosslake and Pierz. Dr. Benja-min Robertson, orthopedic surgeon, is available to see patients at the Essentia Health Clinic in Cross-lake and Dr. Paul Thompson, orthopedic surgeon, will see patients at the Essentia Health Pierz Clinic. Call your local clinic to schedule an appointment. The team of orthopedic specialists is also available in Brainerd at Northern Orthopedics, Ltd., for an appointment call 218-829-7812.

DR. BENROBERTSON

What are my joints telling me?By DR. BEN ROBERTSON

Columnist

Joint pain affects people of all ages, but becomes more common as we get older.

The most common cause of joint pain in adults is osteoarthritis (OA). This is also

sometimes called degenerative joint disease (DJD) or degenerative arthritis. OA

affects 27 million Americans and two of the more common joints affected include

the knee joint and hip joint.

After a 12-year educational journey, a

return home to develop a career and

family is the right choice for me. The

opportunity to build a medical prac-

tice in an area so dear to me as the

Brainerd lakes area seems to be too

good to be true.

Memories of growing up around the lakes and communities were a deciding factor in se-lecting a location for my career. Many people dream of being able to return home to raise a family and have a career.

As my family and I begin settling into the lifestyle that we have missed so much over the years, it is exciting to see familiar faces and know that I have the support of such a great medical system as Cuyuna Regional Medical Center. From the small produce stands to fa-miliar faces at local businesses, there is reas-surance and the comfort of a community at every turn. In the coming years, I plan to enjoy lakes and golf courses that I have missed so much while I was away.

With a new-found appreciation for the Brainerd lakes area, my family and I are al-ready enjoying our return home and all that the area has to offer. ■

Coming HOMEBy DR. MARIE NELSON

Thirty years of helping people live where they most want to live – at home.We’re dedicated to doing whatever it takes to let people live comfortably and safely at home. Just as we’ve done for 30 years. Call or visit us online to learn more.

(218) 829-9238 | (888) 221-5785 | www.gnhomecare.com

We’ll be there.

001280

919r1

A reception to welcome Brainerd lakes native Ma-

rie Nelson, M.D., an Obstetri-cian/Gynecologist who has joined the staff of Cuyuna Regional Medical Center, will be Tuesday, Aug. 4, from 4 to 6 p.m. at Iven’s on the Bay in Brainerd.

All women are invited to meet Dr. Nelson and CRMC’s

four other obstetrician/gyne-cologists, enjoy appetizers and beverages, chair mas-sages, and mini manicures and facials. Reservations are requested by calling Jennifer Holmvig at 218-545-4455.

Dr. Nelson returned to Minnesota after complet-ing a residency in Obstetrics and Gynecology at Creigh-

ton University Medical Cen-ter and Affiliated Hospitals in Omaha, Neb. She earned her Doctor of Medicine at the University of Minnesota Med-ical School in Minneapolis and Bachelor of Science de-gree at the University of Notre Dame in Indiana.

For an appointment with Dr. Nelson, call 218-546-7462.

8

A routine dental checkup can tell your

dentist a lot more about you than wheth-

er or not you floss regularly. Your dentist

might be the first person to know if you are

prone to certain types of heart disease or

have developed high blood pressure.

How much do you really know about why it’s im-portant to floss regularly? And, it sounds a little crazy, but did you know that sugar alone doesn’t really cause cavities? We separate fact from fiction about all of those visits to the dentist with a little help from Baxter-area dentist, Dr. David M. Ude, Lakes Dental Care in Baxter, and information from Mayo Clinic and WebMD

MYTH: Flossing is not important. FACT: You need to floss. By not flossing you are

missing over a third of the area that needs to be cleaned on your teeth. Brushing alone just doesn’t do the job well enough. Plaque buildups in every area of the tooth — including those you cannot reach. If you want to do the job really well finish with a swish of some mouth-wash as well.

MYTH: Your dentist is looking for more than cavi-ties and plaque build-up at your appointment.

FACT: Your dentist is looking for signs of good oral health when you go in for your visit. He’ll spot any plaque and issues with your gums but they’re also look-ing for other signs that need to be addressed. During the visit you are likely being screened for signs of oral cancers, lesions and any abscess.

MYTH: Tooth decay is caused by eating too much sugar.

FACT: Cavities are caused by sugar and acid com-bined. Ude said for a cavity to form actually requires three factors. Besides the sugar and acid is the amount of time that it is exposed to our teeth. If you eliminate one of the factors you can decrease the risk of getting a cavity. While it is true, if limit your intake of sugar you can cut down on the risk, by decreasing the amount of time it is in your mouth can help fight the formation of cavities as well. This is just one more good reason they remind you to brush and floss twice a day.

MYTH: Silver fillings are unsafe. TRUTH: The silver fillings are a mixture of a num-

ber of metals including mercury, silver, tin and copper. Some people are concerned about the mercury that the fillings contain. Ude said during the application of the silver on your teeth all of the other elements that are present are pressed out. The American Dental Associa-tion supports the use of dental amalgam as safe, reliable and effective. The use of these fillings has been prac-ticed for over 100 years.

MYTH: Bad breath is a sign of gum disease.FACT: Bad breath is a sign of the presence of un-

healthy bacteria. When you brush your teeth it is a good practice to brush your tongue too as a regular part of your dental care. If you notice that your breath smells bad regularly it can be a sign of a periodontal problem or an abscess or cavity.

MYTH: Gum disease only happens to older people.FACT: Unfortunately, Ude said there are a lot of

younger people that deal with it as well. If you have poor dental health anyone can develop gum disease.

MYTH: Other health conditions can be diagnosed during a dental appointment.

FACT: True. Your dentist may recommend a visit to your regular physician if conditions such as high blood pressure, slow or poor healing from a dental procedure is noted, or certain types of periodontal sores are no-ticed at a dental appointment.

MYTH: White teeth mean your teeth are healthier.FACT: Not true. The natural color of our teeth is dif-

ferent from person to person. Over the years teeth can develop stains from the things we eat and drink also, like coffee and wine. Even though your teeth may be perfectly healthy they can have a slight discolored ap-pearance. On the flip side, Ude said you can go to the

store and use all of the whitening products that are available but you will still have cavities. Just because someone has a nice, bright white smile doesn’t mean that they have healthy teeth.

MYTH: Brushing bleeding gums is really bad.FACT: No. Brushing is good not only for your teeth

and tongue, but also your gums. If you have bleeding gums when you brush make sure to let your dentist know at your appointment but some bleeding isn’t un-common. It’s important to keep the tissue around your gums as clean as the rest of your mouth and you can do this by regularly brushing and flossing them. If your gums are sensitive make sure not to brush them too hard.

MYTH: Using an aspirin on a toothache will take care of the pain.

FACT:. Ude said sometimes the use of aspirin can lead to burns on the tissue of the gums. Aspirin typically works when it enters the bloodstream and not in this type of situation.

MYTH: Bleaching your teeth is dangerous.FACT: It is not. Bleaching teeth is a way to remove

any external stains and this will leave you with a nice, bright smile. The bleaching materials on the market and used at your dentist today are completely safe. ■

Brushing up on GOOD dental careBy SHEILA HELMBERGER

Contributing Writer

When to see your dentist

To prevent gum disease and oth-er oral health problems, sched-

ule regular dental cleanings and exams. In the meantime, contact your dentist if you notice any signs or symptoms that could suggest oral health problems, such as:• Red, tender or swollen gums• Gums that bleed when you

brush or floss• Gums that begin pulling away

from your teeth• Loose permanent teeth• Changes in the way your top

and bottom teeth align with each other.

• Unusual sensitivity to hot and cold

• Persistent bad breath or an unusual taste in your mouth

—Mayoclinic.org

9

Dr. Jessica Tabbatt genuinely

believes she has the best of

both worlds.

A northern Minnesota na-tive, Tabbatt returned to the lakes area in July to launch her career in podiatric surgery with Essentia Health in Brain-erd. Tabbatt will see patients with a wide range of issues in-cluding disorders affecting the foot, ankle and lower leg.

Tabbatt said it wasn’t a life-long interest in feet that led her to her choice in specialty.

“I really wasn’t sure what I wanted to pursue,” Tabbatt recalled.

She said it was a lecture she attended while in medical school with a podiatric surgeon that really introduced her to the idea of making podiatry her career path. Tabbatt said she likes the idea of mixing primary care with surgery.

“It really keeps you on your toes,” she said. “I love both aspects. They really compliment each other well.”

Tabbatt said a lot of people don’t re-alize how important proper foot care is.

“Our feet take us everywhere,” she said. “Without proper care, foot and ankle conditions can be debilitating and prevent us from being able work or take part in activities we enjoy.”

Tabbatt sees patients of all ages and stages of foot disorder but noted that early intervention is often the key to keeping feet healthy and preventing long-term disability.

Tabbatt said she has taken special interest in seeing patients with diabetes who are often at a higher risk for foot in-fection and ulcer due to peripheral neu-ropathy, which is decreased sensation in the feet.

“The most important things some-one with diabetes can do to take care of their feet is to do daily foot checks,” Tabbatt said. “This helps catch sores and

ulcerations before they become compli-cated.”

Tabbatt said it’s important to watch for open sores and any new skin conditions and to not waste time trying to de-cide if it’s worth a visit to the doctor. “Just get it checked out right away,” she said. “Unfortu-nately people often wait until it’s too late.”

Unchecked foot conditions can lead to serious infection and, in extreme cases, ampu-tation.

Tabbatt said she enjoys the excite-ment that comes with surgery but also the relationships that come with patient care. Diabetic patients see their physi-cians often, sometimes on a weekly ba-sis. “You really do build a better relation-ship with them,” she said. “The goal is really to have to see them less often.”

In addition to her excitement in start-ing her career at Essentia, Tabbatt said she is excited to be home again.

“I’m excited to use the cabin and not have to sit in traffic at the end of the weekend,” she joked. “We’re really looking forward to the change of pace and enjoying all that the Brainerd lakes area has to offer.”

With her move from the Twin Cities, Tabbatt said she expects to bring all that she’s learned in her training to the lakes area, noting many people are forced to drive a long way in order to see a podia-trist, particularly one that specializes in working with diabetic patients.

“People shouldn’t need to drive to the cities just to see a specialist,” she said. “I expect to bring everything I do in the cities up to Brainerd.”

Tabbatt joins the podiatry team at Es-sentia that includes Dr. Daniel Ryan and Nurse Practitioner Melissa Erickson. “It really takes a team effort to keep people healthy,” Tabbatt said.

To schedule an appointment with Dr. Tabbatt call 218-828-2880. ■

DR. JESSICATABBATT

First steps on a NEW journey

By SARAH NELSON KATZENBERGER Editor

10


Ready to Roll in Cuyuna Country

By JODIE TWEED Contributing Writer

Mountain bike enthusiasts are

a hearty bunch, but sometimes

even the toughest rider can

run into a medical emergency

while out on the trails.

Fortunately for riders in the Cuyuna Country State Recreational Area, emer-gency help may be closer than they think.

The Cuyuna Lakes Mountain Bike Patrol is a volunteer-based group trained to administer first-aid to riders within the Cuyuna Country SRA. Sev-eral crewmembers work as emergency personnel, including Darrell Dwire, bike patrol director, who is a paramed-ic at Cuyuna Regional Medical Center in Crosby.

CRMC has provided some bikes for the EMS staff to use while out riding as part of the bike patrol. CRMC also provides first-aid training for dedicated volunteer bike patrol members, as well as medical supplies that they can carry on their bikes to help other riders in need of help.

Dwire said the bike patrol has six EMS bike patrol members and about six other volunteers who have gone through the training program. The bike patrol is always looking for new mem-bers, especially those who already en-joy riding out on the trails, anyway.

The bike patrol can provide pro-spective members with medical train-ing, and there isn’t a specific amount of time when members should be out monitoring the 25-miles of single-track trails. There are special events that the bike patrol members provide support

Cuyuna Lakes Mountain Bike Patrol

members Tim Nelson (front), Josh Bou-

dreaux, Darrell Dwire and Kelly Ziegler

ride along a trail at the Pennington Mine

access.

Cuyuna Lakes

Mountain Bike PatroL

Provides heLP to Bikers

out in the rugged terrain

of Cuyuna Country state

reCreationaL area

for, but ultimately, they simply have to en-joy mountain biking and helping others.

“The patrollers are passionate about biking. They’re advocates for the trail,” Dwire said of the bike patrol team. The team includes both male and female rid-ers. “It’s a real, unique opportunity that the Cuyuna Lakes area has been given with the construction of the bike trails. They are one of the greatest in the state, and they’re getting bigger. It’s cool to be part of that.”

Dwire said bike patrol members often find themselves helping lost riders find their way, assisting with bike repairs and handing out bandages, rather than re-sponding to serious medical emergencies.

“Most of these guys are pretty tough,” Dwire said of mountain bike riders. “There are a lot of abrasions, and we’ll hand out Band-Aids and bleeding con-trols. A big part of the job is being an advocate for the trails and community.”

If a serious emergency did occur out in the 800-acre recreation area, riders should call 911. There are EMS access points listed on the trail maps. Dwire said the Crosby and Ironton fire departments have specialized litter rescue baskets on one wheel equipped to get injured riders off the rugged trails.

Bike patrol members aren’t the only riders voluntarily manning the mountain bike trails. Aaron Hautala, president of the Cuyuna Lakes Mountain Bike Crew Chapter of the International Mountain Bicycling Association, said the bike pa-trol and members of his bike crew work together as advocates and stewards of the recreational area to make sure everyone is

safe and having a good time on the trails.The volunteer bike crew helps with

trail maintenance and runs mountain biking events in Cuyuna Country SRA. There are about 75 bike crew members, Hautala said, but they hope to continue to add more crew members within the next few years.

“We have many different groups working together to make Cuyuna hap-pen,” Hautala explained. “All these groups are collaborating to make it the best destination it can be.”

Cuyuna Country SRA, which opened five years ago, currently has 25 miles of single track and construction on an addi-tional three-and-a-half miles are expected yet this year. The Minnesota State Legisla-ture allocated $600,000 to the trails system in Legacy funds. Hautala said the master plan is that one day there will be 75 miles of single-track mountain bike trails within the recreation area. Single track is safer for mountain bike riders, since everyone is traveling in the same direction.

“The long-term goal is to have three days of riding without ever repeating a trail,” Hautala explained. “The reason we want to do that is to make it a desti-nation, not just a day trip.”

Hautala said Cuyuna Country SRA is ranked among the top 20 mountain bik-ing trails in the world — no small feat. The more trails within the trails system, the more people who trek to the Cuyuna Range for mountain biking, which cre-ates a huge economic impact for the community.

Dwire said with the popularity of fat tire bike riding in the winter, he is hop-

ing to get some fat tire bikes for the am-bulance staff so the EMS staff can go out and patrol during the winter.

If you’re interested in learning how to become a trained member of Cuyuna Lakes Mountain Bike Patrol, contact Dwire at [email protected]. The

Cuyuna Lakes Mountain Bike Crew is also looking for more volunteers. They meet at 7 p.m. the first Thursday of each month at Hallett Community Center in Crosby. ■JODIE TWEED is a freelance writer/editor who lives

in Pequot Lakes.

11

Your Home, Our CareKnute Nelson Home Care offers personalized care

in the comfort of a client’s home:

24-Hour Skilled Nursing Care Physical, Occupational & Speech TherapyWound Care • Medication Reconciliation

IV Therapy • Pediatric CareOstomy and Catheter Care • Home Health Aide

Homemaking

001281062r1

15175 Edgewood Drive, Suite 160 • Baxter, MN 56425 P:218-454-1542 • F:218-454-1541

www.knutenelson.org • facebook.com/knutenelson

We accept most other insurance

plans and self-pay.

Medicare Certifi ed

Kelly Ziegler (left),

Darrell Dwire, Josh

Boudreaux and Tim

Nelson, members of

the Cuyuna Lakes

Mountain Bike Patrol,

are seen here at the

Pennington Mine ac-

cess with a specialized

litter basket with one

wheel that is used to

get injured riders off

rough terrain.


12


Chiropractor WORKS TO HELPDr. Thea Feierabend

discusses the many

methods of treat-

ment she uses with

patients at Lone

Oak Chiropractic in

Brainerd. Feierabend

treats patients of all

ages and stages in

life.


Dr. Thea Feierabend has always known

she wanted to help heal people.

Growing up in a family that practiced holistic medicine, Feierabend has seen first hand the ben-efits of treating illness and injury the most natural way possible.

“We didn’t make many trips to the doctor,” she said. “That’s really kind of how I kind of decided to go into chiropractic care.”

In 2012, the one-time medical laboratory technician set out in a completely new direction in life. She launched her career as a chiropractor. Feierabend said she has always had an interest in medicine and just wanted to do more with her career.

“I wanted to be more of a provider and treat people to help them find healing,” she said.

Feierabend said her journey into chiropractics wasn’t a completely straightforward decision. She actually considered becoming a dental hygienist, a physician’s assistant or a doctor before going to school for chiropractics.

“Something just wasn’t clicking,” she said.A friend she knew from her undergraduate

studies was attending chiropractic school, and their experience helped Feierabend find her way into chiropractics.

“It was everything I grew up with and a doc-tor all wrapped into one,” she said. “It was just perfect.”

Opening an office in Brainerd, called Lone Oak Chiropractic, Feierabend has made a con-scious effort to be a distinctive kind of chiroprac-tor.

“I have a lot of people come in and they’re just tired of the whole come in, get adjusted, go home, come back again a few days later,” she said. “They want something a little different.”

Along with chiropractic treatment, Feierabend uses acupuncture, massage and nutritional re-sponse testing to help her patients find healing. She said while many people shy away from acu-puncture because of a fear of needles, Feierabend said they are nothing to be afraid of and can be helpful in treating many kinds of ailments includ-ing lower back pain, headache, sinus trouble, al-lergies, stress and gastrointestinal issues.

“A lot of people call and wonder, ‘Can it help me?’ and I always say, ‘Well, it can’t make any-thing worse,” Feierabend said, noting that every-one is different so individual treatment varies.

“I do see great results,” she said. “It’s really fun to do.”

Feierabend makes the use of essential oils a regular part of her patient treatment. Her go-to blend before doing a back or neck adjustment is

13

patients find nature’s best healingpeppermint, eucalyptus and clove, or others depending on what her patients prefer.

Feierabend credits her up-bringing with her knowledge of essential oils and their use in chiropractic care.

”There’s so many and there’s so many ways to use them,” she said. “People get very overwhelmed and they’re really not that scary and not that hard to use.”

Feierabend said essential oils can be used to treat many ailments that might normally result in a visit to the doctor’s office.

For the common cold Feier-abend said it’s a good idea to go to the chiropractor and get adjusted as soon as symptoms start.

“It can help boost that immune system right away,” she said.

For ear infection, Feierabend said to never drop oils directly into the ear but using basil, purification (a blended oil from essential oil company Young Liv-ing) and tea tree can be massaged around the ear and down the neck. Feierabend said mullein garlic can be dropped directly into the ear. “Garlic is anti-viral, anti-bacterial. It’s very soothing,” she said.

For persistent fever, Feierabend said until a child is age 3 she recommends lemon along the spine and the bottom of the feet. After age 3, peppermint oil can be used directly on the bottom of the feet or with coconut oil as a rub used on the upper chest.

“Peppermint is really good but it can be harsh on the respiratory system in young children,” she noted.

In addition to oils, Feierabend said apple cider vinegar is often helpful in fighting fever and other infection. In can be ingested directly, but since the taste is not very kid-friendly, Feierabend said it can be used in the bath as an alternative.

For gastrointestinal issues Feierabend recom-mends peppermint oil in adults and a blended oil called DiGize.

“You can dilute it and rub it right on their tummy and bottoms of the feet,” she said. “That’s a great one.”

For headaches she recommends lav-ender. For sleep issues she said a blend called Peace and Calming as well as lavender and cedarwood.

Feierabend sees patients of all ages and actually recommends parents bring their children in at a young age.

“With all their running and falling and jumping around, it’s a good idea, just for general maintenance to (have them adjusted),” she said. “We can keep them healthy as they grow older.”

Feierabend sees children from in-fancy and often helps desperate par-ents find simple solutions to colic, con-stipation and bedwetting.

“Kids are so easy and they love it. They just have so much fun in here,”

she said. “And they respond so well.”As far as using supplements for children, Feiera-

bend recommends a probiotic, Vitamin D and a fish oil. “They’re great to keep the immune system up and fish oil helps with brain development,” she said.

Feierabend said she isn’t opposed to seeing a med-ical doctor when necessary. With her own 16-month-

old son, she makes time for well-child check-ups and when acute illnesses make it necessary.

“I’m still a parent,” she said. “I may have grown up a certain way and know all these things but when it comes to my kid, my response is still, ‘What do I do?’”

Feierabend said she does a lot of chiropractics with her son who has never had so much as an ear infection or an over the counter drug, much less pre-scription medicine. “It doesn’t mean I wouldn’t take him in,” she said. “I just try to do all my own things before hand.”

Feierabend makes herself readily available to her patients by phone, email and Facebook. “I don’t mind answering questions,” she said. “I really want to be able to help people find what they are looking for.”

Feierabend said she really believes working on the spine can create a healing environment and allow the human body to heal themselves as they were in-tended to do.

“I don’t cure anything necessarily — I don’t cure headache, I don’t cure back pain,” she said. “I help your body to get to the point where it can heal itself.”

For an appointment with Dr. Feierabend call 454-3015. ■

Dr. Thea Feierabend uses a separate treatment room

for administering essential oil treatments. She uses es-

sential oils to assist in treatment of everything from the

common cold to constipation.



Brad Carlson

discusses the

benefits of his new

Resound hear-

ing aids and their

enhanced technol-

ogy controlled

from his iPhone.

Steve Kohls • [email protected]

Brad Carlson has had trouble with his hear-

ing for as long as he can remember.

“I was born that way, probably,” he said.Carlson said he really started to notice his hearing

impairment in both of his ears as an eighth grader when he failed his standard hearing test. Carlson, who would not disclose his age but said he is “old enough to need hearing aids,” said he’s lived his en-tire life with his poor hearing.

Until now.“I’m brand new,” he said. “I’m telling everyone

about it.”In March 2015, Carlson visited Dr. Whitnea

Engelbrecht, an audiologist with Essentia Health in Brainerd. Engelbrecht introduced Carlson to a tiny inner-ear device that he said has changed his life.

Carlson’s hearing aid, made by Resound, pairs with an app on his iPhone and allows him control the volume level, frequency, speech focus and back-ground noise he hears with his hearing aid. It allows him to personalize settings based on location. The technology even uses Carlson’s iPhones GPS to re-member locations he has preselected and automati-

cally adjusts his hearing aid’s setting accordingly.“When I go home, it knows I’m home and

the settings change on their own,” Carlson said.Carlson can also take phone calls, listen to

music, watch movies and access all audio and video functions on his phone directly through his hearing aids.

“Some people don’t like their hearing aids — I love mine,” he said.

Carlson said he’s a gadget guy and while the adjustment period required came with a learn-

ing curve he enjoyed the experimentation. “I had no other options until now,” he said.

“They couldn’t fix it. I was just kind of stuck.”Engelbrecht said the hearing aid Carlson uses has

been out for a few years, but the Bluetooth technol-ogy that pairs the device directly with iPhone is new and is particularly new to the Brainerd lakes area.

“We’re not seeing everybody doing them,” she said. “We want to get the word out — what is new out there for hearing aid products and technology.”

Engelbrecht said while Bluetooth technology had existed for some time, it previously required an ad-ditional device to pair with a phone, or other Blue-tooth compatible technology. The Resound hearing aid that Carlson uses is made specifically for use with iPhone 5 or better. The device also pairs with iPad and iPod devices.

Easy listeningNew techNology eNhaNces heariNg aid experieNce

14

15

001278

076

r1

Peace of mind in an experience delivered daily by Lakes Imaging Center. We’re expanding that experience with our new High-Field Oasis Open MRI.

• Brand new 1.2T magnet produces excellent image quality• Unmatched room and comfort for larger patients, up to 660 lbs.• True Open design to put even the most claustrophobic patients at ease• Highly trained, friendly staff

Only Open MRI in Central MinnesotaOnly High-Field Oasis MRI in Minnesota

You have a choice!

Engelbrecht said as patients learn about the new technology and test it for themselves, the response has been very positive. “It doesn’t matter what type of hearing loss you have, anybody could wear these hearing aids,” she said. “If you want a hearing aid that is sleek, small and nobody would see it or even if you need a hearing aid because of a profound hearing loss — you could still take advantage of all of the made for Ap-ple devices.”

Engelbrecht noted that the hearing aids can still be used without pairing with iPhone, allowing for better hear-ing regardless.

“You’d still be getting the most up-to-date technology,” she said. “It’s worth it to take advantage of that.”

Engelbrecht said she sees patients of all ages and levels of hearing loss. “Anybody can have a hearing loss,” she said. The most common contribu-tors to hearing loss are family history, noise exposure and age. Damage of-ten becomes noticeable when a per-son reaches their 30s and more so in their 50s.

Patients tend to be older and often more resistant to the idea of their own hearing loss.

“When family and friends start to question their hearing it’s time to come in and get a baseline exam,” she said. “If you’re not noticing any hearing loss, then after the age of 50 get a baseline

just so we can monitor changes down the road.”

Engelbrecht said pricing is often an inhibitor for people in need of a hear-ing aid. Pricing differs and depends on insurance coverage. “Some help and some don’t,” Engelbrecht said. Pro-grams like the Sertoma Club and the Lions Club help with cost assistance in situations where the hearing aid is a need and patients cannot afford the cost.

Carlson warned those in the mar-ket for a new hearing aid against third party distributors because they tend to charge far more for the device.

“You see these big ads and they suck you in,” he said. “Go shop around. Go see two or three people at least.”

Carlson said he discovered Essentia Health carries hearing aids through a customer. “Whitnea is cool,” he said. “She talks loud, but that’s OK — she’s used to talking to older people.”

Carlson noted that Essentia Health provides unlimited battery supplies. “These are expensive,” he said, joking-ly. “I’m careful with my usage because I like Essentia.”

Carlson said he is still getting used to his hearing aids, but is happy with his decision to finally make the invest-ment after a lifetime of feeling like he was always missing something.

“I hear more birds. I had no idea there were so many birds in the world,” he said.

Carlson is hopeful that after a life-time of poor hearing the use of his new hearing aids will help him regain some

of his lost hearing. “Can I get all of it back — I think I

can,” he said. ■

Carlson’s tiny hearing

aids are barely visible

when in use but provide

vast improvement to

Carlson’s damaged natu-

ral hearing.

Steve Kohls • [email protected]

I hear more birds. I had no idea there were so many birds in the world.Brad Carlson

16

ST. PAUL — A few false starts, a whir of

motors and Evans Bille was off and walk-

ing down the hospital hallway.

It might not have been remarkable for most peo-ple — except Bille hasn’t had the use of his legs for nearly a year.

The White Bear Lake 22-year-old was leaning on a deck railing last August when the railing gave way. The fall left him with much of his spine fused and no feeling from the chest down.

That’s still the case, but he’s one of a small group

of paraplegic patients at Regions Hospital who are trying a new motorized exoskeleton that lets them stand upright and, with no small effort, walk.

The device, called ReWalk, is made by a Massa-chusetts company. It was approved last summer by the U.S. Food and Drug Administration — the only one of its kind cleared for use in the home or in pub-lic.

Those who have used it see life-changing poten-tial in ways great and small — even as they struggle to convince their insurers to cover the considerable price tag.

“That feeling of all of a sudden being six feet tall

again,” Bille said, “is surreal.”He’s one of three Regions patients who spent a

few hours working with the device Wednesday. It most closely resembles a pair of robotic legs. Motors strap to the outside of the patient’s thighs and calves, with a battery pack and a computer in the back.

It’s controlled by a wristwatch. The motors move the legs as the patient uses crutches to balance.

Invented by Amit Goffer, an Israeli man who is quadriplegic, the device is still rare — there are just 74 private users worldwide. The company is current-ly looking for hospital to partner with and run clinics to give patients a look at it.

By MARINO ECCHER St. Paul Pioneer Press

Motorized EXOSKELETON helps

Ms. Wheelchair Minnesota, Angelique Lele, gets up with her ReWalk device at a

monthly exoskeleton clinic July 15 at Regions Hospital in St. Paul. Greta Wolf (left), a

physical therapist, helps. Lele was paralyzed a few years ago after falling off a trapeze.

Jean Pieri • St. Paul Pioneer Press

“The goal is to bring more access,” said Lina Alsauskaite, the company’s clinical training manager in the Mid-west.

This month’s clinic was the third at Regions — the only hospital in Min-nesota to use the device so far. Bille, the first patient to strap it on back in April, can now motor through the cor-ridors with some proficiency — aided by an upper body sculpted by sports and carpentry.

For Angelique Lele, the reigning “Ms. Wheelchair Minnesota, Wednes-day was the first try. She was paralyzed in the legs three years ago in a fall from a trapeze.

By the time her physical therapists

got her strapped into the ReWalk, she joked she was ready for a map. When she stood up for the first time, she is-sued an audible “whoa.”

It’s “so funny,” she said, “what you forget.”

It was the first time, too, for Scott Collier, a Montgomery, Minn., farmer who was paralyzed a year and a half ago when heavy equipment collapsed on him as he changed a tire.

The session left him sweaty, ex-hausted and satisfied.

“It was nice standing up, stretching your legs and looking eye to eye with everyone,” he said.

Dr. Steven Jackson, a spinal cord specialist at Regions, said the device

offers a handful of health benefits. It builds bone strength, which atrophies when limbs don’t bear weight. It’s a form of aerobic exercise. It alleviates sitting sores and cuts down on intes-tinal and bowel issues that crop up in patients who can’t stand.

Moreover, he said, it can offer a huge psychological lift to people who had to cope with a sudden and harsh change when they were injured.

“I believe the mental benefits from it cannot be overstated,” he said.

Collier sees it as a way to regain the freedom to do things as simple as reaching the oil dipstick in his car to as meaningful as dancing at his daugh-ter’s wedding.

“It gets to be real hard on a person, that you want to do this and you can’t do this,” he said.

He’s trying to convince his insur-ance company to see things the same way. The device costs $70,000 per unit, and the insurer thus far has re-fused to cover it on the grounds that it isn’t a necessity.

Bille is in the same position, having fought similar battles over other mobil-ity and therapy devices. He and Lele both have funding pages set up with GoFundMe.com to help defer medical expenses.

“How can a group look at your pa-perwork,” Collier said, “and say it’s not a medical necessity when at the end of the day, they get up and walk out to their cars?” ■

The Pioneer Press is a media part-ner of Forum News Service.

Lina Alsauskaite (right), a ReWalk clinical training manager, readjusts a ReWalk device in between patients at Regions Hospital in St. Paul. The ReWalk system — a device that fits outside the patient’s legs — powers the hip and knee movement to allow them to stand and walk.

Jean Pieri • St. Paul Pioneer Press

17

paraplegic patients stand & walk

18

DULUTH — My feet are flat on the floor,

and I’ve made myself as comfortable as I

could in an office chair within a claustro-

phobically cramped medical office. As in-

structed, my eyes are closed.

It’s shortly after the beginning of a busy work shift. My mind is focused on what’s coming next. After I get back to the office, I’ve got a phone interview and then a face-to-face interview with a senator sched-uled.

And Elizabeth Zuber is telling me to think about my breathing.

I invite you to just notice right now how you’re breathing.

She speaks slowly in a calm, steady voice.And there is no right way or wrong way to do

this. It’s your own personal experience of how you’re breathing.

Zuber is introducing me to Mindfulness-Based Stress Reduction, a technique she has taught at Es-sentia Health for 13 years. Formerly the hospice vol-unteer coordinator for St. Mary’s hospice, Zuber and some colleagues had studied the methods developed in the 1970s by Jon Kabat-Zinn of the University of Massachusetts Medical School.

Mindfulness simply means “paying attention in a particular way,” Zuber explains.

She first learned about it from Dr. Steven Kuross, an oncologist/hematologist at the Essentia Health Cancer Center who remains ardently enthused about mindfulness.

“I developed a meditation practice, and it had such a profound effect on my life,” Kuross said in a telephone interview. “It just profoundly changed how I live for the better.”

Kabat-Zinn was a researcher and a Buddhist prac-titioner when he developed his ideas, Kuross ex-plained.

“Buddhism is now a religion, but it wasn’t really founded as a religion,” Kuross said. “When the Bud-dha achieved enlightenment, he realized what he learned was applicable to all humans.”

‘EVERYONE CAN RELATE’Mindfulness also could be described as heartful-

ness or awareness, he said. It’s meditation by another name.

“If you advertised ‘take a meditation class,’ peo-ple wouldn’t respond very well,” Kuross said. “But if you said, ‘How about stress reduction?’ Everyone can relate to that.”

It works, say people who have taken Zuber’s class

at Essentia Health.“It’s the only thing I can attribute to my improving

health,” said Jennie Krech, 45, of Duluth.Krech was in the midst of a health crisis when

she took the class from late January through late March of this year, she said. She also learned that her ex-husband was getting remarried, and the news reopened some old wounds.

“The class helped me observe the emotions, ac-cept and let go,” she wrote in an email. “I have also been much more focused at work, my digestion and overall health has been much better, and I have been sleeping better than I have in years.”

THE CLASSESZuber teaches two eight-week Mindfulness-Based

Stress Reduction classes each year and also offers an abridged version, a four-week stress class, through Essentia Health’s Wellness Program.

The classes are experiential, with some lecture each week, Zuber said. Each session has its own fo-cus, such as breath and body work or mindful com-munication and mindful consumption. Students are often referred from hospital departments, such as the Cancer Center or internal medicine or by psycholo-gists, she said.

Because students may not know what they’re get-ting into, she starts with an orientation class and an application form.

“My sense is people have to have a readiness to look at themselves and to do the work,” Zuber said. “If they want somebody else to fix them, this is prob-ably not the program for them.”

THE CARTOONISTLike Krech, Chris Monroe finds mindfulness helps

her sleep.“In the middle of the night when you wake up

and your mind is worrying ... mindfulness has given me the tools to work for better sleep,” she said.

Monroe, cartoonist and author of children’s books (“Violet Days,” “Monkey With a Tool Belt”), took the class about three years ago, she said, when she was experiencing some health issues.

She knew stress was hard on her health, and she was looking for ways to counter that.

“I was really searching ... to eliminate stress with-out resorting to medication,” said Monroe, 53, who lives in the Observation Hill neighborhood.

Unlike her sometimes cynical alter ego in “Violet Days,” Monroe is all in when it comes to the process. She’s so pleased with the results that Monroe said she thinks everyone should try it, even people who aren’t feeling particularly stressed out.

By JOHN LUNDY Forum News Service

Enthusiasts say MEDITATION The class

helped me

observe

the emotions,

accept and let

go. I have also

been much more

focused at work,

my digestion and

overall health

has been much

better, and I

have been sleep-

ing better than I

have in years.Jennie Krech, Duluth

THE WIGGLING PUPPYPeople who took the class talk about help they’ve

gotten from images they were encouraged to visualize.For Monroe, it’s images of thoughts as clouds. “If this

cloud is getting your attention because it’s negative and scary, you just have another cloud bump it along,” she said. “Actually visualizing that has helped me so much.”

Krech was struck by a visual image of her mind be-ing like a wiggling puppy. As a puppy can be trained to obey and stay calm, so you can your mind, Krech said.

“It wants to think, but sometimes it overthinks,” she said. “Until we learn to train our brain, it will keep spin-ning.”

Linda Nervick, who took the class earlier this year, said it taught her to appreciate the moment. If it’s the start of a busy day and she’s taking a shower, she takes time to appreciate the warm water and scented soap.

“(Zuber) changed my life within 10 minutes of the first class,” said Nervick, 51, who lives in the Hillside neighborhood. “My life just clicked.”

Nervick, self-employed as owner of a public rela-tions and marketing firm, said the class helped her real-ize a source of stress in her life was one of her clients. She had the confidence to make the difficult financial decision to end her relationship with that client.

“I feel healthy; I sleep well,” Nervick said. “(In the past) I would find myself on a Sunday night so stressed out. Now I listen to KUMD jazz on Sunday night and I celebrate Sunday night.”

Zuber’s soft, calm voice continues.And on your next exhale I want you to soften your

shoulders and let your chest be open almost as though your skin, muscle and tissue are just melting. ... And your breath is becoming deeper.

... Just notice with curiosity how often your mind, or perhaps your body or sounds want to pull you away. And just gently escort yourself back to the in breath coming in and the out breath going out.

... Feeling the breath with your senses as it enters, feeling the sensation in your body as it expands and contracts. Letting go of the thinking mind and moving more into the senses.

... And switching your attention to the out breath. Making that one or two seconds longer than the in breath.

... Begin to wiggle your fingers and your toes and gently transition yourself back. Let your eyes flutter open on the next out breath.

My guided, three-minute mini-meditation has come to a close.

“So that’s what it’s like to be a human being rather than a human doer,” Zuber concludes.

But I’m new at this, and I’d have to admit that I hadn’t completely let go of thinking about those later assign-ments. I also was thinking about the parking meter out-side, which hadn’t responded when I plugged it with three quarters before coming in.

Perhaps my distraction on the first try is not unusual. Mindfulness is a discipline, Kuross said.

“It does take time,” he said. “It’s often very frustrating at first.”

That’s because you’re becoming aware of what’s re-ally going on in your thoughts, he explained.

“The saying is you open the door and you get what’s outside,” Kuross said. “So when you start to meditate, you open the door and you get what’s there, and it’s

often a lot of crap.”But the choice to do that is worth making, according

to Zuber, a choice to “wake up and be a participant in our own life” instead of living half asleep.

Before leaving, I ask Zuber if it’s difficult to practice meditation in the context of a busy day.

“Well, if you practice it, it becomes easier,” she says. “It becomes who you are. You then become a human being doing stuff.” ■

improves health, quality of life

■ Studies on meditation give varied results

DULUTH — When Dr. Steven Kuross first told Elizabeth Zuber about Mindfulness-Based

Stress Reduction, he noted that its effectiveness is evidence-based, she said.

Zuber cites research she says validates that ef-fectiveness. Studies, based on 30-45 minutes of daily meditation, show reduced stress, increased productivity, enhanced relationships and in-creased sensations of joy and peace, Zuber said.

Sara Lazar, a neuroscientist at Massachusetts General Hospital and Harvard Medical School, used brain scans to compare a control group with people who practiced meditation. In a “TEDx Talk,” she reported that 50-year-olds who practice meditation didn’t experience the same shrinkage of their prefrontal cortex as those in the control group. That shrinkage is the phenomena that makes it harder for us to figure things out and to remember things, she said.

In a 2004 study published in the Journal of Psychosomatic Research, a German research team analyzed previous studies and cautiously concluded: “These results suggest that MBSR may help a broad range of individuals to cope with their clinical and nonclinical problems.”

A similar analysis by a team from Johns Hopkins University, about meditation but not specifically about MBSR, was published last year in the Jour-nal of the American Medical Association. It found “moderate evidence” of improved anxiety, depres-sion and pain; “low evidence” of improved stress/distress and mental health-related quality of life; and “low evidence or no effect or insufficient evi-dence of any effect” on positive mood, attention, substance use, eating habits, sleep and weight.

The Johns Hopkins researchers also said they found no evidence that meditation was better than “active treatment,” such as drugs, exercise and other behavioral therapies.

But from looking at the studies within that study, “It appears that mindfulness had the best reviews,” Zuber said.

MOORHEAD — Dale Thornton began tak-

ing a small white pill as part of his battle

with kidney cancer. Within a few weeks he

could sleep lying flat on his back, some-

thing he hadn’t been able to do for months

because of pain.

“So I knew good things were happening inside,” he said. It took him six weeks to wean himself from mor-phine.

Luckily, tests had determined that Thornton, a retired financial aid director at Concordia College, was a good candidate for Afinitor, a drug to treat advanced kidney cancer that blocks a protein that controls other proteins that trigger cancer cells to grow.

He’s participating in a cancer research trial at San-ford Health’s Roger Maris Cancer Center in Fargo and is one of a growing number of patients whose cancer is being treated by drugs targeted by genetic markers.

The targeted drugs, designed to pinpoint specific forms of cancer, are enabled by a growing body of re-search into molecular and genetic changes in cells that cause cancer. They offer hope--albeit an often costly one--in cases where conventional chemotherapy hasn’t been effective.

Afinitor, besides checking the growth of targeted cancer cells, also inhibits the growth of blood vessels that feed the tumor, and can restrict the cells from get-ting nutrients.

Thornton began taking Afinitor early this year to control kidney cancer that originated nine years ago as bladder cancer.

His bladder cancer had disappeared for years, but his doctor became concerned about his kidneys two years ago when red flags appeared in test results during a routine check-up.

One kidney, stricken with cancer, looked like a shriveled prune. After surgery, rounds of radiation and chemotherapy failed to eliminate three tumors on sites where the cancer had spread.

His oncologist mentioned the possibility of the re-search trial involving Afinitor and asked if he was in-terested.

“I said, “Sure, why not?’ “ Thornton said.At the time, his kidney function was not good

enough to participate, but his oncologist kept watch on his condition and enrolled him in the study once his health made him eligible.

Luckily, Thornton had genetic markers that matched an available targeted drug to treat kidney cancer.

The only problem, and it was sizable: Targeted drug therapies are expensive. Afinitor reportedly has a wholesale cost of $7,500 for a 28-day supply.

Even with health coverage through Medicare and

supplemental insurance, Thornton couldn’t afford the medication. Fortunately, the pharmacy at the cancer center applied for a grant, and he was accepted.

“In the absence of that grant, I’d be in deep trouble,” said Thornton, who started taking Afinitor in January. “If I had to pay for it, it would be such that I couldn’t do it. I would endanger the financial future of my wife.”

Despite the steep financial cost, a major advantage of targeted cancer therapies is they produce fewer side effects than conventional chemotherapy.

Thornton’s experience with the drug so far as been encouraging--scans show one of his three tumor sites has disappeared.

“That makes everybody happy, including my wife,” he said.

Because doctors aren’t allowed to comment on pa-tients in clinical trials, Thornton’s oncologist, Dr. Anu Gaba, can’t comment on his case. But Thornton said she’s been pleased with early results of the drug.

After he was able to wean himself from morphine, he asked, “Isn’t that what you expected?”

“She said she didn’t know what to expect, it’s a re-search thing,” he said.

Targeted cancer drugs and drugs that enhance the body’s immune system to fight malignancies are two promising areas of cancer treatment enabled by re-search advances, Gaba said.

Both are examples, she added, of the emerging trend of more personalized cancer prevention, diagnosis and treatments made possible by genomic medicine.

In the future, samples of patients’ DNA from blood and tissues increasingly are being “biobanked” and can be available to guide treatments for a growing number of cancers, something Sanford is piloting in its internal medicine clinics in Sioux Falls, S.D., and will bring to Fargo, said Dr. David Pearce, president of Sanford Re-search.

“We’ll be biobanking everybody here,” he said.Roger Maris Cancer Center, where Gaba serves as

medical director, has been banking blood and tumor samples for about a year for genetic analysis, she said.

Targeted cancer drugs can cause fewer side effects than chemotherapy because they act more directly on the tumors. Even so, side effects of Afinitor, the drug Thornton is taking, can include breathing problems, delayed wound healing and might make patients more prone to infections.

Fatigue has been the biggest side effect Thornton has noticed, but he said overall he is doing much better on the drug than without it, and his doctors are closely monitoring his organ function. He’s able to travel and feels comfortable enough to work in his garden, some-thing he wasn’t able to do for a time.

“The reality is I feel much better than eight months ago,” he said. “My quality of life has improved consid-erably.” ■

By PATRICK SPRINGER Forum News Service

Dave Wallis • Forum News Service

Targeted drugs PINPOINT cancersDale Thornton is feeling more like getting

back into doing some gardening in his Moor-

head backyard after some drug treatments

to battle his cancer tumors and his pain is

greatly reduced.

20

21

DULUTH — When Dr. Mark

Monte operates on a patient,

chances are The Boss is singing

along.

“I’m a huge Springsteen fan,” the Duluth general surgeon said. “I proba-bly have on my MP3 player any record-ing Springsteen has ever made.”

Like many surgeons, Monte takes his musical tastes into the operating room with him. Picking the music is a perk of being the surgeon, said Monte, who has practiced at St. Luke’s hospital since 1997. But it’s also to the benefit of everyone involved.

“Good studies have been (showing) that appropriately selected music in the operating room can help,” Monte said.

One such study was conducted in the mid-1990s by a team led by Karen Allen, a research scientist at the State University of New York at Buffalo, and published in the Journal of the Ameri-can Medical Association. The 50 sur-geons who volunteered were studied while performing a stressful task. Al-len’s team found that the surgeons per-formed “significantly better” when lis-tening to music they chose than when no music was on at all.

But music can benefit patients as well as operating teams, said Mark Johnson, cath lab manager at Essentia Health-St. Mary’s Medical Center.

“The more pleasant and relaxed the patient’s environment is when they’re inducing that anesthesia, the vastly bet-ter experience the patient is going to have,” said Johnson, whose division is responsible for vascular surgery “from head to toe” as well as the electronic side of heart procedures, such as installing a pacemaker.

When patients are going to be awake during the procedure, the staff seeks to accommodate their mu-sical tastes, Johnson said.

“We’ve had some things that we can get close to, but we can’t quite duplicate,” Johnson said. “We don’t have a big repertoire of CDs.”

Dr. David Fogarty also defers to the patient’s

wishes if the patient is going to be awake — with an exception.

“I’ll let the patient pick whatever they want to lis-ten to as long as it’s not country,” said Fogarty, an orthopedic surgeon at St. Luke’s hospital for the past five years. “I tell them my hand is less steady if I have country music on.”

Fogarty, who grew up in the ‘80s, said his tastes run to alternative: performers such as The Clash, Nir-vana, Social Distortion and Maynard James Keenan. Other members of the team generally set up the mu-

sic in accordance with his tastes, Fog-arty said.

Music can lighten the load for an op-erating team, particularly if the surgery takes four or five hours, Fogarty said. But it’s not always appropriate.

“Sometimes, you get into cases that are either pretty technical or a little more tense,” he said. “So I want some quiet, so I can concentrate more closely.”

When he’s working, Fogarty often is concentrating so much that he doesn’t hear the music anyway, he said.

The surgery always takes precedence over the music, Monte said.

“The first rule we all swear to is: First, do no harm,” he said. “So (the music) can’t interfere with the operation.”

Monte, who grew up in New York, could be said to have an obsession with Springsteen’s music. He has been to 33 of the rocker’s concerts, he said. He’s also a big fan of U2 and “anything Motown.”

The latter, he said “is amusing to the surgical techs who are half my age.”

Monte will listen to Christmas music around the holidays, he said. He doesn’t listen to hip-hop.

“Cardiac surgeons and vascular sur-geons, for whatever reason, they tend toward classical music,” Monte said. “I like a little classical music, but eight hours of the Boston Symphony is a little bit much.”

Both Monte and Fogarty said they also have colleagues who prefer coun-try music.

Dr. Christopher Heck, a cardiovas-cular surgeon at Essentia Health-St. Mary’s Medical Center, likes rock ‘n’ roll — Counting Crows, Neil Young and

the Beatles, among others. No heavy metal, rap or head-banging music, he said.

“Music helps people to relax,” Heck said. “It helps alleviate stress.”

A lengthy procedure with no music can become tedious, Monte said.

But there might be something that’s even worse than no music.

“If you pump in music that the surgeon doesn’t like, nobody has a good day,” he said. ■

Sponge ... Scalpel .... SpringsteenMany surgeons don’t stop the Music while operating

Andrew Krueger • Forum News Service


22

THE END — it’s good to be preparedDULUTH — As an oncologist, Dr. Jona-

than Sande is used to conversations about

death. It’s a subject that dominates his time

even more now as he helps develop an ad-

vance care planning program for Essentia

Health’s Twin Ports facilities.

Yet when it’s personal, it’s still not easy to discuss.“I can tell you from my experiences with my par-

ents that even for health care professionals, it’s hard to have this type of conversation with family members,” Sande said.

It’s an unassailable fact: We’re all going to die. Health care and legal professionals agree that resolv-ing matters before a health crisis or deteriorating men-tal capabilities occur can save family members and loved ones untold grief.

“I see so many clients that come in that miss the boat on it, and it’s cost a lot of money, and it’s caused a lot of frustration,” said Greg Gilbert, a Duluth attorney whose specialties include estate planning. “It caused a lot of conflict.”

Gilbert, who is a former city councilor, helps hun-dreds of clients with estate planning. He always asks if they’d like to fill out a Minnesota Health Care Direc-tive while they’re at it, he said.

USER-FRIENDLY FORMThe form, which in the past might have been called

a living will and also might be known as an advance directive, is simple enough so that a lawyer’s help isn’t necessarily required, Gilbert said.

It’s divided into two parts. The first allows you to designate an “agent” — and alternative agents — who will make health care decisions if you are unable to decide or speak for yourself.

“Your spouse may be the worst choice,” Sande said. “Your agent ideally would be someone who is solid, who can make decisions in tough times, who won’t be paralyzed by emotions.”

The second is devoted to your health care instruc-tions on issues such as when you want, or don’t want, life-prolonging treatment.

Sue Schettle, CEO of the Twin Cities Medical Soci-ety, offered a sample issue: “If you were unable to eat and you had to rely on a feeding tube, is that some-thing you would want to do or not want to do?”

You can fill out the part designating an agent and not answer the treatment questions or vice versa, said Patty Minogue, ER department case manager for St. Luke’s hospital. She recommends filling out the whole form.

“Make sure that people know what you want,” Mi-nogue said. “And that you choose the person that is most likely going to act on what it is that you want.”

THE NEXT STEPEvery state has a health care directive, but they vary

from state to state, Gilbert said. In Minnesota, your form becomes a legal document if you have it witnessed or notarized. But the rules are different in other states.

“If a person changes states, they’ll want to check the laws for the new state,” he said.

So your form is completed and notarized or wit-nessed. What do you do with it?

“Don’t have it in your safety deposit box or your at-torney’s office,” Minogue said.

You want it quickly available when you’re brought into the emergency room at 3 a.m., Gilbert said.

If you live in the Duluth area, you should bring your form to both hospital systems and ask to have it scanned in, Gilbert and Minogue said. Your doctor’s of-fice should have a copy as well. If your church has a parish nurse, give a copy to him or her, Minogue said.

If you’re on the road a lot, keep a copy in your glove compartment, Gilbert suggested.

Both also said you should take a fresh look at your form from time to time to see if you want to make changes. Minogue does so with her own form every year at tax time, she said.

“You’re already doing that stuff that you don’t want to do anyway,” she explained.

In about 25 years of having a form, she has revised hers three or four times, Minogue said. Hospitals will follow wishes expressed in your most recent document.

TALK ABOUT ITBut it’s not just about filling out a form.“For us, an advance directive is the end product,”

Sande said. “Our goal is to help the patients and their loved ones understand, reflect upon, discuss their goals of care for future health conditions that they might have.”

Filling out the document is better than noth-ing, Sande said, but it’s much more valuable to talk through the options. He cited a study in which pa-tients and their designated agents — placed in sepa-rate rooms and given identical scenarios — reached the same conclusion less than 50 percent of the time.

Agreed Heather Opsahl, executive director of the Lake Superior Medical Society: “It’s not all about a document. You don’t necessarily have to have a doc-ument. It’s more of the conversation with the loved ones. I’ve gone through that with my mom.”

Gilbert has done that, too, he said, traveling to Michigan earlier this year to discuss health care di-rectives with his parents, who are in their 80s.

It’s not just a conversation for the middle-aged and elderly among us, said Ben Wolfe, retired pro-gram manager of Grief Support services at Essentia Health-St. Mary’s Medical Center.

“When you’re 16, you’ve got that driver’s license.

More and more kids are saying we want to be organ and tissue donors,” Wolfe said. “Having had even that conversation is important.”

‘HONORING CHOICES’But that doesn’t mean we do it. Gilbert compared it

to flossing: We agree with our dentist that we should do it, but that doesn’t always mean it happens.

In fact, an electronic medical records system across the Essentia Health System revealed that about 25 per-cent of patients have some sort of advance directive, Sande said. That’s about the national average, he said.

Efforts are under way to change that.The Twin Cities Medical Society began developing

“Honoring Choices” in 2008, Schettle said. Modeled after a program developed in La Crosse, Wis., it brings together hospitals, insurance companies and other health care organizations in a uniform effort to help people with end-of-life planning, she said.

“What we’re trying to do is normalize the conversa-tion, change a culture,” she said.

Sande is heading a similar effort at Essentia Health with Sandee Carlson, program coordinator for ad-vanced-care planning.

“We’re trying to create a program where these kinds of conversation that result in creation of a living will or advance directive becomes a standard part of your care,” Sande said.

Although it has started in Essentia’s Twin Ports facili-ties, plans are to expand to the health system’s East Re-gion and perhaps systemwide he said.

Regionally, a group has been working for 14 years to advocate for advance planning in northeast Minnesota, Wolfe said. Three years ago, they approached the Lake Superior Medical Society, which now is spearheading an organization known as Advance Care Planning-Northeast Minnesota.

“We are the last section in Minnesota not doing this, so it’s a big deal,” Opsahl said. “We’re trying very hard to get some funding. ... Our idea is to mimic exactly what’s going on in Honoring Choices (in the Twin Cit-ies).”

The hope is to develop a pool of volunteers who would be available to help people with advance care planning, Opsahl said.

It might seem like a morbid topic, but experts say it’s not really about dying.

“This is about living,” Sande said. “We’re all going to die; this is about living the best that we can.” ■

TO LEARN MORE• Learn more about Advance Care Planning-

Northeast Minnesota at lsmedsoc.org.• Learn more about Healthy Choices Minnesota

and download a Minnesota Health Care Directive form at honoringchoices.org.


001282407r1

HealthcareCuyuna Regional Medical Center320 East Main Street Crosby MN 56441

13205 Isle Drive Baxter MN 56425888-487-6437 218-546-7000www.cuyunamed.org

Essentia HealthSt. Joseph’s Medical Center218-829-2861Brainerd Clinic218-828-2880Baxter Clinic218-828-2880www.essentiahealth.org

Lakewood Health SystemStaplesMotleyPillagerEagle BendBrowerville218-894-15151-800-525-1033www.lakewoodhealthsystem.com

Home HealthcareGood Neighbor14387 Edgewood Drive NorthBaxter MN 56425218-829-9238888-221-5785www.gnhomecare.com

Knute Nelson15175 Edgewood Drive, Suite 160Baxter, MN 56425218-454-1542 www.knutenelson.org facebook.com/knutenelson

MRILakes Imaging Center2019 S. 6th Street Brainerd, MN 56401218-822-OPEN (6736)1-877-522-7222www.lakesimagingcenter.com

Senior LivingAccra Care218-270-5905866-935-3515www.accracare.org

VeinsThe Vein Center1990 Connecticut Ave SouthSartell, MN 56377320-257-VEIN (8346)www.beautifulresults.com

Health Watch Advertising Directory • August 2015

Thank you to the advertisers who support this publication.

Food for thought.Why Advertise in HealthWatch?

Reach Your TargetHealthWatch appeals to individuals devot-ed to pursuing a healthy lifestyle as well as preventing and treating the ailments that could keep them from that. They’re proactive and interested in products and

services that add to their overall well being; mind, body, spirit.

Healthcare Coverage for the whole family!

From obstetrics to geriatrics; from holistic health and fi tness to the latest

advances in healthcare technologies and treatments; HealthWatch is dedicated

to covering the whole family with a wide range of topics.

Call today!218-829-4705

healthwatch magazine: august 2015

Documents