upnorth healthwatch 07/2003

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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.

JULY 2003

LASIKThe eyes have itBarb Zajac of Pierzwas legally blind —before she underwentsurgery at the CrosbyEye Clinic.

Page 5

A DAY IN THELIFE OF...

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

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WASHINGTON (AP) —Diabetics are about to get the firstdevice that promises to calculatehow much insulin they need aftera meal and signal an implantedpump to emit that dose.

The Food and DrugAdministration recently approvedthe Paradigm system, made byMedtronic MiniMed Inc. andBecton Dickinson.

Patients still will have to prick afinger to see how much bloodsugar is in their systems and pro-gram in how many carbohydratesthey plan to eat. But until now,they’ve also had to calculate theirrequired insulin dose based onthe two figures, math that if donewrong could result in dangerous-ly high or low blood sugar.

The new machine does thatmath automatically, and special-ists hope a result will be better-managed diabetes.

“The smarter these systems canbecome, ... the better our patients

ought to be able to do,” saidAmerican Diabetes Associationpast president Francine Kaufman,a pediatric endocrinologist atChildren’s Hospital of LosAngeles.

Diabetes is a leading cause ofblindness, kidney failure andamputations, and significantlyraises the risk of heart attacks. Itkills 180,000 Americans each year.Some diabetics control their dis-ease with diet, exercise and vari-ous medications; others requireregular injections of insulin, ahormone crucial to convertingblood sugar into energy.

More than 200,000 diabeticshave insulin pumps implanted intheir abdomens, a programmablesystem that can provide moreprecise, regular doses, infusingeven while the patient is sleepingif necessary. But patients still haveto test their blood sugar and thendo some math to decide howmuch their pumps should emit

and when.With the new system, patients

still will perform the glucose test.The pager-sized glucose monitoruses wireless technology to beamthe result straight to the implant-ed insulin pump. Punch in mealplans, and an internal calculatorwill figure target glucose levels,the patient’s insulin sensitivity andhow much insulin is already in theblood to deliver a dose recom-

mendation.The patient has final control,

pushing a button to accept thatdose or override it if more or lessinsulin is needed for some rea-son.

Medtronic said the prescrip-tion-only device will begin ship-ping July 21 and cost $5,995, $500more than Medtronic’s manuallyprogrammed insulin pump.

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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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Readers: Just what the doctor orderedSo many of us wait until the last minute to visit a

physician or ask questions about ailments we areexperiencing. Our hope is that HealthWatch willanswer some of those questions, educate you onmedical breakthroughs and perhaps encourage ahealthier lifestyle.

HealthWatch is a new quarterly publication of TheBrainerd Daily Dispatch that covers a variety ofissues, both local and national. In this first issue, wetried to include stories of interest for people of allages, from tattoo removal (Page 16) to hospice care(Page 26).

Jenny Kringen-Holmes, a former Dispatchreporter, is a free-lance writer for HealthWatch. Shegraduated from Central Lakes College andConcordia College, St. Paul, with a degree in organi-zational management and communication. Kringen-

Holmes is a new mom and currently resides inNisswa.

I graduated from Minnesota State UniversityMoorhead in 2001 with a degree in print and onlinejournalism and moved to Brainerd shortly thereafter.A Dispatch reporter and Web guru for more than ayear, HealthWatch marks my debut as an editor.

I’d appreciate hearing any comments or storyideas you may have on this publication. Send me anote to [email protected], or call medirectly at (218) 855-5879.

Also, be sure to check out HealthWatch online atwww.upnorthhealthwatch.com.

Healthful wishes,

Heidi LakeEditor

HEIDILAKE

JENNYKRINGEN-

HOLMES

Who we arePublisher — Terry McColloughAdvertising Director — Mary PanzerEditor — Heidi LakeEditorial Consultant — Roy MillerCopy Editors — Roy Miller, DeLynn HowardWebmasters — Denton Newman, Cindy Spilman

Cover photo/Steve Kohls

Read HealthWatch onthe Web at www.upnorth-healthwatch.com.

For advertising oppor-tunities call Mary Panzer at(218) 855-5844 or 1-800-432-3703.

E-mail your commentsto [email protected] or mail themto:

HealthWatch is a quarterly publication of TheBrainerd Daily Dispatch.

Heidi LakeHealthWatchBox 974Brainerd, MN 56401

Prescription for healthy reading

5

10

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26

31

20

16

22

COVER STORY: LASIK surgery.

LIFE AND DEATH: Hospice care.

HEALTH WIRE: Notes and quotes.

PARENTING:Post-natal chiropracticcare.

A DAY IN THE LIFE: The ER nurse.

DIETING:The Atkins diet.

COSMETICS: Tatoo removal.

PET HEALTH:Beware of summer heat.

(Continued from Page 32)

your pet is better off staying put in the coolconfines of your home. Brachycephalicbreeds, such as pugs and bulldogs, are mostsusceptible to suffer from heat stroke due totheir physical structure and poor respiratoryabilities. Even with the windows cracked open,a car can reach dangerously hot temperaturesin minutes, and a brief trip into the store canbe deadly. If you spot a pet locked in a parkedvehicle, contact store management or author-ities immediately. Good grooming is also aneasy preventative measure to keep your petcool during the heat of summer.

Hot pavement“Dogs have the same shoes on year round,”

Rehnblom said, noting how dangerous hotpavement can be on dogs’ pads. Rehnblomsaid he sees dogs every year who went too faron hot pavement and got blisters on its feet. Ifyou’re going to take your dog for a walk,Rehnblom suggests avoiding hot pavement.Also, avoid the heat from 10 a.m. to 4 p.m., thehottest times of the day.

Too much sunDogs can get burned by the sun just as eas-

ily as humans. Dogs with light-colored coatsor those with light-colored noses are especial-ly susceptible to a bad burn. Your best bet?Apply a layer of sunscreen to their ear tips andnoses before going outdoors. And provideplenty of shade.

Storm PhobiaThe booming sound and changes in the

barometric pressure signaling an approachingthunderstorm can unleash fear in many dogs.If your dog is affected by storms, Rehnblomsuggests you put them in the lowest and cen-ter-most room in your house. He also said pro-viding a kennel in that room for your pet tohide in can help them feel more secure. Insome instances, veterinarians can dispensetranquilizers to help pets get through thestorm, or similar noisy events, with minimalfear.

AccidentsFireworks, energy, or even a dog’s curiosity

to see what’s going on can be just a few of thereasons that make dogs run from home. It’simportant to keep your dog in a fenced-inyard or on a tie-out or leash to prevent themfrom running to high traffic areas and getting

hit by a car. Also, be sure to keep proper iden-tification tags on your pet’s collar or invest inmicrochip technology in case he or she doesrun away from home so they can be safelyreturned. When going to loud concerts orfireworks displays, be sure to leave your pet athome and locked up safely. Also, have yourpet spayed or neutered to decrease theirdesire to wander from home.

Ear infectionsRehnblom said ear infections are one of the

most common problems he sees during thesummer. Be sure to dry out your dog’s ears asmuch as possible after swimming and use acleaning product, available from your veteri-narian or many pet stores, to prevent seriousinfections from occurring.

Lapping it upAll that summer activity and heat can bring

on quite a thirst. Be sure to supply your petwith plenty of fresh, cool water throughoutthe day. Don’t allow your pet to drink standingwater in puddles or collected in pools, asmuch of this water can contain algae andcause gastroenteritis, or stomach upset, inyour pet.

Warm summer months lead to many risks for pets

34 DISEASE:Managing diabetes.

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Fishing and Sun!A great summer combination if you stay protected by sunscreen

1 in 5 of us will develop a skin cancer as a result of too much sun! If diagnosed,do you know your best option for treatment? Mohs Micrographic Surgery hasthe highest cure rate of all available treatments and minimizes scars anddisfigurement associated with conventional surgeries.

This state of the art surgery requires a highly trained surgeon specialized indermatology, pathology and reconstructive surgery. The surgeon uses theaccuracy of a microscope to see beyond the visible disease to remove the cancerand all its “roots” leaving the healthy tissue unharmed. Cure rates are up to 99%even after other treatments have failed.

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Summertime can be a great time for caninecompanions. But these long summer days canalso spell trouble when pet owners fail to takethe right precautions.

Veterinarians Steve Rehnblom and WalkerBrown of the Animal Care Center in Baxtershare a few potential summer pet threats andthe steps you can take to keep your pet safe,happy and healthy all season long.

TicksMany ticks throughout the Midwest carry

Lyme and Ehrlichia disease. Both diseases canaffect humans and animals alike. So far thisyear, Rehnblom said about 25 to 30 percent ofLyme disease tests came back positive. Topicaltreatments such as Frontline and Advantix areavailable to treat fleas and ticks.

Be sure to check over your pet’s skin andcoat after coming in from the outdoors. If atick has embedded itself into your pet, usetweezers to grab and remove as much of thetick as possible.

A yearly vaccination to prevent Lyme dis-ease is also available from your veterinarian.

FleasThey may be small, but they can sure wreak

havoc on a pet. Notonly will fleas makeRover rollover anditch all day and night,but these bugs can alsocarry tapeworm and cause aller-gies, according to Rehnblom.Collars and preventative medicinesare available to fight off fleas. Goodgrooming is also essential in keepingfleas in check.

MosquitoesOutbreaks of the West Nile Virus are all the

buzz lately. Not only does West Nile affecthumans, the disease can also strike dogs.Mosquitoes are carriers of both West Nile andheartworm disease.

Rehnblom suggests pet owners have theirdogs tested on an annual basis for heartworm.If the test comes back negative, the animal willthen be put on a preventative medication tobe taken throughout mosquito season.

As for the West Nile Virus, to date, there is

no preventative medication or vaccine avail-able. Your best bet is to avoid mos-quitoes altogether — get rid of

standing water around your home,stay in screened-in areas, and even

apply repellent to yourself and yourpets’ coat when going outside dur-

ing early evening, at dawn or atdusk.

Biting flies and gnatsJust when you think you’ve got Fluffy pro-

tected from the bugs, out come biting fliesand gnats. Flies tend to bite around the earsand result in scabs, Rehnblom noted. Gnatbites show up as smaller welts and leave a redring around them. Prescription and non-pre-scription products are also available for ward-ing off these pests.

OverheatingThe mere mention of a “car ride” will work

many dogs into an excitable frenzy, but some-times

(Continued on Page 33)

PET WATCH

Watch animals’ health in summerSTORY/Jenny Kringen-Holmes

5

During LASIK surgery, an excimer laser is used to reshape the cornea, resulting in clearer vision.

DITCH theGLASSESSee 20/20 in lessthan 10 minutes

Without her glasses, Barb Zajac was legally blind.After less than 10 minutes of surgery, Zajac can seewell enough to legally drive a vehicle without wear-ing any type of corrective lenses.

Her vision was 20/1,000, meaning what she couldsee from 20 feet away could be seen by someonewith 20/20 vision from 1,000 feet away.

Zajac said while lying in bed she couldn’t even seeher alarm clock only a few feet from her bed.

Zajac, 36, wore glasses since she was 12, and con-tacts since she was 19. After a couple instanceswhen she lost her contacts, Zajac got frustrated andbegan thinking about getting laser-assisted in situkeratomileusis, more commonly known as LASIKsurgery.

(Continued on Page 6)STORY/Heidi LakePHOTOS/Steve Kohls

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Northern Orthopedics, Ltd.OAK RIDGE PROF. BLDG., 2014 SOUTH SIXTH STREET

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Northern Orthopedics, Ltd.

(Continued from Page 5)“I wanted to see without glasses or contacts,”

Zajac said.Zajac, of Pierz, made an appointment with Dr.

Jerome Poland at the Crosby Eye Clinic in Baxterfor an eye exam to see if she qualified for theprocedure.

Zajac had an eye exam on a Thursday, LASIKon Friday and was back to work Monday withperfect vision.

Thursday began with a typical eye exam.Letters were projected on a wall and technicianJerry Villella asked, “Which is better, one ... ortwo.” Villella determined Zajac’s prescription,checked for retinal problems and signs of glau-coma as well as the curvature of her eye andpupil.

Poland also tested Zajac, declaring her eyeswere healthy and her prescription was stable,making her a “good candidate” for the surgery.


Dr. Jerome Poland discussed LASIK surgery with Barb Zajac recently at the Crosby Eye Clinic.Poland gave Zajac an eye exam and performed the surgery the next day.

She was a goodcandidate

Barb Zajac recently had her eyes tested at theCrosby Eye Clinic.

Campaign set to educate aboutdisorder

The national CHADD(Children and Adults WithAttention-Deficit/HyperactivityDisorder) organization is startingan initiative to educate the publicon the condition.

For more information on thecampaign and about ADHD, visitwww.chadd.org, or call CHADD’snational resource center at 800-233-4050.

Yerba mate tea increases cancerrisk

Yerba mate tea is brewed fromthe dried leaves of the Ilexparaguayensis plant, a type ofholly tree native to SouthAmerica. The bitter drink is popu-lar in many South Americancountries and parts of the MiddleEast. In the United States, it’savailable as a tea and in pill form.

Supplement makers tout theherb’s energizing effects andhigh vitamin and mineral con-tent, but recent research has sug-gested that regularly drinkinglarge amounts of mate increasesthe risk of developing severaltypes of cancer.

Cutting drug costsWhether or not the govern-

ment acts to lower drug prices,consumers can cut their drugcosts in many cases by compari-son shopping, buying in bulk,choosing generics over namebrands and splitting pills. For adramatic example of the potentialsavings, consider the case of theanti-anxiety drug Xanax (alprazo-lam).

According to “Shopping forDrugs,” a report slated for publi-cation this week by the NationalCenter for Policy Analysis, a sen-ior or uninsured consumer pay-ing full price for Xanax couldbring the cost down 95 percent.But there are caveats: Not every-one can take generics. The sav-ings would be lower for con-sumers with prescription drug

coverage. And, as the Center forPolicy Analysis notes, patientswho buy drugs from multiplesources lose the protection ofhaving a single pharmacist checkfor drug interactions.

The center is a nonpartisan,nonprofit research group thatpromotes alternatives to govern-ment regulation and takes what itcalls a “pro-free-enterpriseapproach to health care policy.”

Mercury can be serious catch toeating fish

Lee Flynn thought she had ahealthy lifestyle. She was thin andactive and she ate well — withlunches of tuna and fresh vegeta-bles and dinners of halibut, seabass or swordfish.

Yet she spent more than adecade plagued by fatigue, stom-achaches and headaches, as ifshe had “a wicked hangover.”Herhair started falling out. Memorylapses made her think she waslosing her mind.

“I really felt something waspoisoning me, but I couldn’t findthe source,” said Flynn, 59.

The Sausalito, Calif., anthropol-ogist and documentary filmmak-er eventually ended up in theoffice of Dr. Jane Hightower, aSan Francisco internist. WhenHightower heard that Flynn waseating fish nine times a week, sheimmediately ordered a blood testfor mercury. A heavy metal thataccumulates in the flesh of fish,especially the popular predatoryvarieties, mercury can also accu-mulate in people who eat thosefish.

The test’s stunning result:Flynn’s mercury level was 20.6micrograms per liter of blood. Asafe level is about 5, according tothe federal EnvironmentalProtection Agency.

Like Flynn, many adults andchildren may be unwittingly over-dosing on mercury, sayHightower and some publichealth activists, and it’s likely thatmost of them are going undiag-nosed.

THE HEALTH WIRE

From Dispatch Wire Services

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Imagine having the opportunity to live as a member of a community where living is tailored toyou! At Excelsior Place, regardless of your idea of independence or enjoyment, we have theservices to meet your personal needs, both now and in the future. The best time in life is whenyou can relax and enjoy the “good life” that you’ve earned. At Excelsior Place, you’ll find all theamenities you need to enjoy life to its fullest while maintaining your independence. A rich,rewarding lifestyle awaits you, providing comfort, and the peace of mind you are looking for!

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“He wanted to die there,” Yeh said. “We try to fulfill those types ofwishes.”

Under hospice care, the hospice team tries to make patients as com-fortable as possible by easing their pain. Yeh said people in hospicecare often complain about pain, nausea, sleeplessness, depression,constipation and shortness of breath. Doctors, nurses and pharmacistswork together to assure comfort during the patient’s last days.

“We want (patients) to dwell on the quality of life they have, not thatthey’re going to die,” Klein said.

Hospice nurses do more than just care for patients. Kochsiek said alot of hospice is caring for the family by educating them about what’sgoing on with their sick family member.

Klein said she enjoys being a hospice nurse because it allows her toget to know her patients and share her personality while she’s working.Kochsiek said Klein has been known to sing and dance for her patientsin order to brighten their day.

“In hospice care you become part of (the patient’s) family,”Kochsiek

said.Yeh remembered one of his cancer patients who was cured and

years later returned with another form of cancer.“I’ve known this woman 15 years now,”he said. “I’ve seen pictures of

her grandchildren, I know every one of her children’s names.”In an occupation that frequently ends in death, members of the hos-

pice team said they sometimes feel stressed, but try to stay focused ontheir job.

“Some days it’s like, I can’t have any more death right now, I justcan’t,”Klein said. “Then you get a second wind ... you always have to beready for the next patient.”

Klein said the hospice nurses talk to each other and help ease eachother’s workload when someone feels overwhelmed.

“It helps to concentrate on things in our real life, happier things,”she said.

Kochsiek and Klein agree getting to know patients and their familiesoutweigh the hardships of their job.

“It’s very fulfilling, meaningful work,” Klein said.

‘You always have to beready for the next patient’

7

Dr. Jerome Poland per-formed LASIK eye sur-gery on Barb Zajac ofPierz. Poland performsabout 20 LASIK surgeriesone day a week at theCrosby Eye Clinic.

Technician Jerry Villella cleanedBarb Zajac’s eyelids with cottonswabs before LASIK surgery toprevent dust or other foreignobjects from entering her eyes.

Education plays a big role(Continued from Page 6)

Poland said the odds of Zajac getting 20/20 visionafter surgery were 90 percent, while the odds ofgetting 20/40 vision were 98 percent.

Between exams, Zajac and her husband watcheda video about the LASIK procedure to preparethem for what was going to happen the next day.

“Most of our time is spent preparing patients forsurgery and doing post surgery patient education,”said Bob McBeath, outreach coordinator. “We want(patients) to know what’s to be expected every partof the way.”

Zajac’s appointment was 1:30 p.m. on a Friday atthe Crosby Eye Clinic in Crosby. Zajac wasn’tallowed to wear contacts two weeks before surgerybecause they tend to reshape the eye. She couldn’twear makeup one week prior to surgery or hair-spray the day of surgery in case it got in her eyes.Zajac underwent another eye exam to make sureher eyes were ready for surgery.

Zajac was then moved to a surgical suite, a rela-tively small, rectangular room where the surgerytook place.

Poland, Villella and two other technicians were inthe surgical suite at the time of the surgery. Zajac layback in a dentist’s-type chair while Poland and his

technicians got situated. This was Poland’s 24thLASIK surgery of the day.

First, Zajac’s eyelids were cleaned and she wasgiven numbing eye drops. A lid speculum was usedto hold her eye lids apart to prevent blinking.

Zajac was told to stare at a red light and keep hereyes as still as possible throughout the procedure.Clutching a Nerf football to help ease her stress,Zajac said she was confident as she lay perfectly stillstaring at the light.

First, a machine called a microkeratome wasused to slice a thin, circular flap in Zajac’s cornea,the transparent outer layer of the eyeball. Polandthen folded the flap out of the way while he usedan excimer laser to remove corneal tissue. The laserreshaped the cornea by using an ultraviolet lightbeam to remove tiny bits of tissue from the cornea.The flap was then laid back into place, covering thearea where the corneal tissue was removed. Whena cornea is reshaped, it focuses light into the eyebetter, providing clearer vision.

The laser was used on each of Zajac’s eyes forless than 40 seconds. The entire surgery took lessthan 10 minutes. And then came “the wow factor,”what Poland calls the most rewarding part of hisjob.


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Bradley R. Pierce, M.D.Fellow, American College of General Surgery

When it comes to surgery, you want the best possible care. But you shouldn’t have to drive forhours to find it. At Brainerd Medical Center and St. Joseph’s Medical Center, our comprehensivesurgery team routinely performs delicate blood vessel surgery, non-cardiac chest surgery,advanced laparoscopy, oncology-related surgery and more. In August, our surgical team will begrowing to include Ross Bengston, M.D. – just another way to show we are committed to servingyou. Experienced specialists. Comprehensive care. And a team approach to keeping you well. It’s all here at BMC. Call (218) 855-5477or 800-277-8262.

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Before LASIK Barb Zajac was legally blind. Immediately after surgery her vision was good enough to legally drive a vehicle without wearing correctivelenses.

During surgery, a camera projected Barb Zajac’s eye on a TVscreen that could be seen from an observation room. Thisimage was projected on the screen after a thin flap was cut inZajac’s cornea.

“Most people don’t want to die alone in sterile surroundings, they want to spend their last days at home.”


Kochsiek spent several years as an intensivecare nurse at a Twin Cities hospital, but hasbeen a home care/hospice nurse in theBrainerd area for the last 14 years.

“(Hospice) is the best way to get the bestcare,” she said. “It’s a lot harder to watch peo-ple die in intensive care (rather than in theirown home).”

“We believe in (hospice),”Klein said. “To diewithout it would be sad.”

Klein, a home care/hospice nurse for thelast 22 years, said hospice is more than med-ical care, it’s about the support given topatients and their families.

St. Joseph’s Medical Center’s Hospice pro-gram includes people from many back-grounds. Social workers, spiritual workers,home health aides and pharmacists join theteam of hospice nurses and doctors who pro-vide comfort to dying patients. Twice a monththe hospice team meets to review patientcases.

Fifteen home care/hospice nurses cover aterritory that includes Brainerd and its sur-rounding areas. Hospice averages eightpatients at one time, while home care patientsfill the rest of the nurses’ schedules.

Home care patients are people who are

sick, but prefer to be cared for at home ratherthan in a hospital. Home care patients areexpected to recover from their illness, whilehospice patients have limited life expectan-cies.

To qualify for hospice care, patients musthave a primary caregiver, usually a familymember, who stays with them at all times andmust not be treating their illness aggressively.

Timothy Yeh, hospice medical director andoncologist at Brainerd Medical Center, saidwhen a patient’s condition is at the pointwhere further treatment is not likely to helpthem get better, he suggests they forgoaggressive treatment. At that time, patientscan decide to start hospice care.

The purpose of hospice is to allow peopleto live out their lives at home, rather than in ahospital.

“Most people don’t want to die alone insterile surroundings, they want to spend theirlast days at home,” said Barb Anderson, direc-tor of home care and hospice at St. Joe’s.“Hospice exists to make this possible.”

Yeh said he remembers a patient who want-ed to put his bed on the porch of his lakehome overlooking the water.


Dr. Timothy Yeh, an onocologist at BrainerdMedical Center, is the hospice medical director.

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Poland asked Zajac to close her eyes and situp. When Poland instructed Zajac to open hereyes, Zajac had 20/40 vision.

“It was amazing,” she said.She could see well enough to legally drive a

car without glasses immediately after surgery.Zajac was instructed to sleep at least three

hours following the surgery in order to speedup the healing process. For the rest of the dayshe had to wear eye shields to prevent dustand other foreign objects from getting in hereyes. She was given three types of eye dropsto help her heal.

The next day, Saturday, Zajac headed backto Crosby for a follow-up check with Poland.Her vision was better than 20/20.

Zajac has to return for chone month and one year afsure everything is healing

“It takes one year for thely heal, but 80 percent wifirst month,” Poland said.

Zajac said she did not ethroughout the surgery, scratchy for about three ho

“There was no real defi“It was just a little uncomfafter surgery.”

Poland is one of the pioeye surgery, claiming he wpeople to perform laser ssurgery, Poland said he min the eye with steel andprocess called radial k

‘There was no realwas just a little unc

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eck-ups one week,ter surgery to makeproperly. flaps to complete-

ll be healed in the

ncounter any painbut her eyes felturs afterward.

nite pain,” she said.rtable a few hours

neers of correctiveas one of the firstrgery. Before laserde actual incisionsdiamond knives, aeratotomy. Today,

Poland said the Crosby Eye Clinic is a teachingcenter for laser surgery so it always has themost up to date equipment.

“Dr. Poland has the best equipment outthere,”Villella said. “People come from all overto have LASIK here.”

Most insurance companies don’t coverLASIK surgery because it’s an elective proce-dure. Crosby Eye Clinic charges $999 per eyefor LASIK which includes all the follow-up vis-its up to one year following the surgery. Anadditional $132 is charged for the pre-surgeryexam, making the total cost of LASIK $2,130.

Poland and Dr. Ina Luca each perform about20 LASIK surgeries one day a week at theCrosby Eye Clinic. They also do other oph-thalmic surgeries such as glaucoma andcataract removal.

definite pain. Itomfortable a few surgery.’

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Registered nurse Kris Tollefson started paperwork for one of her emergency room patients.

It’s a Friday afternoon on a busyrace weekend. Five nurses andthree doctors work the mid-dayshift at St. Joseph’s Medical Centeremergency room in Brainerd.

In just six hours, dozens of peoplevisit the ER with ailments varyingfrom bumps and bruises to cardiacconditions. Regardless of the sever-ity, each nurse is called upon to pro-vide patients with the best care pos-sible.

With the hospital’s approval, thiswriter spent time following nursesand finding out, first hand, what atypical day is like in the fast-pacedenvironment of an emergencyroom.

This is just a glimpse into a day inthe life of an ER nurse.

(Continued on Page 11) STORY and PHOTOS/Jenny Kringen-Holmes

nurse

The

ERA DAY IN THE LIFE

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Mary Klein (middle), a home care/hospice nurse, talked with two of her co-workers. Klein said being a hospice nurse is stressful because she oftenhas to deal with the death of her patients, some of whom she’s become

close to. Klein said hospice nurses talk to each other to help ease eachother’s stress.

Hospice care helps ease the inevitableKaren Kochsiek and Mary Klein know the ben-

efits of hospice care first hand.They’d even recommend the program to their

closest friends and family members.They are hospice nurses.


STORY/Heidi LakePHOTO / Nels Norquist

11

Dr. Paul Rud, an orthopedic surgeon at St. Joseph’s Medical Center, put a cast on a patient whobroke his wrist after falling off a skateboard.

ER not like TV show(Continued from Page 10)

2 p.m. Registered nurse Sal Peterson hasone hour to go on her 7 a.m. to 3 p.m. shift inthe emergency room at St. Joe’s. Peterson hasworked as a nurse for 35 years with about halfthat time spent at St. Joe’s.

2:05 p.m. Peterson currently has twopatients. One arrived earlier in the day com-plaining of chest pain. An electrocardiogram,or EKG, and several tests have been done.Peterson visits with the patient briefly andexplains the man likely has pericarditis, orfluid around his heart. She lets them know adoctor will be in soon to discuss his diagnosisand answer any questions he may have.

2:09 p.m. Several of the ER nurses visit atthe nurse’s station and discuss the level ofexcitement in the ER compared to what’s por-trayed on television. Peterson, noting one par-ticular nurse who had been working since 3a.m., said there is difficulty in covering all thenecessary shifts in the ER.

“We have a hard time finding nurses withER experience,”Peterson says. “There’s a lot tolearn. How to start IVs, how to read EKGs.”

2:11 p.m. Peterson just received a newpatient. The woman, coming in by wheelchair,asks to use the restroom first. After beingassisted by Peterson, the woman is wheeledinto an exam room and helped into a gown.Asked if she is experiencing any pain, thewoman answers, “Nothing’s working. That’sall.” She complains of shortness of breath.After helping her into bed, Peterson beginsthe standard line of questioning. She alsoadministers oxygen, takes her blood pressureand hooks her up to a cardiac monitor toclosely monitor her heart rate.

2:31 p.m. Peterson visits with ER doctor andinternal medicine specialist Dr. Hong Liregarding the new patient. After giving Li thewoman’s history and current status, Petersonstarts the necessary paperwork.

2:39 p.m. While Peterson takes a phonecall, the nurses discuss the upcoming week-end shift and the American MotorcycleAssociation races at Brainerd InternationalRaceway. Many events and vacationers influ-ence the amount of activity in the ER, they say.

One nurse noted something as simple asbathroom breaks are dictated by that particu-lar day’s pace in the ER.

“And others when it’s so slow...”adds anoth-er.

Off the phone, Peterson jokes with Dr. Jonvan der Hagen who critiques her writing on achart, “And sometimes you work with doctorswho are so impossible,” she said.


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Patients triaged from most to leastsevere while getting checked in

(Continued from Page 11)2:49 p.m. Peterson checks in with her car-

diac patient who is currently having anechocardiogram done on his heart by an EKGspecial diagnostics technician. Watching fromthe doorway, Peterson points out the bloodflow to the heart as well as the valves openingand closing.

2:55 p.m. Peterson visits with her femalepatient who was experiencing shortness ofbreath. Examining her arms in preparation foran IV, Peterson notes the woman has tiny veinsand is very bruised from previous blooddraws. She calls in a fellow RN for assistance.Teamwork in the ER is an important aspect toproviding the best care to patients.

3 p.m. As the nurses update their chartsbefore the next shift comes on, another ERpatient’s husband approaches Peterson andasks if his wife can have a glass of water.

“I only ask because you got me a cup of cof-fee before,” the gentleman jokes.

3:10 p.m. Peterson updates an incomingnurse on her current patients as she handsthem over. There’s a flurry of activity as the ear-lier shift prepares to leave and the new shiftarrives. Peterson finishes her paperwork andgets ready to go home, but not before one lastjab by van der Hagen who jokes with Petersonon her new “celebrity status.”

3:15 p.m. RN Kris Tollefson is now on dutyfor the 3-11 p.m. shift and, without much timeto spare, gets her first patient of the day. Awoman has come to the ER complaining offoot pain. She tells Tollefson and nurse JohnStone it began hurting about 10 days ago. Sherates her pain, on a scale of one to 10, as a 4.5.She notes her history of gout, blood clots andhigh blood pressure.

3:25 p.m. Tollefson changes the sheets inRoom 1 and prepares for the next patient asshe talks about the expectations of variouspeople who come to the ER.

“Some people think they can just come inand (immediately) be treated,” Tollefson says,noting the patients are triaged, or prioritizedfrom most to least severe when they firstcheck-in at the admitting desk. “Sometimespeople just don’t understand how thingswork. So I try to explain to them why there is await. It helps if they understand the processbetter.”

Tollefson is no stranger to the medical field.She has worked in the ER for about one year.Previously, she worked in the cardiac care unitat St. Joe’s and also as a nurse on the thirdfloor. She has also worked as an emergencymedical technician for North Ambulance inBrainerd.

“With nursing, you can move from one areato the next,” Tollefson said. “You can changeareas and keep things interesting. If you pay

attention you can learn something new everyday.”

3:31 p.m. A car comes in the emergencyroom car port. A female passenger complainsof serious abdominal pain and has difficultygetting out of the vehicle. Tollefson, Stone andtwo fellow nurses help her into a wheelchairand into the ER. Stopping at the nurse’s sta-tion, the triage nurse (aka: “the orchestraleader,”Tollefson said) directs them to a room.

“You never know what’s going to be out inthe garage waiting for you,” Stone said.

3:35 p.m. An older gentleman comes to theER complaining of pain, noting it may be kid-ney stones. Tollefson and Stone get the man’svital signs and medical history once he’s in theroom and in a gown.

“I’m healthy as a hog,” the man tells themwith a laugh.

3:38 p.m. Back at the nurse’s station,Tollefson looks at the chart of her patient inRoom 11 with foot pain. An X-ray has beenordered as well as a uric acid test to check forgout.

3:46 p.m. Tollefson discharges a womanwith bursitis of the knee. She goes overinstructions with the woman and her husbandand informs them of her follow-up appoint-ment with Dr. Paul Rud. Before leaving,Tollefson draws a blood sample to check thewoman’s ProTime, or blood coagulation abili-ty.


Registered nurses Sal Peterson (right) and Joe Berge reviewed a patient’s chart. Peterson has workedas a nurse for 35 years.

Caring for a baby is rewarding —and hard work. Like other kinds ofwork that requires lifting, bending,long periods of sitting, and repeti-tive motions, it can be harmful toyour body. Try these simple tips toprevent problems that may hinderyour parenting:

• Put one foot on a box or lowshelf when you stand and changediapers. This causes your pelvis totilt in a way that decreases pelvicfatigue.

• Keep work surfaces at a com-fortable height. Put somethingunder the legs of the changing table,for instance, to raise it if you’re tall.

• Don’t try to hold the baby andwrestle the side of a crib down at thesame time. Instead, drop the cribside before you pick up the child.

• Don’t bend from the waistwhen you lift the child. Squat with

your back straight, keep the childclose to you, and use your leg mus-cles to rise.

• Don’t bend over into the carwhen putting your child in the carseat. Sit sideways on the seat withthe child on your lap, then rotate toface front and put the child in theseat.

• Make sure your feet are on thefloor and your back is supportedwhen you sit holding your child.Keep your knees at the same heightas your hips or slightly higher.

• Adjust stroller handles soyou’re not bending over when youpush.

• When loading a stroller or gro-ceries in the car trunk, rest one footon the bumper to keep the load closeto your body.

(Source: ColoradoChiropractic Association)

Tips to help ease thestrain of caring for baby

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healthy habits they had while pregnant. As part of his aim to promote healthy living,

Davis travels throughout the country trainingmen and women in proper lifting techniquesto be implemented into everyday life. Heoffers similar lifting courses at his Brainerdclinic and plans to hold pre- and post-natalcourses for new parents in the near future.

A lending library is also available to thepublic at Lakes Chiropractic with resourceson prenatal and post-natal care, as well as anassortment of other topics. For more informa-tion or to register for the free lifting course,call Lakes Chiropractic at 828-4418.

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Jim Davis taught a new mother the proper procedure in lifting a baby out of a car seat.

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3:52 p.m. On her way back to the nurse’sstation, Tollefson stops to clean two rooms,making the beds and emptying the garbage.She discusses how an ER doctor can only rec-ommend to the on-call physician that a patientbe admitted to the hospital. The on-call physi-cian comes to the ER, visits with the patient,reviews their chart and then determines ifthey will be hospitalized, which floor they willgo to, what medications they should receive,the level of activity, and any necessary inter-ventions or the “total plan of care.”Then a floataide comes to get the patient and moves themupstairs.

4:06 p.m. The nurse call light in Room 11goes off. The woman with foot pain asks forTollefson’s assistance to use the restroom.

4:11 p.m. The call light in Room 11 goes offagain.

4:12 p.m. Rud visits with a young man whofractured his wrist while skateboarding. Afterreviewing his X-rays, Rud decides to cast thearm and gives the man his color options forthe cast. Tollefson assists Rud by preparing thenecessary casting supplies.

“I probably won’t be playing the drums forawhile,” the patient jokes.

“Your pain level will tell and cannot do,” Rud tells hi

“I’ve been riding that thpatient says, referring to his nearby. “What a drag.”

4:25 p.m. Tollefson goeinformation with the skatebhim to the hospital pharmaof the ER.

4:34 p.m. After refilling thTollefson reviews current pa

4:40 p.m. Tollefson’s firThere is a one-vehicle rollovNorth. Tollefson, noting shBrainerd Fire Department fosays she wears her pager twhat’s happening outside oto give her a heads-up of whin to the ER.

4:45 p.m. A car pulls introom car port. An elderly into a wheelchair by Tollefnurse. The woman compbreathing and water reterecently hospitalized for simhas had blood clots in her dialysis in the past.

“You did the right thing,”the woman’s daughter of b

‘Your pain level will tell you wha

13I V E I N B A X T E R • 8 2 4 - 5 0 2 7

you what you canm. ing for years,” theskateboard sitting

s over dischargeoarder and directscy on his way out

e blanket warmer,tients with Stone. e pager sounds.er on Highway 371e’s been on ther nearly 13 years,

o keep on top off the hospital andat may be coming

o the emergencywoman is helpedson and a fellowlains of difficulty

ntion. She wasilar problems andlungs and kidney

Tollefson assuresringing her to the

ER. 5:07 p.m. North Ambulance calls the ER en

route with two patients involved in the caraccident on Highway 371. Tollefson takesinformation over the radio of the status of the29-year-old woman and her 7-year-old son.Two more from that same vehicle are alsocoming in by a second ambulance, they note.

At the ER front desk, an inmate from theCrow Wing County Jail, dressed in orange andon crutches, is being admitted.

5:10 p.m. Cleaning another room andchanging the sheets in preparation for theaccident victims, Tollefson discusses howshe’s found various individuals’ pain toleranceto differ.

“People just need to be reassured,” shesaid. “They just need to know that you’regoing to take care of them.”

5:12 p.m. Walking back to the nurse’s sta-tion, van der Hagen passes in the hall andcomments on the unrealistic portrayal of anER on television.

“What I’d like to see is Dr. Green gettingthree ear infections in a row. That’s reality. AndI’d like to see Dr. Green sit down and fill outsome charts now and then.”


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Injured fisherman stillable to joke(Continued from Page 13)

5:16 p.m. The first ambulance from the caraccident arrives in the ambulance port. As theambulance crew pushes a stretcher with the 7-year-old boy to an exam room, the man withpossible kidney stones is pushed in a wheel-chair by a radiology technician and the daugh-ter of the elderly woman with shortness ofbreath all pass each other in front of thenurse’s station.

“Busy day,” the woman’s daughter com-ments.

In an exam room, the female EMT fromNorth Ambulance introduces the young boyand his mother to Tollefson and Stone. Shenotes to both nurses that all occupants of thevehicle were wearing their seatbelts at thetime of the accident and that the vehiclerolled. The boy says the only pain he feels isinside his mouth, while his mother says she’sexperiencing pain in her shoulder and minorcuts on her body.

“It just happened so fast,” the mother tellsthe nurses.

5:37 p.m. Tollefson takes a second to catchher breath and grabs a snack from the break-room before heading back down the hall to

check on her elderly female patient. Shebrings her another warm blanket.

5:40 p.m. A man involved in a motorcycleincident at the BIR races arrives at the ER. Theward clerk comments that nearly all of the 17exam rooms are full, with the exception of thespecialty rooms, designated for specificinjuries. Tollefson takes a few minutes to catchup on her charts.

5:46 p.m. A State Patrol trooper arrives inthe ER asking about the people involved in thecar accident. Tollefson shows him to theirroom.

5:55 p.m. Tollefson decides to run down tothe hospital’s cafeteria before it closes to graba bite to eat and takes her dinner break in theER breakroom.

6:14 p.m. Dinner’s over and Tollefson isback on her feet.

“Let’s see what we’ve missed,” she says asshe grabs a couple charts to catch up with herpatients’ status.

6:17 p.m. Lab results are back on severalpatients. Tollefson restocks the blanketwarmer, then checks in on her elderly femalepatient.

6:26 p.m. Tollefson visits with an older cou-ple sitting at the admitting desk. The manexplains he cut his hand with a fillet knifewhile cleaning fish. Tollefson discusses roomoptions with the triage nurse before showingthe couple to an exam room.

“I didn’t have time to shave and shower

before I came,” the man jokes with Tollefsonas she unwraps the bloodied towel from hisinjured hand. The cut measures 2 centimeterslong by 1/2 centimeters wide, Tollefson tellsthe man who continually apologizes for “tak-ing up” her time.

“I used to be a Boy Scout,” he tells her. “Ididn’t make Eagle though.”

6:45 p.m. Stone checks in with Tollefson tolet her know all is well and that he’s discharg-ing the young boy involved in the car accidentas well as his mother and another occupant.

6:49 p.m. Dr. Clay Schulte has met with theman who cut himself with the fillet knife andasks Tollefson to wash the man’s cut and givehim a tetanus shot. Tollefson visits with thefriendly couple and prepares him for suturing.

7:08 p.m. As Tollefson checks in with apatient, a nurse at the nurses’ station com-ments on the night’s activity.

“This is one of those busy nights that’s notgoing very fast,” she says.

7:12 p.m. Tollefson visits with the triagenurse on the ER’s current patients. She thenrevisits the couple with the “fishing injury” asSchulte finishes up suturing.

Once again apologizing to the staff for hisinjury, the man concedes something good didcome of his visit.

“We wouldn’t have had the chance to meetall these nice people,” he said.


Regular chiropractic adjust-ments are important for thewell-being of expectant andnew moms.

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Being a mom is hard work. And that’s not even considering the 3 a.m.

feedings, diaper changes and teething.Carrying and caring for your little bundle

can cause major stress on your ligaments andmuscles. Something as simple as learningproper lifting techniques as well as perform-ing a few easy exercises each day can make allthe difference in an already hectic woman’slife.

Jim Davis of Lakes Chiropractic in Brainerdsays regular chiropractic visits during preg-nancy are the best way to maintain yourbody’s proper alignment, as well as ease theaches and pains associated with pregnancy.

Eighty-four percent of chiropractic patientsreceiving chiropractic adjustments reportedrelief of back pain during pregnancy, accord-ing to a 1991 study. Davis said first time moth-ers under chiropractic care have 24 percentshorter labor times versus women who donot. In addition, chiropractic patients whohave had previous children enjoyed 39 per-cent shorter labor times.

“I believe pregnancy and labor should bean unforgettable experience, and not becauseit hurts so bad,” Davis said.

Vertebral subluxation takes place due tothe hormonal changes in an expectant moth-er’s body. This condition brings on back aches

in pregnant women because the spine has lostits normal position and irritates the surround-ing nerve tissue. Davis explains through pre-natal chiropractic care the chance and/or painof subluxation can be minimized.Chiropractic techniques can also ensure thepelvis is correctly aligned to allow sufficientspace for the developing baby as well as for aquicker and easier delivery.

If a woman enters her pregnancy with exist-ing low back pain, those problems may onlybecome magnified as the pregnancy pro-gresses, Davis said. If those same pains aren’taddressed during pregnancy, long term painwill result.

Davis said it’s important a new mom visitsher chiropractor soon after giving birth tohelp in the healing process. A chiropractorcan share tips on how to ensure proper mus-culo-skeletal health. Many moms experiencepains from the most unsuspecting situationsafter their babies are born, Davis said. Forexample, new mothers are always lookingdown as they hold or nurse their newborn,putting strain on the neck and shoulders.

“We want to keep mom’s spine in shapeand comfortable,” Davis said, adding propernutrition is key. He encourages moms to con-tinue the


FORMOTHERS

ONLYChiropractoroffers advice

STORY/ Jenny Kringen-HolmesPHOTOS/Nels Norquist

Lakeland PsychiatryWelcomes New Physicians

CLINIC

lakelandpsychiatry

St. Joseph’s Medical Center523 North Third Street

Brainerd, Minnesota 56401

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


7:30 p.m. After being notified her elder-ly female patient will be admitted to thehospital, Tollefson visits the woman to startan IV. The woman tells Tollefson she is hun-gry, and Tollefson offers to get her a sand-wich.

7:43 p.m. As one patient is movedupstairs to a regular room, more continueto come through the doors of the ER.

7:55 p.m. A woman comes to the ER withher little boy in tow. The boy is crying andbleeding from the left side of his face.

“This one is for us,” Tollefson says as sheleaves the nurses’ station. She approachesthe boy and helps him into a wheelchair.

The boy’s mother tells the nurses her sonfell off his bike as they examine his skinnedup knees and hands as well as a swollen lipand cut on his forehead. Tollefson puts iceon all the boy’s “owies” and tries to calmhim.

Meanwhile, the triage nurse stops by theexam room to tell Tollefson the boy willneed to be moved as that particular roomwould be needed for a new patient comingin to the ER with an abscess.

“This one’s going to be a challenge,”Tollefson comments as she leaves the roomfor more supplies.

But she takes it all in stride. After all, it’sjust another day in the life of an ER nurse.

‘This one’s go

A motorcyclist from the supeEmergency Room. X-rays show a

15

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.

ing to be a challenge’

rbike races at Brainerd International Raceway visited the clean break of the humerus bone in the arm.

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Three years ago, a 24-year-old womandecided to leave a lasting impression — liter-ally.

Armed with courage, she entered a tattoostudio and changed herself forever. Nearlytwo hours later, she emerged with a feeling ofsatisfaction and a colorful work of art on herback.

Fast forward three years. That same womanis now 27 and a new mom. No longer is thattattoo so appealing. In fact, these days italmost seems larger than life when she looksin the mirror.

As the trend of body art continues to gainmomentum, so does the business of tattooremoval.

Dr. Kurt Waters and Dr. Paul Lundstrom offacial plastics at Brainerd Medical Center offertattoo removal as part of their services at theirBrainerd clinic. Waters, who has been in the

practice for eight years, says the most com-mon reason many men and women seek tat-too removal is due to a change in lifestyle.They want a previously applied tattoo,whether it be a design, a symbol or even aname, erased from their bodies and lives for-ever.

Unfortunately, Waters says, it isn’t as easy as“erasing” the ink.

The History of TattooingThe word tattoo comes from the Tahitian

“tatu” which means “to mark something.”Tattoos are created by injecting colored pig-ment into tiny holes punctured into the skin.Once applied, tattoos become a permanentfixture within the layers of skin.

Tattoos are believed to date back to 1300BC, and possibly earlier, when Egyptian mum-mies were found to have blue marks resem-bling tattoos on their skin. Markings can signi-

fy affiliation with certain groups or organiza-tions. In some cultures, tattoos are used tomark married women or even criminals.

In 1891, the first electric tattooing machinewas patented. During World War I and II,many soldiers proudly marked their militaryaffiliation through tattoos. As time went on,the fad began to fade, but today tattooing ismaking a strong comeback. Both amateursand professionals alike are leaving their markon bodies throughout the world.

Making the ‘Permanent’ Not So PermanentWaters recalled a male patient who wanted

to join the U.S. Marine Corps. The young manwas turned away due to the fact he had tattooson his face. He came to Waters looking for a“quick fix,” but was surprised to find out theprocess is more involved than that.


As the popularity of tattooing increases, so does the businessof tattoo removal. The facial plastics department at BrainerdMedical Center is one of a few area clinics that offers tattooremoval as part of their services.

STORY and PHOTOS/Jenny Kringen-Holmes


Atkins approach to weight loss and comparedit to the American Heart Association’s Step 1diet, a low-fat approach. Westman studied 120overweight volunteers and found after sixmonths people on the Atkins diet lost an aver-age of 31 pounds compared to 20 pounds onthe Step 1 diet.

“(People on the Atkins diet) lose weightbecause they are cutting out whole foodgroups,” Coughlin said. “... but moderateamounts of carbs have a place too.”

Westman’s study found people on theAtkins diet had an 11 percent increase in HDL,good cholesterol, and a 49 percent decrease intriglycerides, which may raise the risk of heartdisease. On the AHA diet, HDL wasunchanged and triglycerides dropped 22 per-cent. LDL, bad cholesterol, didn’t changemuch on either diet.

Why people who have increased their fatintake have increased HDL levels is surprising

to many doctors.“In my opinion, weight loss will control

cholesterol levels, but research is not showinganything for sure yet,” Coughlin said.

Westman’s study also found that more peo-ple stuck with the Atkins plan.

After unsuccessfully trying various dietingmethods for years, Sandi and Bob Colbensonof Brainerd decided to try the Atkins diet ninemonths ago. So far Sandi has lost 30 poundsand Bob has lost 50.

“We don’t call it a diet. We have justchanged our eating habits by watching ourcarbohydrate intake,” Sandi said. “This issomething we’ll do for the rest of our lives.”

Sandi said she and her husband tried theSlimfast diet, calorie counting and exercisingand nothing has worked as well as Atkins.

“Before we started this I told (Bob) I could-n’t go on a diet and exercise at the same timebecause I hate doing both of those things andI knew I’d never last,” Sandi said. “(On Atkins)

I lost weight without doing anything extra.”Because the Atkins approach to dieting has

only recently become popular, a limitedamount of research concerning the long termeffects of high protein, low carbohydrate dietsis available. Until research is completed, manydoctors and dietitians, including Coughlin,will stick to recommending low-fat diets.

One thing is for sure, Coughlin said, two-thirds of American adults are overweight, astatistic she calls a national crisis.

“Obesity is a major crisis in this countryright now,” she said. “We are going to see somany more people with chronic diseases withthis increase in obesity.”

Coughlin said it’s been proven grains andcertain vitamins not provided in low carbohy-drate, high fat diets help lower the risk of can-cer and other chronic diseases.

“Eating right and exercise is ultimatelywhat’s going to (lead to a healthier life),”Coughlin said.

Study shows good cholesterol increasesafter six months of Atkins diet

Doctors zap tatoos with laser

16

For all your Pharmacy Needs

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Poison Ivy!Poison Ivy!Ask about Zanfel.

CR 3 Crosslake, MN218-692-2502 or 800-595-7312

Mon-Fri 9-5:30; Sat [email protected]

Steve Kappes,Owner/Pharmacist

Summer is here and although people flock tothe Brainerd lakes area to soak up the sun onone of the many beaches this area has to offer,there is one dreaded fact of summer that tomany isn’t so appealing.

Putting on a bathing suit. For some, the task isenough to skip out on outdoor activities alltogether. To prepare for the bathing suit season,people look for a diet that will help them shedthose extra pounds gained during the wintermonths quickly.

People look for a diet that fits their lifestyleand will result in fast weight loss, said KellyCoughlin, a registered dietitian at LakewoodClinic in Staples.

The days when eating right meant eating dailyportions of the five food groups may be over.The latest craze in the dieting world is high pro-tein, low carbohydrate diets. Meats, cheeses andother high-fat foods top the list on diets such asDr. Atkins’ New Diet Revolution. The dietaryguidelines of these high fat diets are leaving doc-tors and researchers scrambling to find longterm effects of such diets.

The Atkins diet, or Dr. Atkins’ New Diet Revolution, isn’tso new after all. It’s been around for more than 30 years andhas only recently become a popular dieting fad.

During the two-week induction period of Atkins, pro-

teins, including meat, fish, poultry, eggs andcheese, and fats such as butter, olive oil and may-onnaise, are allowed. A maximum of 20 grams ofcarbohydrates is allowed in the form of such veg-etables as lettuce, eggplant, broccoli and cauli-flower. Fruit, bread, grains and starchy vegeta-bles must be avoided during the induction peri-od.

Experts say diets deficient in major nutrients,including carbohydrates, can be dangerous inthe long run.

“Any food plan that takes a group of foods andcuts them out, it’s not a good thing,” Coughlinsaid. “I can’t see how that can be good for youlong term.”

Many doctors disagree on the healthiness ofhigh fat, low carbohydrate diets. A study recent-ly published in The New England Journal ofMedicine stated after six months on a low-car-bohydrate diet people lost more weight thanthose on the traditional low-fat diet doctors havebeen pushing for years. The low-carbohydratediet was also associated with “... improvement insome risk factors for coronary heart disease.”

Last year Eric Westman, an internist at Duke University’sdiet and fitness center, studied the


20

CM

Searching for a weapon in the BATTLE of theSTORY/Heidi Lake

Is Atkins dietthe answer?


“There’s more to tattooremoval than people realize,”Waters said.

When a person opts for tattooremoval, they are evaluated onseveral factors: the size of the tat-too; the various colors involved inthe design; the size and location;as well as whether the tattoo wasdone by an amateur or profes-sional, which makes a differencein determining the depth of thepigment. All of those factorsweigh heavily into which methodof removal is used.

“On the ‘average Joe’ tattoo,more than one color is involvedand laserremoval ismost com-monly used,”Waters said.

Accordingto theA m e r i c a nAcademy ofDermatology,several typesof lasers cane f f e c t i ve l yremove tat-toos with avery low risk of scarring. The typeof laser used to remove the tattoodepends upon the pigment col-ors. The three lasers most com-monly used in tattoo removal arethe Q-switched Ruby, the Q-switched Alexandrite and the Q-switched Nd:YAG.

The laser targets the pigment,or ink, below the skin with wave-lengths, or a high-intensity lightbeam. These wavelengths areeither absorbed, reflected or sim-ply passed through the skin butare absorbed by the ink. Thewavelength fractures the pig-ment, which is then absorbed bythe body and broken down.

Each laser session lastsbetween 20 and 30 minutes,Waters said. Often times, it takesanywhere from two to 10 sessionsin order to completely remove

the entire tattoo, he said. “Gradually you see a lightening

effect,” Waters commented, not-ing each individual’s response tothe laser determines how manytreatments will be necessary toachieve the desired results.

Black tattoo pigment absorbsall laser wavelengths, making itthe easiest to treat. Other colors,such as green, selectively absorblaser light. These colors can onlybe treated by selected lasersbased upon the pigment color.

“From a pain standpoint,”Waters said, “it’s a strong feelingof, like, a rubber band beingsnapped on the skin.” A topicalanesthetic can be applied to min-

imize discom-fort. Followingeach treat-ment, thepatient isinstructed toapply oint-ment forseven to 10days to pro-tect the affect-ed area.

Cost forlaser tattooremoval runs

between $175 and $250 per treat-ment, based upon the length oftime required at each session.Removal is not covered by healthinsurance due to its cosmetic pur-pose.

Other Forms of RemovalLasers aren’t the only option

when it comes to tattoo removal. Incision, or cutting the tattoo

out of the skin, is used for smallersized tattoos. A balloon-typedevice is placed below the skin,and for eight to 12 weeks stretch-es out that particular area of skinto allow the tattoo to be removedand excess skin to be sewn backtogether.

Less evasive techniquesinclude having skin-colored pig-ment injected over the site of the

tattto t

TL

risk“

a ch(suror trun“Thoneremthrodonthindowa tathroopt

“From a pain stand-point, it’s a strong feelingof, like, a rubber bandbeing snapped on theskin.”

-Dr. Kurt Waters

Light beam targetsthe pigment below th

oo or simply using cosmeticsemporarily cover the area.

he Bottom Lineaser removal isn’t without itss. Ideally, I’d like to say there isn’tance of lightening of the skinrounding or below the tattoo)here’s no scarring, but we do the risk,” Waters said. e bottom line is there isn’t any great option for tattoooval,”Waters said. “Think itugh before having a tattooe because it’s not a quickg to erase. We’re notnplaying that you should get

ttoo. You just need to think itugh first and weigh all the

ions.”

17

e skin

File/Photo illustration

191

CM

YK

8

18

CM

YK

19

For all your Pharmacy Needs

• PrivateConsultations

• Gifts & Cards• Kodak Film

Developing• Toys• Clothing• Dry Cleaning

ServiceWe have the cure forWe have the cure forWe have the cure for

Poison Ivy!Poison Ivy!Ask about Zanfel.

CR 3 Crosslake, MN218-692-2502 or 800-595-7312

Mon-Fri 9-5:30; Sat [email protected]

Steve Kappes,Owner/Pharmacist

Summer is here and although people flock tothe Brainerd lakes area to soak up the sun onone of the many beaches this area has to offer,there is one dreaded fact of summer that tomany isn’t so appealing.

Putting on a bathing suit. For some, the task isenough to skip out on outdoor activities alltogether. To prepare for the bathing suit season,people look for a diet that will help them shedthose extra pounds gained during the wintermonths quickly.

People look for a diet that fits their lifestyleand will result in fast weight loss, said KellyCoughlin, a registered dietitian at LakewoodClinic in Staples.

The days when eating right meant eating dailyportions of the five food groups may be over.The latest craze in the dieting world is high pro-tein, low carbohydrate diets. Meats, cheeses andother high-fat foods top the list on diets such asDr. Atkins’ New Diet Revolution. The dietaryguidelines of these high fat diets are leaving doc-tors and researchers scrambling to find longterm effects of such diets.

The Atkins diet, or Dr. Atkins’ New Diet Revolution, isn’tso new after all. It’s been around for more than 30 years andhas only recently become a popular dieting fad.

During the two-week induction period of Atkins, pro-

teins, including meat, fish, poultry, eggs andcheese, and fats such as butter, olive oil and may-onnaise, are allowed. A maximum of 20 grams ofcarbohydrates is allowed in the form of such veg-etables as lettuce, eggplant, broccoli and cauli-flower. Fruit, bread, grains and starchy vegeta-bles must be avoided during the induction peri-od.

Experts say diets deficient in major nutrients,including carbohydrates, can be dangerous inthe long run.

“Any food plan that takes a group of foods andcuts them out, it’s not a good thing,” Coughlinsaid. “I can’t see how that can be good for youlong term.”

Many doctors disagree on the healthiness ofhigh fat, low carbohydrate diets. A study recent-ly published in The New England Journal ofMedicine stated after six months on a low-car-bohydrate diet people lost more weight thanthose on the traditional low-fat diet doctors havebeen pushing for years. The low-carbohydratediet was also associated with “... improvement insome risk factors for coronary heart disease.”

Last year Eric Westman, an internist at Duke University’sdiet and fitness center, studied the



“There’s more to tattooremoval than people realize,”Waters said.

When a person opts for tattooremoval, they are evaluated onseveral factors: the size of the tat-too; the various colors involved inthe design; the size and location;as well as whether the tattoo wasdone by an amateur or profes-sional, which makes a differencein determining the depth of thepigment. All of those factorsweigh heavily into which methodof removal is used.

“On the ‘average Joe’ tattoo,more than one color is involvedand laserremoval ismost com-monly used,”Waters said.

Accordingto theA m e r i c a nAcademy ofDermatology,several typesof lasers cane f f e c t i ve l yremove tat-toos with avery low risk of scarring. The typeof laser used to remove the tattoodepends upon the pigment col-ors. The three lasers most com-monly used in tattoo removal arethe Q-switched Ruby, the Q-switched Alexandrite and the Q-switched Nd:YAG.

The laser targets the pigment,or ink, below the skin with wave-lengths, or a high-intensity lightbeam. These wavelengths areeither absorbed, reflected or sim-ply passed through the skin butare absorbed by the ink. Thewavelength fractures the pig-ment, which is then absorbed bythe body and broken down.

Each laser session lastsbetween 20 and 30 minutes,Waters said. Often times, it takesanywhere from two to 10 sessionsin order to completely remove

the entire tattoo, he said. “Gradually you see a lightening

effect,” Waters commented, not-ing each individual’s response tothe laser determines how manytreatments will be necessary toachieve the desired results.

Black tattoo pigment absorbsall laser wavelengths, making itthe easiest to treat. Other colors,such as green, selectively absorblaser light. These colors can onlybe treated by selected lasersbased upon the pigment color.

“From a pain standpoint,”Waters said, “it’s a strong feelingof, like, a rubber band beingsnapped on the skin.” A topicalanesthetic can be applied to min-

imize discom-fort. Followingeach treat-ment, thepatient isinstructed toapply oint-ment forseven to 10days to pro-tect the affect-ed area.

Cost forlaser tattooremoval runs

between $175 and $250 per treat-ment, based upon the length oftime required at each session.Removal is not covered by healthinsurance due to its cosmetic pur-pose.

Other Forms of RemovalLasers aren’t the only option

when it comes to tattoo removal. Incision, or cutting the tattoo

out of the skin, is used for smallersized tattoos. A balloon-typedevice is placed below the skin,and for eight to 12 weeks stretch-es out that particular area of skinto allow the tattoo to be removedand excess skin to be sewn backtogether.

Less evasive techniquesinclude having skin-colored pig-ment injected over the site of the

tattoo or simply using cosmeticsto temporarily cover the area.

The Bottom LineLaser removal isn’t without its

risks. “Ideally, I’d like to say there isn’t

a chance of lightening of the skin(surrounding or below the tattoo)or there’s no scarring, but we dorun the risk,” Waters said. “The bottom line is there isn’t anyone great option for tattooremoval,”Waters said. “Think itthrough before having a tattoodone because it’s not a quickthing to erase. We’re notdownplaying that you should geta tattoo. You just need to think itthrough first and weigh all theoptions.”

17

CM

Searching for a weapon in the BATTLE of theSTORY/Heidi Lake

Is Atkins dietthe answer? “From a pain stand-

point, it’s a strong feelingof, like, a rubber bandbeing snapped on theskin.”

-Dr. Kurt Waters

Light beam targetsthe pigment below the skin

File/Photo illustration

20

16

CM

YK

Three years ago, a 24-year-old womandecided to leave a lasting impression — liter-ally.

Armed with courage, she entered a tattoostudio and changed herself forever. Nearlytwo hours later, she emerged with a feeling ofsatisfaction and a colorful work of art on herback.

Fast forward three years. That same womanis now 27 and a new mom. No longer is thattattoo so appealing. In fact, these days italmost seems larger than life when she looksin the mirror.

As the trend of body art continues to gainmomentum, so does the business of tattooremoval.

Dr. Kurt Waters and Dr. Paul Lundstrom offacial plastics at Brainerd Medical Center offertattoo removal as part of their services at theirBrainerd clinic. Waters, who has been in the

practice for eight years, says the most com-mon reason many men and women seek tat-too removal is due to a change in lifestyle.They want a previously applied tattoo,whether it be a design, a symbol or even aname, erased from their bodies and lives for-ever.

Unfortunately, Waters says, it isn’t as easy as“erasing” the ink.

The History of TattooingThe word tattoo comes from the Tahitian

“tatu” which means “to mark something.”Tattoos are created by injecting colored pig-ment into tiny holes punctured into the skin.Once applied, tattoos become a permanentfixture within the layers of skin.

Tattoos are believed to date back to 1300BC, and possibly earlier, when Egyptian mum-mies were found to have blue marks resem-bling tattoos on their skin. Markings can signi-

fy affiliation with certain groups or organiza-tions. In some cultures, tattoos are used tomark married women or even criminals.

In 1891, the first electric tattooing machinewas patented. During World War I and II,many soldiers proudly marked their militaryaffiliation through tattoos. As time went on,the fad began to fade, but today tattooing ismaking a strong comeback. Both amateursand professionals alike are leaving their markon bodies throughout the world.

Making the ‘Permanent’ Not So PermanentWaters recalled a male patient who wanted

to join the U.S. Marine Corps. The young manwas turned away due to the fact he had tattooson his face. He came to Waters looking for a“quick fix,” but was surprised to find out theprocess is more involved than that.


As the popularity of tattooing increases, so does the businessof tattoo removal. The facial plastics department at BrainerdMedical Center is one of a few area clinics that offers tattooremoval as part of their services.

STORY and PHOTOS/Jenny Kringen-Holmes

Doctors zap tatoos with laser

rlif

t

Service Drug218 West Washington • 829-3664

(Tyrol Hills Shopping Center)Mon.-Fri. 9 a.m.-5:30 p.m. • Sat. 9 a.m.-1 p.m.

It should come as no surprise that LiquidSupplements work much better than

tablets. Service Drug offers a completeselection of Liquid Supplements: Daily

Multiples, Glucosamine, Calcium, energyand stress and children’s multiples.

Ask about how well they work!

NOW…10% Off

thru August 23rd, 2003


Atkins approach to weight loss and comparedit to the American Heart Association’s Step 1diet, a low-fat approach. Westman studied 120overweight volunteers and found after sixmonths people on the Atkins diet lost an aver-age of 31 pounds compared to 20 pounds onthe Step 1 diet.

“(People on the Atkins diet) lose weightbecause they are cutting out whole foodgroups,” Coughlin said. “... but moderateamounts of carbs have a place too.”

Westman’s study found people on theAtkins diet had an 11 percent increase in HDL,good cholesterol, and a 49 percent decrease intriglycerides, which may raise the risk of heartdisease. On the AHA diet, HDL wasunchanged and triglycerides dropped 22 per-cent. LDL, bad cholesterol, didn’t changemuch on either diet.

Why people who have increased their fatintake have increased HDL levels is surprising

to many doctors.“In my opinion, weigh

cholesterol levels, but reseanything for sure yet,” Cou

Westman’s study also fople stuck with the Atkins p

After unsuccessfully trymethods for years, Sandi aof Brainerd decided to try months ago. So far Sandi and Bob has lost 50.

“We don’t call it a dchanged our eating habitcarbohydrate intake,” Sasomething we’ll do for the

Sandi said she and herSlimfast diet, calorie counand nothing has worked a

“Before we started this n’t go on a diet and exercibecause I hate doing bothI knew I’d never last,” Sand

Study shows good chafter six months of At

ee

a

ulinth

isn tsIs o

o

21

Obstructive Sleep ApneaThe Dark Side Of Night

Obstructive Sleep Apnea is when a person stops breathingpeatedly during sleep…a serious, potentially life altering and threatening condition. It can be effectively treated with CPAPherapy which is safe, effective and returns your quality of life.

Respiratory Care Practitioner on staff to providefor all your CPAP/BIPAP needs.

Call today for more information.

206 W. Washington, Tyrol Hills Center, Brainerd(218) 829-2100

Mon.-Fri, 8:00-5:30, Sat. 9:00-1:00

t loss will controlrch is not showing

ghlin said.nd that more peo-an.ng various dietingd Bob Colbenson

he Atkins diet nineas lost 30 pounds

et. We have just by watching ourdi said. “This is

rest of our lives.”husband tried theing and exercising well as Atkins. told (Bob) I could-e at the same timef those things and

i said. “(On Atkins)

I lost weight without doing anything extra.”Because the Atkins approach to dieting has

only recently become popular, a limitedamount of research concerning the long termeffects of high protein, low carbohydrate dietsis available. Until research is completed, manydoctors and dietitians, including Coughlin,will stick to recommending low-fat diets.

One thing is for sure, Coughlin said, two-thirds of American adults are overweight, astatistic she calls a national crisis.

“Obesity is a major crisis in this countryright now,” she said. “We are going to see somany more people with chronic diseases withthis increase in obesity.”

Coughlin said it’s been proven grains andcertain vitamins not provided in low carbohy-drate, high fat diets help lower the risk of can-cer and other chronic diseases.

“Eating right and exercise is ultimatelywhat’s going to (lead to a healthier life),”Coughlin said.

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7:30 p.m. After being notified her elder-ly female patient will be admitted to thehospital, Tollefson visits the woman to startan IV. The woman tells Tollefson she is hun-gry, and Tollefson offers to get her a sand-wich.

7:43 p.m. As one patient is movedupstairs to a regular room, more continueto come through the doors of the ER.

7:55 p.m. A woman comes to the ER withher little boy in tow. The boy is crying andbleeding from the left side of his face.

“This one is for us,” Tollefson says as sheleaves the nurses’ station. She approachesthe boy and helps him into a wheelchair.

The boy’s mother tells the nurses her sonfell off his bike as they examine his skinnedup knees and hands as well as a swollen lipand cut on his forehead. Tollefson puts iceon all the boy’s “owies” and tries to calmhim.

Meanwhile, the triage nurse stops by theexam room to tell Tollefson the boy willneed to be moved as that particular roomwould be needed for a new patient comingin to the ER with an abscess.

“This one’s going to be a challenge,”Tollefson comments as she leaves the roomfor more supplies.

But she takes it all in stride. After all, it’sjust another day in the life of an ER nurse.

‘This one’s going to be a challenge’

A motorcyclist from the superbike races at Brainerd International Raceway visited theEmergency Room. X-rays show a clean break of the humerus bone in the arm.

Being a mom is hard work. And that’s not even considering the 3 a.m.

feedings, diaper changes and teething.Carrying and caring for your little bundle

can cause major stress on your ligaments andmuscles. Something as simple as learningproper lifting techniques as well as perform-ing a few easy exercises each day can make allthe difference in an already hectic woman’slife.

Jim Davis of Lakes Chiropractic in Brainerdsays regular chiropractic visits during preg-nancy are the best way to maintain yourbody’s proper alignment, as well as ease theaches and pains associated with pregnancy.

Eighty-four percent of chiropractic patientsreceiving chiropractic adjustments reportedrelief of back pain during pregnancy, accord-ing to a 1991 study. Davis said first time moth-ers under chiropractic care have 24 percentshorter labor times versus women who donot. In addition, chiropractic patients whohave had previous children enjoyed 39 per-cent shorter labor times.

“I believe pregnancy and labor should bean unforgettable experience, and not becauseit hurts so bad,” Davis said.

Vertebral subluxation takes place due tothe hormonal changes in an expectant moth-er’s body. This condition brings on back aches

in pregnant women because the spine has lostits normal position and irritates the surround-ing nerve tissue. Davis explains through pre-natal chiropractic care the chance and/or painof subluxation can be minimized.Chiropractic techniques can also ensure thepelvis is correctly aligned to allow sufficientspace for the developing baby as well as for aquicker and easier delivery.

If a woman enters her pregnancy with exist-ing low back pain, those problems may onlybecome magnified as the pregnancy pro-gresses, Davis said. If those same pains aren’taddressed during pregnancy, long term painwill result.

Davis said it’s important a new mom visitsher chiropractor soon after giving birth tohelp in the healing process. A chiropractorcan share tips on how to ensure proper mus-culo-skeletal health. Many moms experiencepains from the most unsuspecting situationsafter their babies are born, Davis said. Forexample, new mothers are always lookingdown as they hold or nurse their newborn,putting strain on the neck and shoulders.

“We want to keep mom’s spine in shapeand comfortable,” Davis said, adding propernutrition is key. He encourages moms to con-tinue the


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Injured fisherman stillable to joke(Continued from Page 13)

5:16 p.m. The first ambulance from the caraccident arrives in the ambulance port. As theambulance crew pushes a stretcher with the 7-year-old boy to an exam room, the man withpossible kidney stones is pushed in a wheel-chair by a radiology technician and the daugh-ter of the elderly woman with shortness ofbreath all pass each other in front of thenurse’s station.

“Busy day,” the woman’s daughter com-ments.

In an exam room, the female EMT fromNorth Ambulance introduces the young boyand his mother to Tollefson and Stone. Shenotes to both nurses that all occupants of thevehicle were wearing their seatbelts at thetime of the accident and that the vehiclerolled. The boy says the only pain he feels isinside his mouth, while his mother says she’sexperiencing pain in her shoulder and minorcuts on her body.

“It just happened so fast,” the mother tellsthe nurses.

5:37 p.m. Tollefson takes a second to catchher breath and grabs a snack from the break-room before heading back down the hall to

check on her elderly female patient. Shebrings her another warm blanket.

5:40 p.m. A man involved in a motorcycleincident at the BIR races arrives at the ER. Theward clerk comments that nearly all of the 17exam rooms are full, with the exception of thespecialty rooms, designated for specificinjuries. Tollefson takes a few minutes to catchup on her charts.

5:46 p.m. A State Patrol trooper arrives inthe ER asking about the people involved in thecar accident. Tollefson shows him to theirroom.

5:55 p.m. Tollefson decides to run down tothe hospital’s cafeteria before it closes to graba bite to eat and takes her dinner break in theER breakroom.

6:14 p.m. Dinner’s over and Tollefson isback on her feet.

“Let’s see what we’ve missed,” she says asshe grabs a couple charts to catch up with herpatients’ status.

6:17 p.m. Lab results are back on severalpatients. Tollefson restocks the blanketwarmer, then checks in on her elderly femalepatient.

6:26 p.m. Tollefson visits with an older cou-ple sitting at the admitting desk. The manexplains he cut his hand with a fillet knifewhile cleaning fish. Tollefson discusses roomoptions with the triage nurse before showingthe couple to an exam room.

“I didn’t have time to shave and shower

before I came,” the man jokes with Tollefsonas she unwraps the bloodied towel from hisinjured hand. The cut measures 2 centimeterslong by 1/2 centimeters wide, Tollefson tellsthe man who continually apologizes for “tak-ing up” her time.

“I used to be a Boy Scout,” he tells her. “Ididn’t make Eagle though.”

6:45 p.m. Stone checks in with Tollefson tolet her know all is well and that he’s discharg-ing the young boy involved in the car accidentas well as his mother and another occupant.

6:49 p.m. Dr. Clay Schulte has met with theman who cut himself with the fillet knife andasks Tollefson to wash the man’s cut and givehim a tetanus shot. Tollefson visits with thefriendly couple and prepares him for suturing.

7:08 p.m. As Tollefson checks in with apatient, a nurse at the nurses’ station com-ments on the night’s activity.

“This is one of those busy nights that’s notgoing very fast,” she says.

7:12 p.m. Tollefson visits with the triagenurse on the ER’s current patients. She thenrevisits the couple with the “fishing injury” asSchulte finishes up suturing.

Once again apologizing to the staff for hisinjury, the man concedes something good didcome of his visit.

“We wouldn’t have had the chance to meetall these nice people,” he said.


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3:52 p.m. On her way back to the nurse’sstation, Tollefson stops to clean two rooms,making the beds and emptying the garbage.She discusses how an ER doctor can only rec-ommend to the on-call physician that a patientbe admitted to the hospital. The on-call physi-cian comes to the ER, visits with the patient,reviews their chart and then determines ifthey will be hospitalized, which floor they willgo to, what medications they should receive,the level of activity, and any necessary inter-ventions or the “total plan of care.”Then a floataide comes to get the patient and moves themupstairs.

4:06 p.m. The nurse call light in Room 11goes off. The woman with foot pain asks forTollefson’s assistance to use the restroom.

4:11 p.m. The call light in Room 11 goes offagain.

4:12 p.m. Rud visits with a young man whofractured his wrist while skateboarding. Afterreviewing his X-rays, Rud decides to cast thearm and gives the man his color options forthe cast. Tollefson assists Rud by preparing thenecessary casting supplies.

“I probably won’t be playing the drums forawhile,” the patient jokes.

“Your pain level will tell you what you canand cannot do,” Rud tells him.

“I’ve been riding that thing for years,” thepatient says, referring to his skateboard sittingnearby. “What a drag.”

4:25 p.m. Tollefson goes over dischargeinformation with the skateboarder and directshim to the hospital pharmacy on his way outof the ER.

4:34 p.m. After refilling the blanket warmer,Tollefson reviews current patients with Stone.

4:40 p.m. Tollefson’s fire pager sounds.There is a one-vehicle rollover on Highway 371North. Tollefson, noting she’s been on theBrainerd Fire Department for nearly 13 years,says she wears her pager to keep on top ofwhat’s happening outside of the hospital andto give her a heads-up of what may be comingin to the ER.

4:45 p.m. A car pulls into the emergencyroom car port. An elderly woman is helpedinto a wheelchair by Tollefson and a fellownurse. The woman complains of difficultybreathing and water retention. She wasrecently hospitalized for similar problems andhas had blood clots in her lungs and kidneydialysis in the past.

“You did the right thing,” Tollefson assuresthe woman’s daughter of bringing her to the

ER. 5:07 p.m. North Ambulance calls the ER en

route with two patients involved in the caraccident on Highway 371. Tollefson takesinformation over the radio of the status of the29-year-old woman and her 7-year-old son.Two more from that same vehicle are alsocoming in by a second ambulance, they note.

At the ER front desk, an inmate from theCrow Wing County Jail, dressed in orange andon crutches, is being admitted.

5:10 p.m. Cleaning another room andchanging the sheets in preparation for theaccident victims, Tollefson discusses howshe’s found various individuals’ pain toleranceto differ.

“People just need to be reassured,” shesaid. “They just need to know that you’regoing to take care of them.”

5:12 p.m. Walking back to the nurse’s sta-tion, van der Hagen passes in the hall andcomments on the unrealistic portrayal of anER on television.

“What I’d like to see is Dr. Green gettingthree ear infections in a row. That’s reality. AndI’d like to see Dr. Green sit down and fill outsome charts now and then.”


‘Your pain level will tell you what you can and cannot do’


healthy habits they had while pregnant. As part of his aim to promote healthy living,

Davis travels throughout the country trainingmen and women in proper lifting techniquesto be implemented into everyday life. Heoffers similar lifting courses at his Brainerdclinic and plans to hold pre- and post-natalcourses for new parents in the near future.

A lending library is also available to thepublic at Lakes Chiropractic with resourceson prenatal and post-natal care, as well as anassortment of other topics. For more informa-tion or to register for the free lifting course,call Lakes Chiropractic at 828-4418.

More coursesfor newparentsplanned

Jim Davis taught a new mother the proper procedure in lifting a baby out of a car seat.

24

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Patients triaged from most to leastsevere while getting checked in

(Continued from Page 11)2:49 p.m. Peterson checks in with her car-

diac patient who is currently having anechocardiogram done on his heart by an EKGspecial diagnostics technician. Watching fromthe doorway, Peterson points out the bloodflow to the heart as well as the valves openingand closing.

2:55 p.m. Peterson visits with her femalepatient who was experiencing shortness ofbreath. Examining her arms in preparation foran IV, Peterson notes the woman has tiny veinsand is very bruised from previous blooddraws. She calls in a fellow RN for assistance.Teamwork in the ER is an important aspect toproviding the best care to patients.

3 p.m. As the nurses update their chartsbefore the next shift comes on, another ERpatient’s husband approaches Peterson andasks if his wife can have a glass of water.

“I only ask because you got me a cup of cof-fee before,” the gentleman jokes.

3:10 p.m. Peterson updates an incomingnurse on her current patients as she handsthem over. There’s a flurry of activity as the ear-lier shift prepares to leave and the new shiftarrives. Peterson finishes her paperwork andgets ready to go home, but not before one lastjab by van der Hagen who jokes with Petersonon her new “celebrity status.”

3:15 p.m. RN Kris Tollefson is now on dutyfor the 3-11 p.m. shift and, without much timeto spare, gets her first patient of the day. Awoman has come to the ER complaining offoot pain. She tells Tollefson and nurse JohnStone it began hurting about 10 days ago. Sherates her pain, on a scale of one to 10, as a 4.5.She notes her history of gout, blood clots andhigh blood pressure.

3:25 p.m. Tollefson changes the sheets inRoom 1 and prepares for the next patient asshe talks about the expectations of variouspeople who come to the ER.

“Some people think they can just come inand (immediately) be treated,” Tollefson says,noting the patients are triaged, or prioritizedfrom most to least severe when they firstcheck-in at the admitting desk. “Sometimespeople just don’t understand how thingswork. So I try to explain to them why there is await. It helps if they understand the processbetter.”

Tollefson is no stranger to the medical field.She has worked in the ER for about one year.Previously, she worked in the cardiac care unitat St. Joe’s and also as a nurse on the thirdfloor. She has also worked as an emergencymedical technician for North Ambulance inBrainerd.

“With nursing, you can move from one areato the next,” Tollefson said. “You can changeareas and keep things interesting. If you pay

attention you can learn something new everyday.”

3:31 p.m. A car comes in the emergencyroom car port. A female passenger complainsof serious abdominal pain and has difficultygetting out of the vehicle. Tollefson, Stone andtwo fellow nurses help her into a wheelchairand into the ER. Stopping at the nurse’s sta-tion, the triage nurse (aka: “the orchestraleader,”Tollefson said) directs them to a room.

“You never know what’s going to be out inthe garage waiting for you,” Stone said.

3:35 p.m. An older gentleman comes to theER complaining of pain, noting it may be kid-ney stones. Tollefson and Stone get the man’svital signs and medical history once he’s in theroom and in a gown.

“I’m healthy as a hog,” the man tells themwith a laugh.

3:38 p.m. Back at the nurse’s station,Tollefson looks at the chart of her patient inRoom 11 with foot pain. An X-ray has beenordered as well as a uric acid test to check forgout.

3:46 p.m. Tollefson discharges a womanwith bursitis of the knee. She goes overinstructions with the woman and her husbandand informs them of her follow-up appoint-ment with Dr. Paul Rud. Before leaving,Tollefson draws a blood sample to check thewoman’s ProTime, or blood coagulation abili-ty.


Registered nurses Sal Peterson (right) and Joe Berge reviewed a patient’s chart. Peterson has workedas a nurse for 35 years.

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Caring for a baby is rewarding —nd hard work. Like other kinds ofork that requires lifting, bending,ng periods of sitting, and repeti-

ive motions, it can be harmful toour body. Try these simple tips torevent problems that may hinderour parenting:

• Put one foot on a box or lowhelf when you stand and changeiapers. This causes your pelvis toilt in a way that decreases pelvicatigue.

• Keep work surfaces at a com-ortable height. Put somethingnder the legs of the changing table,or instance, to raise it if you’re tall.

• Don’t try to hold the baby andrestle the side of a crib down at the

ame time. Instead, drop the cribide before you pick up the child.

• Don’t bend from the waisthen you lift the child. Squat with

your back straight, keep the childclose to you, and use your leg mus-cles to rise.

• Don’t bend over into the carwhen putting your child in the carseat. Sit sideways on the seat withthe child on your lap, then rotate toface front and put the child in theseat.

• Make sure your feet are on thefloor and your back is supportedwhen you sit holding your child.Keep your knees at the same heightas your hips or slightly higher.

• Adjust stroller handles soyou’re not bending over when youpush.

• When loading a stroller or gro-ceries in the car trunk, rest one footon the bumper to keep the load closeto your body.

(Source: ColoradoChiropractic Association)

ips to help ease thetrain of caring for baby

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Dr. Paul Rud, an orthopedic surgeon at St. Joseph’s Medical Center, put a cast on a patient whobroke his wrist after falling off a skateboard.

ER not like TV show(Continued from Page 10)

2 p.m. Registered nurse Sal Peterson hasone hour to go on her 7 a.m. to 3 p.m. shift inthe emergency room at St. Joe’s. Peterson hasworked as a nurse for 35 years with about halfthat time spent at St. Joe’s.

2:05 p.m. Peterson currently has twopatients. One arrived earlier in the day com-plaining of chest pain. An electrocardiogram,or EKG, and several tests have been done.Peterson visits with the patient briefly andexplains the man likely has pericarditis, orfluid around his heart. She lets them know adoctor will be in soon to discuss his diagnosisand answer any questions he may have.

2:09 p.m. Several of the ER nurses visit atthe nurse’s station and discuss the level ofexcitement in the ER compared to what’s por-trayed on television. Peterson, noting one par-ticular nurse who had been working since 3a.m., said there is difficulty in covering all thenecessary shifts in the ER.

“We have a hard time finding nurses withER experience,”Peterson says. “There’s a lot tolearn. How to start IVs, how to read EKGs.”

2:11 p.m. Peterson just received a newpatient. The woman, coming in by wheelchair,asks to use the restroom first. After beingassisted by Peterson, the woman is wheeledinto an exam room and helped into a gown.Asked if she is experiencing any pain, thewoman answers, “Nothing’s working. That’sall.” She complains of shortness of breath.After helping her into bed, Peterson beginsthe standard line of questioning. She alsoadministers oxygen, takes her blood pressureand hooks her up to a cardiac monitor toclosely monitor her heart rate.

2:31 p.m. Peterson visits with ER doctor andinternal medicine specialist Dr. Hong Liregarding the new patient. After giving Li thewoman’s history and current status, Petersonstarts the necessary paperwork.

2:39 p.m. While Peterson takes a phonecall, the nurses discuss the upcoming week-end shift and the American MotorcycleAssociation races at Brainerd InternationalRaceway. Many events and vacationers influ-ence the amount of activity in the ER, they say.

One nurse noted something as simple asbathroom breaks are dictated by that particu-lar day’s pace in the ER.

“And others when it’s so slow...”adds anoth-er.

Off the phone, Peterson jokes with Dr. Jonvan der Hagen who critiques her writing on achart, “And sometimes you work with doctorswho are so impossible,” she said.


Mary Klein (middle), a home care/hospice nurse, talked with two of her co-workers. Klein said being a hospice nurse is stressful because she oftenhas to deal with the death of her patients, some of whom she’s become

close to. Klein said hospice nurses talk to each other to help ease eachother’s stress.

Hospice care helps ease the inevitableKaren Kochsiek and Mary Klein know the ben-

efits of hospice care first hand.They’d even recommend the program to their

closest friends and family members.They are hospice nurses.


STORY/Heidi LakePHOTO / Nels Norquist

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Registered nurse Kris Tollefson started paperwork for one of her emergency room patients.

It’s a Friday afternoon on a busyrace weekend. Five nurses andthree doctors work the mid-dayshift at St. Joseph’s Medical Centeremergency room in Brainerd.

In just six hours, dozens of peoplevisit the ER with ailments varyingfrom bumps and bruises to cardiacconditions. Regardless of the sever-ity, each nurse is called upon to pro-vide patients with the best care pos-sible.

With the hospital’s approval, thiswriter spent time following nursesand finding out, first hand, what atypical day is like in the fast-pacedenvironment of an emergencyroom.

This is just a glimpse into a day inthe life of an ER nurse.

(Continued on Page 11) STORY and PHOTOS/Jenny Kringen-Holmes

nurse

The

ERA DAY IN THE LIFE

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Poland asked Zajac to close her eyes and situp. When Poland instructed Zajac to open hereyes, Zajac had 20/40 vision.

“It was amazing,” she said.She could see well enough to legally drive a

car without glasses immediately after surgery.Zajac was instructed to sleep at least three

hours following the surgery in order to speedup the healing process. For the rest of the dayshe had to wear eye shields to prevent dustand other foreign objects from getting in hereyes. She was given three types of eye dropsto help her heal.

The next day, Saturday, Zajac headed backto Crosby for a follow-up check with Poland.Her vision was better than 20/20.

Zajac has to return for check-ups one week,one month and one year after surgery to makesure everything is healing properly.

“It takes one year for the flaps to complete-ly heal, but 80 percent will be healed in thefirst month,” Poland said.

Zajac said she did not encounter any painthroughout the surgery, but her eyes feltscratchy for about three hours afterward.

“There was no real definite pain,” she said.“It was just a little uncomfortable a few hoursafter surgery.”

Poland is one of the pioneers of correctiveeye surgery, claiming he was one of the firstpeople to perform laser surgery. Before lasersurgery, Poland said he made actual incisionsin the eye with steel and diamond knives, aprocess called radial keratotomy. Today,

Poland said the Crosby Eye Clinic is a teachingcenter for laser surgery so it always has themost up to date equipment.

“Dr. Poland has the best equipment outthere,”Villella said. “People come from all overto have LASIK here.”

Most insurance companies don’t coverLASIK surgery because it’s an elective proce-dure. Crosby Eye Clinic charges $999 per eyefor LASIK which includes all the follow-up vis-its up to one year following the surgery. Anadditional $132 is charged for the pre-surgeryexam, making the total cost of LASIK $2,130.

Poland and Dr. Ina Luca each perform about20 LASIK surgeries one day a week at theCrosby Eye Clinic. They also do other oph-thalmic surgeries such as glaucoma andcataract removal.

‘There was no real definite pain. Itwas just a little uncomfortable a few

hours after surgery.’

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Before LASIK Barb Zajac was legally blind. Immediately after surgery her vision was good enough to legally drive a vehicle without wearing correctivelenses.

During surgery, a camera projected Barb Zajac’s eye on a TVscreen that could be seen from an observation room. Thisimage was projected on the screen after a thin flap was cut inZajac’s cornea.

James J. Dehen, M.D.Fellow, American College of General Surgery

Bradley R. Pierce, M.D.Fellow, American College of General S

When it comes to surgery, you want the best possible care. But you shours to find it. At Brainerd Medical Center and St. Joseph’s Medical Csurgery team routinely performs delicate blood vessel surgery, nonadvanced laparoscopy, oncology-related surgery and more. In August, growing to include Ross Bengston, M.D. – just another way to show we you. Experienced specialists. Comprehensive care. And a team approIt’s all here at BMC. Call (218) 855-5477or 800-277-8262.

“Most people don’t want to die alone in sterile surroundin


Kochsiek spent several years as an intensivecare nurse at a Twin Cities hospital, but hasbeen a home care/hospice nurse in theBrainerd area for the last 14 years.

“(Hospice) is the best way to get the bestcare,” she said. “It’s a lot harder to watch peo-ple die in intensive care (rather than in theirown home).”

“We believe in (hospice),”Klein said. “To diewithout it would be sad.”

Klein, a home care/hospice nurse for thelast 22 years, said hospice is more than med-ical care, it’s about the support given topatients and their families.

St. Joseph’s Medical Center’s Hospice pro-gram includes people from many back-grounds. Social workers, spiritual workers,home health aides and pharmacists join theteam of hospice nurses and doctors who pro-vide comfort to dying patients. Twice a monththe hospice team meets to review patientcases.

Fifteen home care/hospice nurses cover aterritory that includes Brainerd and its sur-rounding areas. Hospice averages eightpatients at one time, while home care patientsfill the rest of the nurses’ schedules.

Home care patients are people who are

sick, but prefer to be cared fothan in a hospital. Home caexpected to recover from thehospice patients have limitecies.

To qualify for hospice carehave a primary caregiver, umember, who stays with themmust not be treating their illn

Timothy Yeh, hospice medioncologist at Brainerd Mediwhen a patient’s condition where further treatment is nthem get better, he suggeaggressive treatment. At thacan decide to start hospice ca

The purpose of hospice is to live out their lives at home,hospital.

“Most people don’t want sterile surroundings, they wanlast days at home,” said Barb Ator of home care and hosp“Hospice exists to make this p

Yeh said he remembers a paed to put his bed on the pohome overlooking the water.


29

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Dr. Timothy Yeh, an onocologist at BrainerdMedical Center, is the hospice medical director.

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Dr. Jerome Poland per-formed LASIK eye sur-gery on Barb Zajac ofPierz. Poland performsabout 20 LASIK surgeriesone day a week at theCrosby Eye Clinic.

Technician Jerry Villella cleanedBarb Zajac’s eyelids with cottonswabs before LASIK surgery toprevent dust or other foreignobjects from entering her eyes.

Education plays a big role(Continued from Page 6)

Poland said the odds of Zajac getting 20/20 visionafter surgery were 90 percent, while the odds ofgetting 20/40 vision were 98 percent.

Between exams, Zajac and her husband watcheda video about the LASIK procedure to preparethem for what was going to happen the next day.

“Most of our time is spent preparing patients forsurgery and doing post surgery patient education,”said Bob McBeath, outreach coordinator. “We want(patients) to know what’s to be expected every partof the way.”

Zajac’s appointment was 1:30 p.m. on a Friday atthe Crosby Eye Clinic in Crosby. Zajac wasn’tallowed to wear contacts two weeks before surgerybecause they tend to reshape the eye. She couldn’twear makeup one week prior to surgery or hair-spray the day of surgery in case it got in her eyes.Zajac underwent another eye exam to make sureher eyes were ready for surgery.

Zajac was then moved to a surgical suite, a rela-tively small, rectangular room where the surgerytook place.

Poland, Villella and two other technicians were inthe surgical suite at the time of the surgery. Zajac layback in a dentist’s-type chair while Poland and his

technicians got situated. This was Poland’s 24thLASIK surgery of the day.

First, Zajac’s eyelids were cleaned and she wasgiven numbing eye drops. A lid speculum was usedto hold her eye lids apart to prevent blinking.

Zajac was told to stare at a red light and keep hereyes as still as possible throughout the procedure.Clutching a Nerf football to help ease her stress,Zajac said she was confident as she lay perfectly stillstaring at the light.

First, a machine called a microkeratome wasused to slice a thin, circular flap in Zajac’s cornea,the transparent outer layer of the eyeball. Polandthen folded the flap out of the way while he usedan excimer laser to remove corneal tissue. The laserreshaped the cornea by using an ultraviolet lightbeam to remove tiny bits of tissue from the cornea.The flap was then laid back into place, covering thearea where the corneal tissue was removed. Whena cornea is reshaped, it focuses light into the eyebetter, providing clearer vision.

The laser was used on each of Zajac’s eyes forless than 40 seconds. The entire surgery took lessthan 10 minutes. And then came “the wow factor,”what Poland calls the most rewarding part of hisjob.



“He wanted to die there,” Yeh said. “We try to fulfill those types ofwishes.”

Under hospice care, the hospice team tries to make patients as com-fortable as possible by easing their pain. Yeh said people in hospicecare often complain about pain, nausea, sleeplessness, depression,constipation and shortness of breath. Doctors, nurses and pharmacistswork together to assure comfort during the patient’s last days.

“We want (patients) to dwell on the quality of life they have, not thatthey’re going to die,” Klein said.

Hospice nurses do more than just care for patients. Kochsiek said alot of hospice is caring for the family by educating them about what’sgoing on with their sick family member.

Klein said she enjoys being a hospice nurse because it allows her toget to know her patients and share her personality while she’s working.Kochsiek said Klein has been known to sing and dance for her patientsin order to brighten their day.

“In hospice care you become part of (the patient’s) family,”Kochsiek

said.Yeh remembered one of his cancer patients who was cured and

years later returned with another form of cancer.“I’ve known this woman 15 years now,”he said. “I’ve seen pictures of

her grandchildren, I know every one of her children’s names.”In an occupation that frequently ends in death, members of the hos-

pice team said they sometimes feel stressed, but try to stay focused ontheir job.

“Some days it’s like, I can’t have any more death right now, I justcan’t,”Klein said. “Then you get a second wind ... you always have to beready for the next patient.”

Klein said the hospice nurses talk to each other and help ease eachother’s workload when someone feels overwhelmed.

“It helps to concentrate on things in our real life, happier things,”she said.

Kochsiek and Klein agree getting to know patients and their familiesoutweigh the hardships of their job.

“It’s very fulfilling, meaningful work,” Klein said.

‘You always have to beready for the next patient’

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(Continued from Page 5)“I wanted to see without glasses or contacts,”

Zajac said.Zajac, of Pierz, made an appointment with Dr.

Jerome Poland at the Crosby Eye Clinic in Baxterfor an eye exam to see if she qualified for theprocedure.

Zajac had an eye exam on a Thursday, LASIKon Friday and was back to work Monday withperfect vision.

Thursday began with a typical eye exam.Letters were projected on a wall and technicianJerry Villella asked, “Which is better, one ... ortwo.” Villella determined Zajac’s prescription,checked for retinal problems and signs of glau-coma as well as the curvature of her eye andpupil.

Poland also tested Zajac, declaring her eyeswere healthy and her prescription was stable,making her a “good candidate” for the surgery.


Dr. Jerome Poland discussed LASIK surgery with Barb Zajac recently at the Crosby Eye Clinic.Poland gave Zajac an eye exam and performed the surgery the next day.

She was a goodcandidate

Barb Zajac recently had her eyes tested at theCrosby Eye Clinic.

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paign set to educate aboutrderhe national CHADDildren and Adults With

ention-Deficit/Hyperactivityorder) organization is startinginitiative to educate the publicthe condition.or more information on thepaign and about ADHD, visit

w.chadd.org, or call CHADD’sional resource center at 800--4050.

ba mate tea increases cancer

erba mate tea is brewed from dried leaves of the Ilexaguayensis plant, a type ofly tree native to Southerica. The bitter drink is popu-in many South Americanntries and parts of the Middlet. In the United States, it’silable as a tea and in pill form.upplement makers tout theb’s energizing effects andh vitamin and mineral con-t, but recent research has sug-ted that regularly drinkinge amounts of mate increases risk of developing severales of cancer.

ting drug costshether or not the govern-

nt acts to lower drug prices,sumers can cut their drugts in many cases by compari- shopping, buying in bulk,osing generics over name

nds and splitting pills. For amatic example of the potentialings, consider the case of thei-anxiety drug Xanax (alprazo-).ccording to “Shopping forgs,” a report slated for publi-on this week by the Nationalter for Policy Analysis, a sen-or uninsured consumer pay- full price for Xanax couldg the cost down 95 percent.

there are caveats: Not every- can take generics. The sav-

s would be lower for con-ers with prescription drug

coverage. And, as the Center forPolicy Analysis notes, patientswho buy drugs from multiplesources lose the protection ofhaving a single pharmacist checkfor drug interactions.

The center is a nonpartisan,nonprofit research group thatpromotes alternatives to govern-ment regulation and takes what itcalls a “pro-free-enterpriseapproach to health care policy.”

Mercury can be serious catch toeating fish

Lee Flynn thought she had ahealthy lifestyle. She was thin andactive and she ate well — withlunches of tuna and fresh vegeta-bles and dinners of halibut, seabass or swordfish.

Yet she spent more than adecade plagued by fatigue, stom-achaches and headaches, as ifshe had “a wicked hangover.”Herhair started falling out. Memorylapses made her think she waslosing her mind.

“I really felt something waspoisoning me, but I couldn’t findthe source,” said Flynn, 59.

The Sausalito, Calif., anthropol-ogist and documentary filmmak-er eventually ended up in theoffice of Dr. Jane Hightower, aSan Francisco internist. WhenHightower heard that Flynn waseating fish nine times a week, sheimmediately ordered a blood testfor mercury. A heavy metal thataccumulates in the flesh of fish,especially the popular predatoryvarieties, mercury can also accu-mulate in people who eat thosefish.

The test’s stunning result:Flynn’s mercury level was 20.6micrograms per liter of blood. Asafe level is about 5, according tothe federal EnvironmentalProtection Agency.

Like Flynn, many adults andchildren may be unwittingly over-dosing on mercury, sayHightower and some publichealth activists, and it’s likely thatmost of them are going undiag-nosed.

HE HEALTH WIRE

m Dispatch Wire Services

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This state of the art surgery requires a highly trained surgeon specialized indermatology, pathology and reconstructive surgery. The surgeon uses theaccuracy of a microscope to see beyond the visible disease to remove the cancerand all its “roots” leaving the healthy tissue unharmed. Cure rates are up to 99%even after other treatments have failed.

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During LASIK surgery, an excimer laser is used to reshape the cornea, resulting in clearer vision.

DITCH theGLASSESSee 20/20 in lessthan 10 minutes

Without her glasses, Barb Zajac was legally blind.After less than 10 minutes of surgery, Zajac can seewell enough to legally drive a vehicle without wear-ing any type of corrective lenses.

Her vision was 20/1,000, meaning what she couldsee from 20 feet away could be seen by someonewith 20/20 vision from 1,000 feet away.

Zajac said while lying in bed she couldn’t even seeher alarm clock only a few feet from her bed.

Zajac, 36, wore glasses since she was 12, and con-tacts since she was 19. After a couple instanceswhen she lost her contacts, Zajac got frustrated andbegan thinking about getting laser-assisted in situkeratomileusis, more commonly known as LASIKsurgery.

(Continued on Page 6)STORY/Heidi LakePHOTOS/Steve Kohls

Summertime can be a great time for caninecompanions. But these long summer days canalso spell trouble when pet owners fail to takethe right precautions.

Veterinarians Steve Rehnblom and WalkerBrown of the Animal Care Center in Baxtershare a few potential summer pet threats andthe steps you can take to keep your pet safe,happy and healthy all season long.

TicksMany ticks throughout the Midwest carry

Lyme and Ehrlichia disease. Both diseases canaffect humans and animals alike. So far thisyear, Rehnblom said about 25 to 30 percent ofLyme disease tests came back positive. Topicaltreatments such as Frontline and Advantix areavailable to treat fleas and ticks.

Be sure to check over your pet’s skin andcoat after coming in from the outdoors. If atick has embedded itself into your pet, usetweezers to grab and remove as much of thetick as possible.

A yearly vaccination to prevent Lyme dis-ease is also available from your veterinarian.

FleasThey may be small, but they can sure wreak

havoc on a pet. Notonly will fleas makeRover rollover anditch all day and night,but these bugs can alsocarry tapeworm and cause aller-gies, according to Rehnblom.Collars and preventative medicinesare available to fight off fleas. Goodgrooming is also essential in keepingfleas in check.

MosquitoesOutbreaks of the West Nile Virus are all the

buzz lately. Not only does West Nile affecthumans, the disease can also strike dogs.Mosquitoes are carriers of both West Nile andheartworm disease.

Rehnblom suggests pet owners have theirdogs tested on an annual basis for heartworm.If the test comes back negative, the animal willthen be put on a preventative medication tobe taken throughout mosquito season.

As for the West Nile Virus, to date, there is

no preventative medication or vaccine avail-able. Your best bet is to avoid mos-quitoes altogether — get rid of

standing water around your home,stay in screened-in areas, and even

apply repellent to yourself and yourpets’ coat when going outside dur-

ing early evening, at dawn or atdusk.

Biting flies and gnatsJust when you think you’ve got Fluffy pro-

tected from the bugs, out come biting fliesand gnats. Flies tend to bite around the earsand result in scabs, Rehnblom noted. Gnatbites show up as smaller welts and leave a redring around them. Prescription and non-pre-scription products are also available for ward-ing off these pests.

OverheatingThe mere mention of a “car ride” will work

many dogs into an excitable frenzy, but some-times


PET WATCH

Watch animals’ health in summerSTORY/Jenny Kringen-Holmes

2Mohs Micrographic Surgeon St. Cloud 320-259-0208 • Alex
Neal Rucks P.A. - C.ndria 320-762-0370

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Readers: Just what the doctor orderedSo many of us wait until the last minute to visit a

physician or ask questions about ailments we areexperiencing. Our hope is that HealthWatch willanswer some of those questions, educate you onmedical breakthroughs and perhaps encourage ahealthier lifestyle.

HealthWatch is a new quarterly publication of TheBrainerd Daily Dispatch that covers a variety ofissues, both local and national. In this first issue, wetried to include stories of interest for people of allages, from tattoo removal (Page 16) to hospice care(Page 26).

Jenny Kringen-Holmes, a former Dispatchreporter, is a free-lance writer for HealthWatch. Shegraduated from Central Lakes College andConcordia College, St. Paul, with a degree in organi-zational management and communication. Kringen-

Holmes is a new mom and currently resides inNisswa.

I graduated from Minnesota State UniversityMoorhead in 2001 with a degree in print and onlinejournalism and moved to Brainerd shortly thereafter.A Dispatch reporter and Web guru for more than ayear, HealthWatch marks my debut as an editor.

I’d appreciate hearing any comments or storyideas you may have on this publication. Send me anote to [email protected], or call medirectly at (218) 855-5879.

Also, be sure to check out HealthWatch online atwww.upnorthhealthwatch.com.

Healthful wishes,

Heidi LakeEditor

HEIDILAKE

JENNYKRINGEN-

HOLMES

Who we arePublisher — Terry McColloughAdvertising Director — Mary PanzerEditor — Heidi LakeEditorial Consultant — Roy MillerCopy Editors — Roy Miller, DeLynn HowardWebmasters — Denton Newman, Cindy Spilman

Cover photo/Steve Kohls

Read HealthWatch onthe Web at www.upnorth-healthwatch.com.

For advertising oppor-tunities call Mary Panzer at(218) 855-5844 or 1-800-432-3703.

E-mail your commentsto [email protected] or mail themto:

HealthWatch is a quarterly publication of TheBrainerd Daily Dispatch.

Heidi LakeHealthWatchBox 974Brainerd, MN 56401

Prescription for healthy reading

5

10

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26

31

20

16

22

COVER STORY: LASIK surgery.

LIFE AND DEATH: Hospice care.

HEALTH WIRE: Notes and quotes.

PARENTING:Post-natal chiropracticcare.

A DAY IN THE LIFE: The ER nurse.

DIETING:The Atkins diet.

COSMETICS: Tatoo removal.

PET HEALTH:Beware of summer heat.

34 DISEASE:Managing diabetes.

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your pet is better off staying put in the coolconfines of your home. Brachycephalicbreeds, such as pugs and bulldogs, are mostsusceptible to suffer from heat stroke due totheir physical structure and poor respiratoryabilities. Even with the windows cracked open,a car can reach dangerously hot temperaturesin minutes, and a brief trip into the store canbe deadly. If you spot a pet locked in a parkedvehicle, contact store management or author-ities immediately. Good grooming is also aneasy preventative measure to keep your petcool during the heat of summer.

Hot pavement“Dogs have the same shoes on year round,”

Rehnblom said, noting how dangerous hotpavement can be on dogs’ pads. Rehnblomsaid he sees dogs every year who went too faron hot pavement and got blisters on its feet. Ifyou’re going to take your dog for a walk,Rehnblom suggests avoiding hot pavement.Also, avoid the heat from 10 a.m. to 4 p.m., thehottest times of the day.

Too much sunDogs can get burned by the sun just as eas-

ily as humans. Dogs with ligor those with light-colored nly susceptible to a bad burnApply a layer of sunscreen tonoses before going outdooplenty of shade.

Storm PhobiaThe booming sound and

barometric pressure signalinthunderstorm can unleash feIf your dog is affected by stsuggests you put them in theter-most room in your houseviding a kennel in that roomhide in can help them feelsome instances, veterinariatranquilizers to help pets storm, or similar noisy evenfear.

AccidentsFireworks, energy, or even

to see what’s going on can breasons that make dogs runimportant to keep your doyard or on a tie-out or leashfrom running to high traffic

Warm summer months lead to

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ht-colored coatsoses are especial-. Your best bet?

their ear tips andrs. And provide

changes in theg an approachingar in many dogs.orms, Rehnblom lowest and cen-

. He also said pro- for your pet to

more secure. Inns can dispenseget through thets, with minimal

a dog’s curiositye just a few of the from home. It’sg in a fenced-in to prevent themareas and getting

hit by a car. Also, be sure to keep proper iden-tification tags on your pet’s collar or invest inmicrochip technology in case he or she doesrun away from home so they can be safelyreturned. When going to loud concerts orfireworks displays, be sure to leave your pet athome and locked up safely. Also, have yourpet spayed or neutered to decrease theirdesire to wander from home.

Ear infectionsRehnblom said ear infections are one of the

most common problems he sees during thesummer. Be sure to dry out your dog’s ears asmuch as possible after swimming and use acleaning product, available from your veteri-narian or many pet stores, to prevent seriousinfections from occurring.

Lapping it upAll that summer activity and heat can bring

on quite a thirst. Be sure to supply your petwith plenty of fresh, cool water throughoutthe day. Don’t allow your pet to drink standingwater in puddles or collected in pools, asmuch of this water can contain algae andcause gastroenteritis, or stomach upset, inyour pet.

many risks for pets

WASHINGTON (AP) —Diabetics are about to get the firstdevice that promises to calculatehow much insulin they need aftera meal and signal an implantedpump to emit that dose.

The Food and DrugAdministration recently approvedthe Paradigm system, made byMedtronic MiniMed Inc. andBecton Dickinson.

Patients still will have to prick afinger to see how much bloodsugar is in their systems and pro-gram in how many carbohydratesthey plan to eat. But until now,they’ve also had to calculate theirrequired insulin dose based onthe two figures, math that if donewrong could result in dangerous-ly high or low blood sugar.

The new machine does thatmath automatically, and special-ists hope a result will be better-managed diabetes.

“The smarter these systems canbecome, ... the better our patients

ought to be able to do,” saidAmerican Diabetes Associationpast president Francine Kaufman,a pediatric endocrinologist atChildren’s Hospital of LosAngeles.

Diabetes is a leading cause ofblindness, kidney failure andamputations, and significantlyraises the risk of heart attacks. Itkills 180,000 Americans each year.Some diabetics control their dis-ease with diet, exercise and vari-ous medications; others requireregular injections of insulin, ahormone crucial to convertingblood sugar into energy.

More than 200,000 diabeticshave insulin pumps implanted intheir abdomens, a programmablesystem that can provide moreprecise, regular doses, infusingeven while the patient is sleepingif necessary. But patients still haveto test their blood sugar and thendo some math to decide howmuch their pumps should emit

and when.With the new system, patients

still will perform the glucose test.The pager-sized glucose monitoruses wireless technology to beamthe result straight to the implant-ed insulin pump. Punch in mealplans, and an internal calculatorwill figure target glucose levels,the patient’s insulin sensitivity andhow much insulin is already in theblood to deliver a dose recom-

mendation.The patient has final control,

pushing a button to accept thatdose or override it if more or lessinsulin is needed for some rea-son.

Medtronic said the prescrip-tion-only device will begin ship-ping July 21 and cost $5,995, $500more than Medtronic’s manuallyprogrammed insulin pump.

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FDA approves new device to manage diabetes

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A DAY IN THELIFE OF...

The ERnursePage 10

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.

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upnorth healthwatch 07/2003

Documents

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continuum of care

care continuum

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