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If you are having a child for the first time, it is easy to feel overwhelmed by questions, fears, and just not knowing what to expect. Many new parents find that childbirth education classes can really help calm their worries and answer many questions.
Our classes cover all kinds of issues surrounding childbirth including breathing techniques, pain management, vaginal birth, and cesarean birth. They can help prepare you for many aspects of childbirth: for the changes that pregnancy brings, for labor and delivery, and for parenting once your baby is born. Mankato Clinic Childbirth Educators are highly trained and knowledgeable and have proven to be a reliable resource for expectant parents.
Typically, new parents take birthing classes during the third trimester of the pregnancy, when the mother is about 7 months pregnant. Each "Prepared Childbirth" class is four sessions- one session per week. You do not need to be a Mankato Clinic patient to participate in these classes.
Benefits of Taking a Childbirth Class At our childbirth class you will be provided with a great forum to ask lots of questions and you will learn more about topics such as:
•how your baby is developing •healthy developments in your pregnancy •warning signs that something is wrong •how to make your pregnancy, labor, and delivery more comfortable •breathing and relaxation techniques •how to write a birth plan •how to tell when you are in labor •pain relief options during labor •what to expect during labor and delivery •the role of the coach or labor partner Many of our classes also address what to expect after the baby is born, including breastfeeding, infant care, and dealing with the emotional changes of new parenthood.
If you have questions or would like more information please call 507-385-4089.
Click here for the 2015 Childbirth Education Class Schedule
It's a fact of life. Everyone breathes a little harder and heavier as they age, but in people with emphysema, the progression occurs much faster. In the United States, nearly four million people have emphysema and more than 100,000 people die from the disease each year. And, many more people die from a secondary disease caused by emphysema. Lung disease, including emphysema, is the fourth most common cause of death in the United States.
What is emphysema?
Emphysema is a serious disease that affects the lungs. It is one of three major diseases included under the category of COPD, or chronic obstructive pulmonary disease, along with chronic bronchitis and asthmatic bronchitis. Because severe bronchitis and emphysema are so closely interrelated, physicians often refer to a combined disorder known as COPD. The two diseases often develop simultaneously and require similar treatments. When the two occur together, it is sometimes difficult to distinguish between the two. When a person suffers from emphysema, the alveoli, or tiny air sacs in the lungs, lose elasticity, making it difficult to breathe.
Smoking, the most common cause of emphysema, often causes chronic bronchitis, which tends to narrow and obstruct the bronchial airways with mucus, scarring, and muscle spasms in the walls of the bronchial tubes. As a result, air becomes trapped in the lungs, making it difficult to exchange with new air; therefore, hard to breathe. There are four stages of emphysema: mild, moderate, severe and very severe. As the disease advances, an individual will see more symptoms and quality of life changes. Although symptoms of emphysema may appear suddenly and rapidly, the disease itself takes a long time to develop.
What causes emphysema?
Smoking is the biggest contributing factor to emphysema. It accounts for 80 percent of all cases. Not surprisingly, cigarette smokers are 10 to 15 times more likely to develop emphysema than non-smokers. Emphysema may also be caused by exposure to other pollutants including occupational hazards and exposures such as chemicals and dust, secondhand smoke, poor indoor ventilation and outdoor air pollution. Some individuals may have a rare genetic deficiency of alpha-1 antitrypsin which is a natural chemical in the body that controls elasticity in the lungs and may protect against damage to the lungs. This deficiency may cause emphysema to develop in non-smokers at a young age, typically under age 40.
What are symptoms of emphysema?
Emphysema is a serious disease that may be fatal. Detecting emphysema in its early stages may make treating and living with emphysema more manageable. The symptoms sometimes do not appear right away but rather when the disease is in its later stages typically in smokers after age 50.
Symptoms: - Shortness of breath (even with light activity)
- Rapid, labored breathing and persistent craving for air Enlarged chest
- Constant tiredness (even after waking up)
- Cough-with or without mucus Inability to exercise
Rare symptoms may include: - Unintentional weight loss
- Excessive sweating
- Fever and chills
If any of the symptoms listed above develop, contact a health care provider immediately. The earlier the diagnosis can be made, the easier it will be to manage the disease and benefit from more treatment options.
How is emphysema diagnosed?
A health care provider may diagnose emphysema by physical exam, history and symptoms. Upon physical exam, a physician may hear wheezing, decreased breath sounds or prolonged exhalation. But, the gold-standard for diagnosing emphysema is via spirometry which is a lung function test that measures volume and force of air as it is exhaled from the lungs. It measures how much air and how fast the air is exhaled. A chest x-ray or CT scan may show inflated lungs but at the point an x-ray reveals the disease, symptoms are apparent to the patient. X-ray or CT may be helpful in ruling out lung cancer.
What kinds of treatment are available for emphysema?
There is not any treatment currently available to reverse emphysema but there are measures to control it and its symptoms. Emphysema is typically considered a progressive, non-reversible disease. The goal is to identify the disease soon enough to administer general maintenance treatments.
Because smoking is the main cause of emphysema, permanent smoking cessation is necessary. Smoking cessation is the only way to stop the progression of emphysema. Continuing to smoke may increase the severity of the disease. In many who do quit smoking early, lung function may stabilize but the lost lung function is never fully recovered.
There are many medical treatments available to slow the progression of the disease. A health care provider may prescribe some medications to relax the bronchial muscles, open the airways and reduce inflammation including short-acting and long-acting bronchodilators. An inhaled steroid, in addition to a long-acting bronchodilator, often heeds the best results. Although bronchodilators do not improve or cure the disease, they do help improve day-to-day quality of life by improving breathlessness and the ability to exercise.
Receiving annual influenza vaccines and the pneumococcal vaccine when recommended can help prevent infections and associated complications in those with emphysema.
Patients may also participate in pulmonary rehabilitation which focuses on exercise training, breathing classes and nutritional education which help ease the symptoms of emphysema. These treatments usually work best for those in the early stages of the disease.
For those with very severe emphysema, some surgeries may be an option including bullectomy (removal of a consolidated area of emphysema) and lung transplant, although these are rare occurrences.
Keeping infection under control is important for maintenance of the disease because any infection can worsen symptoms and speed deterioration of the lungs. A physician may treat an individual with emphysema for respiratory infections such as bronchitis with antibiotics early to prevent this from happening and in severe cases, may add breathing equipment that helps administer oxygen.
Who develops emphysema?
Not surprisingly, smokers have the highest risk of developing emphysema. The typical patient with emphysema is a current or former smoker, over the age 50. Studies show that 15 to 20 percent of all smokers will develop emphysema in their lifetime. Emphysema is very rare in young people under 40 but the incidence of emphysema steadily increases with age. Women are just as likely to develop the disease as men but more women tend to die from emphysema. Women also report more severe symptoms, greater depression and tend to have poorer quality of life. They seem to be more susceptible to the effects of smoking and pollutants possibly because of hormones.
There are a fair number of occupations that put workers at a higher risk of exposure to potentially harmful irritants. Workers exposed to toxic chemicals, dust and air pollutants are at a greater risk to develop emphysema than workers who choose other occupations. Some potential occupations may include: grain farmers, miners, furnace workers, welders and cooks.
What can be done to reduce the risk of emphysema?
Once an individual develops emphysema, the damage cannot be reversed so it is best to reduce the risk of emphysema from happening in the first place. The simplest way to reduce the risk of emphysema is to refrain from smoking altogether. If it is too late to refrain, quit smoking immediately. It is also important to avoid second-hand smoke. Try and avoid occupational risk factors. Additional healthy life-style choices are also helpful. Exercising and eating healthy meals and snacks has been shown to reduce the risk of emphysema.
Katherine Kurth is a native of Mankato. She joined the Mankato Clinic in 2000. She received a bachelor's degree from Gustavus Adolphus College in St. Peter and a master's degree in Nursing from Minnesota State University, Mankato. She is a certified Nurse Practitioner in Pulmonology and Internal Medicine and sees patients at the Main Street Clinic. To schedule an appointment with Katherine Kurth call 507-389-8516.
Ovarian cancer has long been known as a silent killer because there are few symptoms that present themselves until the disease has reached an advanced stage when it is least curable. And, unlike breast cancer which uses mammograms, and cervical cancer which uses pap smears as screening tools, ovarian cancer does not have a good screening test. Therefore, 75 percent of all ovarian cancers are diagnosed in stage three or four, and the outcome is grave. The five year survival rate for ovarian cancer is 45 percent compared to nearly 80 percent for breast cancer and 70 percent for invasive cervical cancer.
One in 80 women will be diagnosed with ovarian cancer in her lifetime. The life-long age of diagnosis is 63. It is the second most common malignancy and fifth leading cause of cancer death in women.
The American Cancer Society, along with several medical societies, has agreed on a set of symptoms that may help with earlier detection.
- Nausea and vomiting
- Persistent swelling
- Bloating or abdominal distention
- Pressure or pain in the abdomen
- Gastrointestinal upset or bowel changes
- Difficulty eating or feeling full
- Frequent or urgent need to urinate
- Abdominal pain
- Lethargy/Weakness
- Weight loss or weight gain
- Pelvic pain
These symptoms are common and may mimic other disorders. Most often, they do not indicate ovarian cancer and may be mistaken for other diseases including gallbladder disease, a benign tumor, inflammatory bowel disease and liver failure. However, if a woman experiences two or more of these symptoms that occur simultaneously and increase in severity over time, she should be checked by her physician.
Early Detection and Diagnosis
Early detection of ovarian cancer is crucial. Still, only 20 percent of ovarian cancer is found before it has spread. Diagnosis of ovarian cancer is most commonly made at a woman's regular gynecological exam. The best index for diagnosis is suspicion by her physician which makes the annual exam a key component to early detection and diagnosis. During the pelvic exam, the physician palpates a woman's ovaries for the presence of ovarian abnormalities such as ovarian cysts or fibroid tumors. If the physician finds any abnormalities, he or she may follow-up with additional tests. The cure rate, if found early, is colossal and, if diagnosed in stage one or two, is nearly 90 percent compared to 45 percent in stage three or four. But 75 percent of women are still diagnosed in the advanced stages, when the prognosis is poor.
Although a woman's best defense to early detection is her annual exam, a physician may recommend that a woman with a family history of ovarian, breast, colorectal or endometrial cancer participate in a genetic risk assessment. This enables physicians to provide an individualized and quantified assessment of risk, as well as options for tailored screening and prevention strategies including prophylactic surgical intervention.
Risk assessment may include a CA 125 blood test. CA 125 is a protein made by the body in response to many different conditions. Many women with ovarian cancer have abnormally high levels of CA 125 in their blood. However, a number of non-cancerous conditions also cause elevated CA 125 levels, and many women with early-stage ovarian cancer have normal CA 125 levels. Because of this lack of specificity, the CA 125 test isn't used for routine screening in average-risk women and is of uncertain benefit in high-risk women.
HE4, or human epididymis protein 4, is another relatively new tumor marker for ovarian cancer. The test is used to monitor the recurrence and progression of ovarian cancer. The most promising advancement is a combination of markers and hormones which is similar to the quad screening, which is a test a woman takes while she is pregnant to help diagnose certain birth defects.
Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy. Initial treatment for suspected ovarian cancer is surgery to confirm diagnosis and determine its stage. Many times a physician may suspect an isolated tumor but during surgery finds that the cancer is wide-spread. This discovery may change treatment options and decisions. Chemotherapy almost always follows surgery and its success is largely based on getting rid of as much of the tumor as possible during the surgical procedure.
It is not completely clear what causes ovarian cancer. But, there are certain factors that may reduce the risk of developing ovarian cancer.
- Oral contraceptives or "the pill": Anything that interrupts incessant ovulation month after month, year after year, including the birth control pill is shown to reduce the risk of ovarian cancer. The longer a woman is on the pill, the more protected she is from developing ovarian cancer. If she is on the pill for seven or more years, there is a six-fold risk decrease in developing the disease.
- Pregnancy and breast-feeding: Having at least one child lowers the risk of developing ovarian cancer and the more times a woman is pregnant, the more protected she is from the disease. Breast-feeding and the longer a woman breastfeeds may reduce the risk.
- Surgical procedures: Having a woman's "tubes tied" helps reduce the risk ovarian cancer. Hysterectomy is also shown to reduce the risk of ovarian cancer. In both procedures, the blood flow to the ovaries may be diminished which may reduce the risk of ovarian cancer.
- Annual exam: Recently changed recommendations regarding the frequency of pap smears still does not mean that a woman does not need a yearly exam. Purely feeling a mass during a pelvic exam may help detect ovarian cancer.
- Infertility and treatment drugs: Infertility may increase the risk of ovarian cancer but treatment of infertility may not.
- Pain relievers: Regular use of aspirin or other pain relievers in postmenopausal women leads to lower estrogen levels, which could contribute to a reduced risk of ovarian cancer.
There are certain factors that may increase a woman's risk of developing ovarian cancer.
Inherited gene mutations: While the majority of women who develop ovarian cancer don't have an inherited gene mutation, the most significant risk factor for ovarian cancer is having an inherited mutation in one of two genes called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). Women with the BRCA1 mutation have a 35 to 70 chance of developing ovarian cancer than do women without this mutation, and for women with a BRCA2 mutation, the chance is between 10 and 30 percent. For most women, the overall lifetime risk is about 1.5 percent, according to the American Cancer Society. You're at particularly high risk of carrying these types of mutations if you're of Ashkenazi Jewish descent.
Family history: Sometimes, ovarian cancer occurs in more than one family member but isn't the result of any known inherited gene mutation. Having a family history of ovarian cancer increases your risk of the disease by 10 to 15 percent.
A history of breast cancer: If you've been diagnosed with breast cancer, your risk of ovarian cancer also is elevated.
Age:Ovarian cancer most often develops after menopause. Your risk of ovarian cancer increases with age through your late 70s. Although most cases of ovarian cancer are diagnosed in post-menopausal women, the disease also occurs in premenopausal women.
Smoking: Smoking is shown to increase the risk of ovarian cancer.
Obesity: Women who are obese have a greater risk of developing ovarian cancer. Obesity may also be linked to more-aggressive ovarian cancers, which can result in a shorter time to disease relapse and a decrease in the overall survival rate.
Talc on surgical gloves: The use of talc on surgical gloves is controversial as to its risk in developing ovarian cancer; nonetheless, the use of talc on surgical gloves has been largely abandoned.
A native of Mankato, Dr. Mark Taylor joined the Mankato Clinic in 1987. He began his medical education at the University of Minnesota/Duluth and received his medical degree from the University of Minnesota, Minneapolis, MN. His post-graduate training was served at the Mayo Clinic, Rochester, MN in the Department of Obstetrics and Gynecology. Dr. Taylor is board certified in OB/GYN and sees patients at the Mankato Clinic Main Street Clinic in the Obstetrics and Gynecology departments. To schedule an appointment with Dr. Taylor call 507-389-8522.
When is comes to weight loss, the promise of a quick fix or magic bullet is appealing to many. The hope that weight loss pills offer may be tempting but may not be the homerun dieters are looking for. Eating a healthy diet and exercising regularly is the best way to shed unwanted pounds. But, for individuals who struggle to lose weight or have weight-related medical problems, weight-loss drugs may help. Keep in mind weight loss pills do not replace healthy eating habits or exercise and may not be appropriate for everyone who is overweight.
Who is a candidate for weight loss drug therapy?
Weight loss medications are designed to help obese individuals as part of a weight loss reduction program and are generally intended for people who have not been successful in losing weight through diet and exercise or who have a medical condition due to obesity. They should not be used as a substitute for healthy eating and exercise and are only effective when used in combination with a healthy diet and exercise.
Before considering drug therapy, a patient must have a body mass index (bmi) of at least 30 and been unsuccessful with diet and exercise. Those with a bmi of 35 or more, with an underlying medical condition such as Type 2 diabetes or high cholesterol, or those with a bmi of 40 or more without medical risk factors, may be candidates for drug therapy and/or surgical intervention. Even if a patient meets the criteria and begins the drug therapy in addition to making lifestyle changes, there is no guarantee they will work. In the end, the foundation of every successful weight-loss program still remains a healthy, low-calorie diet combined with exercise. Permanent changes in lifestyle and overall health habits are the key to losing significant weight and keeping it off.
What Weight Loss Medications are available?
Xenical (prescription orlistat) is currently the only prescription weight loss medication available. Alli is the non-prescription version of orlistat and the only over-the-counter weight loss drug approved by the FDA. The Alli capsules are a lower strength, half the strength of Xenical.
How do they work?
Xenical and Alli prevent the absorption of nearly 25 percent of the fat consumed in a diet. Studies show that when used in conjunction with eating a healthy diet, users were able to lose 50 percent more weight than dieting alone. But, this is no magic bullet. Even Xenical studies showed after one year of use only a modest five percent weight loss. And, when diet and exercise were not included in the weight loss strategy and individuals relied on pills alone, there was almost no change in weight.
What are the risks of weight loss drugs?
In the last year, many well-known weight loss pills including Meridia were pulled from the market due to an increased risk of heart-related conditions including heart attack and stroke in its users. Meridia was causing more harm that good. Additional risks and side effects of weight loss drugs include diarrhea and loose stools, gas, bloating and vitamin deficiency. Overall, weight loss drugs do not teach individuals what they really need to know about living healthy.
What are the benefits of weight loss on overall health?
The benefit of weight loss is not so much about what is lost but what is gained. A healthy weight along with a suitable bmi is directly related to length and quality of life. Studies show that people with a higher bmi have a shorter life-expectancy and more health problems than someone with a lower bmi. Maintaining a healthy weight is extremely beneficial in general as being thinner is easier on the body overall.
Skinny by all means does not define healthy. Skinny is not the answer, being fit is. A person with a lower bmi who does not partake in a regular exercise routine may not be as healthy overall as a person with a higher bmi but who exercises regularly. There is no` substitute for working hard. Many problems are a direct result of being obese such as arthritis, high blood pressure, heart disease and diabetes. These conditions may be eliminated by simply eating right and staying active.
What is the best way to lose and maintain a healthy weight?
The healthiest way to lose weight is first, in a way that is not hard on the body and second, in a way that it can be maintained. One common mistake is to try and take too many pounds off at once. A healthy goal is one pound a week. Individuals who are most successful at weight loss do so in moderation. It is unreasonable to ask patients to never eat sweets just as long as they do not take in large amount of calories at once, at one time of day. It is important to keep the metabolism even, eating at least 3 or more small meals a day or spreading calorie intake out, even if that means spreading meals out to 5-6 times a day.
It is important to be honest about calorie intake. No one likes to think they eat too much. Weight gain is caused by either consuming too many calories or not burning enough. One of the easiest ways to cut back on calories is to limit beverages with high calorie content like regular pop and alcoholic drinks. Instill children at a young age to drink more water and milk, not juice and pop. There are weight loss programs out there that have good track records that may serve as a guideline including Weight Watchers, which teaches users to count calories as points. The long term benefit of this type of program has proven successful even 1-2 years later. To put it simply, the best way to lose and maintain weight is eating right and exercising.
A native of Jackson, MN, Dr. John Benson joined the Mankato Clinic in 1998. He received his premedical education at St. John's University in Collegeville, Minnesota and his medical degree from the University of Minnesota, Minneapolis. He interned at the University of California, Davis Medical Center, and completed his family practice residency at Methodist Hospital and Mercy Family Health Center, Sacramento, California. Dr. Benson is board certified in Family Practice and sees patients at the Mankato Clinic Wickersham Health Campus. If you would like to schedule an appointment please call 507-385-4060.
Almost everyone has had a headache at one time or another. Headache is one of the most common health ailments with over 45 million Americans currently suffering from chronic headache. Headache accounts for more than three million visits to the emergency room and 80 million doctors' office visits every year. Women account for nearly three out of four of those visits. However, not every headache is a medical emergency. Headache may be frightening because many sufferers believe it may be the sign of something serious. Serious causes of headache are extremely rare. There are actually 150 different diagnostic categories for headache but the majority fall into just a few categories. The first step in managing headache is to determine what type the headache is causing the pain.
Headache Types: Headache is a symptom with many causes. It is important to distinguish between the two different types of headaches which are primary and secondary.
1. Primary Headache: Primary headache accounts for 90 percent of all headaches and is a medically-diagnosed condition that is not caused by another underlying cause. They exist independently of from other medical conditions. The most common primary headaches are migraine, tension headache and cluster headache which all have different underlying characteristics and result in different types of pain.
Migraine Headache: Migraine headache is the most common type of headache that physicians see. Over 28 million people suffer from migraine headache. The exact cause of migraines is unknown.
Symptoms of migraine headache are: - Moderate or severe, one-sided pain commonly felt in the temple area.
- Throbbing or pulsating pain lasting 8 to 72 hours, recurring multiple times a month.
- Pain that worsens with physical activity. Pain that interferes with daily routine.
- Sensitivity to light, sound or smells.Nausea with or without vomiting, dizziness.
- Neck pain.Any neurological deficit including visual and auditory disturbances.
Not all migraines are the same. They may present with or without aura. Migraine with aura means the headache is preceded by certain warning signs like changes in vision, disturbances in sound or tingling in the hands or face. Most people do not experience aura with migraines.
Tension Headache - Tension headache is the most common type of headache but is the type least treated in the doctors' office. Tension headache is also referred to as stress headache and can be a cause of chronic daily headache. The pain of tension headache is not disabling but more of a distraction.
Signs of tension headache are:
- Dull, steady ache on both sides of the head. Pain that increases over a few hours and becomes pulsating.
- Persistent pain that may feel like pressure around the head or a band squeezing around the head - Pain that does not worsen with activity. Tight shoulders, neck and jaw and sore scalp, forehead and face. - Signs of clenching teeth.
- Persistent pain that may feel like pressure around the head or a band squeezing around the head
- Pain that does not worsen with activity. Tight shoulders, neck and jaw and sore scalp, forehead and face.
- Signs of clenching teeth.
Cluster Headache - Cluster headache is the least common type of headache but is usually very severe. They affect 1 in 1,000 people and are more common in men than in women. Most cluster headache sufferers experience their first cluster before the age of 30. The term cluster refers to the headaches presenting in groups within a short period of time. They may occur up to eight times a day and last 15 to 45 minutes over a period of weeks. Sufferers may experience headache-free periods for six months to a year later. Cluster headache tends to occur in the early morning hours and wake the person from sleep. Pain is excruciating and many sufferers pace the floor unable to get relief.
Symptoms of cluster headache are:
- Pain that is burning or stabbing in nature.
- Sharp, excruciating pain.
- Pain that is one-sided and does not shift to the opposite side.
- Red eye and runny nose. Present in full force within 5-10 minutes of onset.
- Headache with a similar pattern from episode to episode.
Mixed Headache Syndrome - Mixed headache syndrome is when a headache sufferer actually shows signs and symptoms of having a combination of migraine and tension headache.
Additional Primary Headache - Other less common types of primary headache include hemicrania which is a migraine-like headache that involves a series of multiple short yet severe, stabbing headaches that affects one side of the cranium. Occipital neuralgia is also a common headache caused by a pinched nerve as a result of sleeping with the neck in a bad position, whiplash or other trauma.
2. Secondary Headache: Headache is secondary when it is caused by another underlying condition which may or may not be serious. Many medical conditions list headache as a symptom but patients generally present with clues that usually alert physicians that a headache is secondary in nature.
General medical conditions – There are many common medical conditions that may cause secondary headache. They include infections or disorders of the head and neck including sinusitis, meningitis and thyroid disorders. Head or neck trauma including concussion, whiplash or contusion is additional causes. The fluctuation in blood sugars with diabetes is also a culprit. Headaches are common when the body is imbalanced. Body imbalances include high blood pressure, dehydration, renal failure, thyroid problems, allergy problems and sleep disorders. TMJ, or temporomandibular joint disorder, is the swelling of the temporomandibular joint that can also cause headaches.
Perimenopause and menopause – Over 30 percent of women suffer from perimenopause headache. Because headache may be related to hormones, the abnormal flow of estrogen and progesterone that occurs during perimenopause and menopause may trigger headache. Migraine-like headache is a common symptom of these conditions. Hormone fluctuations and hot flashes may cause sleep disturbances. Sleep deprivation may then lead to headache. Women seem to be prone to headache at puberty and again at perimenopause when hormonal changes are at their peak. Headache generally subsides once menopause passes. Hormone replacement may help headache during this time.
Rare but more serious medical conditions - It is common for many to worry about more serious causes of headache like brain tumor at the first sign of headache. These conditions are rare and the odds of a patient presenting with these are low. Other more serious causes of secondary headache are possible but are very rare. They are stroke, aneurysm and brain tumor. Only a small percentage of strokes produce headache. However the sudden onset of sever headache may lead a physician to check for bleeding on the brain. When a cerebral aneurysm begins to leak blood, a patient may present with a sudden onset of the worst headache of one's life or a thunderclap. Brain tumors rarely present with headache as a first symptom but rather with neurological deficiencies.
Primary or Secondary Headache? The key to distinguishing between primary and secondary headache lies in the characteristics of the headache, other symptoms that are occurring simultaneously and physical examination. Certain warning signs may suggest to a physician that a headache may be a secondary headache and not a primary condition. These include:
- Neurological symptoms during or between headaches. - Abnormal neurological examination. - New or unusual type of headache. - Sudden or worst headache of your life. - Fever.Stiff neck.Swelling of the optic nerves. - Headaches that are not responding to treatment and are steadily worsening. - A new headache that presents over the age of 50.
- Neurological symptoms during or between headaches.
- Abnormal neurological examination.
- New or unusual type of headache.
- Sudden or worst headache of your life.
- Fever.Stiff neck.Swelling of the optic nerves.
- Headaches that are not responding to treatment and are steadily worsening.
- A new headache that presents over the age of 50.
Most headaches can be diagnosed by a patient's history and physical examination but in the presence of any of the signs noted, a doctor may order blood tests, vision tests, x-rays, CT scans, MRIs, lumbar puncture or EEGs to rule out any potentially serious secondary headache causes.
Headache Prevention: Sometimes headache prevention is the best medicine. Not every headache can be stopped but making simple lifestyle changes will help ward them off. Keeping a headache diary will help determine which triggers are unique to each individual and is the first step developing an effective treatment plan.
Common Triggers: While some headache triggers can be controlled others are not including changes in the weather, family history and fluctuations in hormones. Not all headaches can be prevented but recognizing these triggers and modifying lifestyles can help minimize the frequency, duration and degree of headache:
- Stress: manage stress levels.Caffeine consumption: limit caffeine to less than three forms a day - Drinking alcohol: limit alcohol consumption. - Dehydration: stay hydrated by drinking plenty of water throughout the day. - Lack of exercise: stick to an exercise regimen to increase endorphins, which help relieve pain. - Smoking: do not smoke. - Food additives like MSG, processed cheese and aspartame: recognize and avoid food sensitivities. - Skipping meals: do not skip meals and eat smaller more frequent meals. - Change in caffeine intake: even one morning of missed coffee can trigger headache.
- Stress: manage stress levels.Caffeine consumption: limit caffeine to less than three forms a day
- Drinking alcohol: limit alcohol consumption.
- Dehydration: stay hydrated by drinking plenty of water throughout the day.
- Lack of exercise: stick to an exercise regimen to increase endorphins, which help relieve pain.
- Smoking: do not smoke.
- Food additives like MSG, processed cheese and aspartame: recognize and avoid food sensitivities.
- Skipping meals: do not skip meals and eat smaller more frequent meals.
- Change in caffeine intake: even one morning of missed coffee can trigger headache.
- Change in sleep patterns: form good, consistent sleep habits.
Not every headache is the same therefore not every treatment works for every person. Headache tends to vary in frequency, severity and disability, that's why it is important to tailor treatment plans to each individual situation. However, relaxation techniques, stress management and exercise are proven forms of therapy.
- Most over-the-counter analgesics such as aspirin, ibuprofen, acetaminophen and muscle relaxants help relieve tension headaches and if taken at the first sign of attack, may help migraine headache. - - Decongestants may help migraine and tension headache.
- Most over-the-counter analgesics such as aspirin, ibuprofen, acetaminophen and muscle relaxants help relieve tension headaches and if taken at the first sign of attack, may help migraine headache. -
- Decongestants may help migraine and tension headache.
However, the overuse of over-the-counter pain pills may often lead to increased headache frequency or rebound headaches. Botox may also be used for treating migraine headache but only after other forms of treatment have failed. When making changes in lifestyle habits, using relaxation techniques and taking over-the-counter painkillers do not work, sometimes other forms of treatment are necessary.
If migraine headache occurs four or more times a month, a physician may prescribe other prophylactic or preventative medications to help relieve headache symptoms. They include blood pressure drugs, muscle relaxants, antidepressants and anti-seizure medications. To stop a migraine, the physician may prescribe triptans, which come in the form of pills, injection or nasal sprays.
Cluster headaches do not respond to over-the-counter analgesics because they do not act quickly enough. Many abortive treatments are used to relieve cluster headache including Imitrex injections, anesthetics and high flow oxygen. Preventive medications for recurrent cluster headaches include calcium channel blockers, beta blockers and steroids.
When to Consult a Physician For Headache: Seek medical attention immediately for any of the following signs or symptoms which may be indicative of a more serious health problem:
- Headache that is the worst headache of one's life (a good indicator is if a person has to think about if it is the worst of their life, it probably is not). - Abrupt onset of headache without warning signs. - Headache after injury or trauma especially if headaches worsen. - Change in pattern of recurrent headaches or if recurrent headache is life-altering. - Onset of headache at unusual age (before age five or after age 50). - Onset of headache with seizure or syncope. - Experiencing any neurological deficits including seeing or hearing. - Headache that is worse after coughing, straining or any exertion.
- Headache that is the worst headache of one's life (a good indicator is if a person has to think about if it is the worst of their life, it probably is not).
- Abrupt onset of headache without warning signs.
- Headache after injury or trauma especially if headaches worsen.
- Change in pattern of recurrent headaches or if recurrent headache is life-altering.
- Onset of headache at unusual age (before age five or after age 50).
- Onset of headache with seizure or syncope.
- Experiencing any neurological deficits including seeing or hearing.
- Headache that is worse after coughing, straining or any exertion.
Dr. Lisa Davidson joined Mankato Clinic in 2001. She received her medical degree from the University of South Dakota and completed a neurology residency at the University of Wisconsin, Madison. Dr. Davidson is board certified in Neurology and Sleep Medicine. Dr. Davidson sees patients in the Neurology department at Main Street. She also consult with patients who are undergoing sleep studies at the J. Scott Sanders Center for Sleep Medicine. You can schedule an appointment with Dr. Davidson by calling 507-389-8568.
One of the best gifts expectant parents can give their baby is the gift of a healthy pregnancy. Expectant mothers who regularly receive prenatal care have healthier babies and are less likely to experience serious pregnancy-related complications. Early, regular prenatal care is the single most important thing an expectant mother can do to deliver a baby with a clean bill of health.
Prenatal Care Begins Before Conception:
Ideally, prenatal care should begin before pregnancy with a check-up by a health care provider. This includes a routine exam and testing to ensure the mother-to-be is in good health. And, it is important to establish healthy lifestyle habits including smoking and drinking cessation before conception.
- Get Fit. Being physically fit without being fanatical improves fertility and the chances of conceiving. Starting with a good weight baseline helps keep a woman on the right track to delivering a baby with a healthy birth weight.
- Take Vitamins. It's especially important for women who are planning to become pregnant to take a multi-vitamin with folic acid and iron because neural tube defects (like spina bifida) can happen in the first 28 days of pregnancy, often before a woman even knows she's pregnant. Doctors recommend taking 1 mg of folic acid every day throughout pregnancy. Additionally, the iron in the prenatal vitamins will help boost mom's iron supply making it more readily available for her growing baby.
Taking Care of Mom and Baby After Conception: Mothers-to-be need to make additional healthy choices and smart decisions after conception to help prepare for a safe pregnancy and the arrival of a healthy baby. Following are some basic guidelines recommended by the American Academy of Family Physicians (AAFP).
- Exercise. Exercise may help ease discomfort during pregnancy, make labor and delivery easier and reduce the risk of pregnancy-related complications including preeclampsia and gestational diabetes. Try to get at least 30 minutes of exercise each day. Walking and swimming are great choices. It's best to avoid contact sports or anything that could cause a fall.
- Eat a healthy diet. One of the most important things a woman can do for herself and her child is to eat a healthy, balanced diet from the five food groups. But, during pregnancy the foods mom doesn't eat can be just as important as the ones she does. There are some foods to avoid when eating for two.
Fish: There is a lot of buzz about fish and mercury. Fish is actually a great source of protein, iron and valuable omega 3 fatty acids. It is safe to consume fish by following these simple guidelines. Eat no more than two or three servings of fish totaling 12 ounces or less per week including canned fish. The best options are salmon, shrimp, canned tuna and catfish. Avoid the fish with highest risk of mercury content, including shark, swordfish, tilefish and King Mackerel. Ask your doctor for the Minnesota Fish Guide for safety in pregnancy for local regulations.
Dairy: Eat four or more servings of dairy foods each day which provides enough calcium for Mom and baby but avoid soft cheeses such as Brie, feta, Camembert and blue cheese as these carry increased risk for listeria. It is safest to consume dairy products that are pasteurized.
Coffee: Limit coffee and other drinks containing caffeine to one serving each day.
Artificial Sweeteners: There is insufficient information regarding the safety of artificial sweeteners such as aspartame during pregnancy, the best bet is moderation. Limit usage to one or two servings a day or less, and avoid them when appropriate alternatives exist.
Make realistic weight gain expectations during pregnancy. Although it varies from woman to woman, most women gain about 25 to 35 pounds. Women who begin pregnancy underweight may need to gain more and women who are overweight, may need to gain a bit less.
Identifying Concerns in Pregnancy: Thanks to advancements in research and technology, it is now possible to identify more problems and risks earlier in pregnancy than ever before. The following are optional, but available tests that may be offered or recommended by a physician during pregnancy:
- First Trimester Screening: In the last 5-10 years, newer guidelines have been established for first trimester screening between 11-13 weeks which combines lab testing and an ultrasound to helps identify the risk of chromosomal abnormalities in the trisomy family including Down syndrome. This may be especially important for women over 35 who carry an increased risk for these findings.
- Progesterone Treatments: In the last 5-10 years, more emphasis has been placed on prevention of preterm labor. Weekly progesterone injections or daily progesterone vaginal suppositories beginning between 16 and 20 weeks for women who have a history of preterm labor and delivery have been shown to reduce the risk.
- Group B Strep Screening: Studies show that the vast majority of babies who get sick in the first days of life are from a preventable infection by the bacteria Group B streptococcus which can commonly be found in many women's urine, vaginal secretions or stool. It is now routine for all pregnant women to be screened for Group B strep at 36 weeks and, if test positive, be treated with antibiotics during labor.
- Chorionic Villus Sampling or Amniocentesis: These tests check for certain birth defects between 12 and 18 weeks of pregnancy including Down syndrome. Testing of this fashion can be pursued if mom had abnormal results of a routine prenatal screening test, if she is 35 years or older, or if there are specific genetic disorders in the family such as Tay-Sachs disease, Cystic Fibrosis or Down syndrome for which screening is desired. They are done at a tertiary care center and carry with them a small risk of miscarriage. Women wishing to pursue this kind of testing will first meet with a genetic counselor to review in detail the risks, benefits and alternatives.
- CF Carrier Screen: This blood test screens whether or not a person carries the abnormal gene that causes cystic fibrosis, an inherited disease that affects breathing.
- Maternal Quad Screening: This screening is recommended for any expectant mothers to determine if their baby is at an increased risk for serious birth defects including neural tube defects like spina bifida and chromosomal abnormalities like Down syndrome. It is an optional test available between 16-18 weeks.
- Ultrasound: An expectant mother typically gets at least one ultrasound in pregnancy. A first trimester ultrasound may be done to confirm the due date and identify a multiple pregnancy. A routine 18-20 ultrasound is typically done to check the baby's age and size, and look at the growing internal organs to identify serious birth defects, although there is no guarantee that more subtle findings may be missed. A woman may also have an ultrasound later in pregnancy to diagnose any complications like growth restriction, low or high fluid accumulation, breech position, fetal distress or other more infrequent complications.
Dr. Alyssa Stitt joined the Mankato Clinic in 2005 and provides full-spectrum family practice care, including obstetrical care. She received her medical degree from the University of Iowa College of Medicine. Dr. Stitt completed her residency at the University of Wisconsin, Department of Family Medicine, Madison, Wisconsin and is board certified in Family Practice. Dr. Stitt sees patients at Family Practice @ Main Street. You can schedule an appointment with Dr. Stitt by calling 507-389-8587.
Turning 40 and reaching mid-life does not have to mean mid-life crisis. Although many women experience changes both physically and emotionally around age 40, there are ways to embrace and mark the milestone as the beginning of the best years ahead.
Not quite old but not quite young At age 40, a woman may begin to notice her life is changing as her body changes along with it. She is not feeling quite old but isn't quite young. While she may still feel young, her body is beginning to reject what was once considered normal which is due primarily to hormonal fluctuations. Women begin to experience unintentional weight gain despite no dramatic change in eating habits or exercise. Clothes don't quite fit the same as they used to even though the scale reads the same. They may feel testy and short, tired and annoyed. They find it difficult to get a good night's sleep. Their periods may become irregular and different.
Forty is generally too young to experience menopause and its symptoms may not quite be on a woman's radar screen. But, many women are unknowingly beginning to experience symptoms of what is referred to as perimenopause or pre-menopause. Because these symptoms may start on average up to eight years before the onset of menopause, many women do not realize the symptoms they are experiencing are related to menopause or its impending onset. Although these changes may be bothersome, they are a normal part of womanhood and most will experience at least some of the symptoms at one time or another.
Perimenopause-It's all hormonal Perimenopause or pre-menopause is the transitional period that precedes menopause in which hormonal imbalances and fluctuations occur in a woman's body and may cause distress. During perimenopause, the body is beginning to transition into menopause, which is the time when a woman does not have a menstrual cycle for 12 consecutive months.. Levels of the reproductive hormones estrogen and progesterone begin to fluctuate irregularly. The imbalance is primarily caused by a woman having too much estrogen and too little progesterone. She may begin to feel like her body is just a little off. Women's bodies use hormones as a messenger delivering the message to stop and pay attention to their bodies. Hormonal imbalances cause many common symptoms of perimenopause. It may come as a relief to many women experiencing these symptoms that hormonal imbalance caused by perimenopause is normal and may be the culprit.
Physical symptoms of perimenopause: - menstrual changes - sleep disruption and disturbances - headaches - acne - wrinkling - vaginal dryness - changes in libido - weight redistribution and gain - hair loss - dizziness - urinary dysfunction - unwanted hair growth - water retention and bloating - heart palpitations - dry skin - hot flashes night sweats
Emotional symptoms of perimenopause: - anxiety - short-term memory loss - fuzzy thinking - difficulty multi-tasking - fatigue - mood swings - difficulty concentrating - anger - sense of urgency
The most common symptom and first sign that a woman is facing perimenopause is changes in menstruation. Women may experience heavy bleeding, irregular periods, heavy cramping, longer or shorter duration and changes in frequency. Perimenopause is not unlike puberty when a woman's body and mind are also changing. In fact, changes that occur in puberty commonly recur in menopause. Perimenopause affects every woman differently. Intensity, duration and frequency of symptoms vary from woman to woman. It is a normal change all women will experience at one time or another some sooner than later.
Reevaluation at 40 At 40, many women begin to notice that their lives are changing. This is the time in a woman's, mother's and/or wife's life where her plate is the fullest. Her kids may be at the age where she worries the most. They are starting to date, drive or even go to college or leave the nest. Financial troubles and stress may set in as she begins to think about paying for college or building a nest egg. The reality of needing a nest egg sooner than later is more apparent. Her parents are aging. The increase in worry and thought provokes anxiety.
The 40-year-old woman also has to contend with societal changes and expectations. In the back of her mind, she feels young and vibrant but society says 40 and perimenopausal is over the hill. There are pressures to look youthful and fresh while men at this age may be considered sexy or mature. There are many changes occurring at age 40 that are cause for emotional distress and the reevaluation of what matters in life. She may take up a new hobby, dress differently, focus more on herself and speak her mind more.
But these stresses may be the root of many of the emotional symptoms experienced at 40. Because of the all the things on a woman's mind, it is common for her to experience sleep disturbances. She can't stay asleep as long as she used to and may toss and turn all night long. All of those thought processes going through her mind result in sleep disruption which may cause anxiety and worry. And, because she can't sleep, she feels moody and irritable. Because she is feeling moody, she may lose her temper and start to feel guilty. The effects snowball and eventually spiral out of control.
Embracing 40 and good health There are many thought processes and changes occurring in a woman's body and to remain healthy, she must learn how to best deal with them. There is a renewed need in the 40's to focus on being healthy. This decade is critical to making healthy lifestyle changes to not only eat right but to exercise and make sure bone mass and muscles are thriving.
Exercise helps release stress and as the 40-year-old woman contemplates what she wants to tackle first, the endorphins released during exercise will help reduce the stresses. Even though in a woman's 20's she could sit and eat a pint of ice cream, munch on a bag of chips or down a pan of brownies, and would many times like to in her 40's, that is not a reality. Many times women wonder why they have gained weight when they have not changed their eating habits. Reality is that women HAVE to eat differently starting in their 40's because of those hormonal fluctuations that don't allow women to eat the same way they did in their 20's and 30's, even if they feel 20 or 30. Women can not forget as they age, their metabolism slows down and the body is influenced by everything they do. Stretching and yoga, along with cardio fitness, will help boost metabolism. And, healthcare providers recommend that women exercise 30 to 40 minutes a day, five times a week. Eating balanced, healthy meals rich in fruits and vegetables will help.
Because women tend to do a lot of self-reflection in the night time hours, self-journaling to track thoughts and feelings on paper is great therapy. Laying reflections out on paper helps prioritize and create self-awareness, build self-confidence and make good decisions. It helps clarify who a woman strives to be, what she may want out of life and how to achieve it. Another useful outlet for women entering the 40's decade is coming together with same age girlfriends to compare notes and realize they are all in the same boat. Relaxing with girlfriends, having fun, laughing and even crying are all good medicine.
The best days are ahead Forty can be one of the best times of a woman's life both emotionally, sexually and physically. Studies show that women 40 and older tend to be more confident and know what they like and need than in their earlier years. There is a decrease in dependence and self-criticism and an increase in self-confidence and decisiveness. Also-some women tend to have an increased libido at this age. In the child-bearing days, many women feel heavier pressures and demands from children and home life. Children of women in their forties tend to be older and more independent. The days of a child clinging to mom have lessened and she may feel more accepting. Thus, intimacy with her spouse improves.
To put it simply, a woman entering her forties may help herself prepare for the impending physical and emotional changes by making healthier lifestyle choices, in turn making the transition years easier to accept.
Deborah Schilling, PA-C rejoined the Mankato Clinic in 2002. She received a Bachelor of Science degree in biology and chemistry from the University of Minnesota, Morris, as well as a bachelor of medical science degree in physician assistant studies from Midwestern University, Chicago. She is board certified in Family Medicine and practices at Family Practice @ North Mankato.
One in three women and one in five men will develop osteoporosis in their lifetime. The good news is osteoporosis is a manageable disease and with proper screening, healthy lifestyle habits and appropriate medical treatment, the risk of fractures or breaks may be avoided.
What is osteoporosis? Osteoporosis is a disease in which the bones lose bone density and quality. When the bones are not as strong, they are more prone to fractures and breaks. Osteoporosis affects bones in the hip, spine and wrist most often.
How do is it diagnosed? Osteoporosis strikes both women and men but women are four times more likely to develop the disease. It often occurs in women after menopause when there is a reduction in the hormone estrogen and in aging men when there is a loss of testosterone. The lack of estrogen or testosterone causes women and men to lose more bone mass.
What are the symptoms and risk factors? In most cases, osteoporosis builds up gradually and painlessly, often without any symptoms. In fact, many do not know they have the disease until after they experience a broken bone. At this stage, the bones have already experienced serious deterioration.
Because the disease is often symptomless, catching the disease before it causes damage is important. Low bone density is one of the best indicators that a person is at risk of a fracture therefore a bone density test is recommended. A bone density test is a diagnostic test that measures bone density using an x-ray scan. It is recommended that women get a bone density test starting at age 65. Men should be screened starting at age 70.
Risk factors include: - Being thin - Being Caucasian Chronic steroid use - Having certain medical conditions including kidney disease, diabetes, rheumatoid arthritis and hyperthyroidism - Having a history of smoking and alcohol abuse - Having a family history of osteoporosis. Having a previous bone fracture or break from a trauma - Entering early menopause Having poor nutrition Having low calcium intake - Having a history of inactivity - How is osteoporosis treated?
Although osteoporosis is not curable, it is treatable and manageable. A physician may recommend a plan that includes healthy lifestyle changes and possibly medications to reduce the risk of future breaks, help slow the rate of bone loss or increase bone thickness. As part of a treatment plan, it is also important to get enough calcium and Vitamin D in the diet.
How can osteoporosis be prevented? Building strong bones during adolescence is the best defense against developing osteoporosis later in life. And, adopting healthy lifestyle habits can influence bone development and the rate of bone loss later in life.
Adults may also take preventive measures to reduce the risk of developing osteoporosis: - Weight bearing exercises, such as walking 30 minutes a day, five days a week - Quitting smoking and reducing alcohol intake - A diet high in calcium and Vitamin D Taking supplements recommended by a physician also add to bone health. - Drinking milk and eating foods high in calcium at an early age may be important to preventing bone fractures and breaks later in life. - Ensuring healthy bones begins in adolescence but one is never too old to improve bone health. - Adopting healthy habits at an early age and recognizing the benefit of prevention helps everyone work toward a lifetime of healthy bones.
Dr. Katie Anderson joined Mankato Clinic @ Wickersham Family Practice in August 2011. A native of St. Cloud, Minnesota, she attended medical school at Creighton University in Omaha, NE and completed a residency at Siouxland Medical Education Foundation in Sioux City, Iowa. Dr. Anderson's clinical interests include women's health and preventive medicine, and she provides obstetric services. She is an avid runner and bicyclist
Can't sleep? You, along with tens of millions of others, may be suffering from a sleep disorder and not know it. Sleep is as vital to our health and well-being as food and water. When we lack sleep, our bodies suffer; which may lead to serious consequences in our daily lives including diminishing health, safety and alertness. According to the National Sleep Foundation, there are 80 known sleep problems and disorders. It is important to speak with your physician about any disturbances in sleep because these sleep problems can be effectively controlled and treated.
As the numbers suggest, sleep disorders are highly under-diagnosed. Sleep disorders have been linked to hypertension, obesity, diabetes, cardiac abnormalities and uncontrolled high blood pressure. In response, Mankato Clinic's J. Scott Sanders Center for Sleep Medicine now offers six beds to study a patient's state of slumber. And, Neurologists Dr. Nidal Alkurdy and Dr. Lisa Davidson with the Mankato Clinic's neurology and sleep center team, help patients get back to sleep.
The first step to determining if you suffer from a sleep disorder is to discuss any sleep issues with your primary care doctor who may refer you to a neurologist, pulmonologist or ENT. After your consultation with a specialist, you may be invited to participate in a sleep study, or polysomnogram. A polysomnogram is a pain-free, noninvasive procedure that requires spending a night in a realistic bedroom setting at the sleep center facility. Sleep center staff monitor nighttime sleep functions including brain waves, eye movement, breathing and cardiac movement via electrodes to determine if you may have a nighttime sleep disorder. If you are not diagnosed with a nighttime sleep disorder but still complain of daytime sleepiness, sleep center specialists may ask you to participate in a daytime study which consists of a following brainwaves during naps to determine if another condition exists.
Sleep studies provide data that is essential in diagnosing and evaluating sleep disorders including sleep-disordered breathing like sleep apnea, REM behavior disorder, insomnia, periodic limb movement disorder, cataplexy and narcolepsy.
Treatment for sleep disorders may include CPAP or BIPAP devices, medication, light therapy, dental devices and, in rare cases, surgery.
It is possible to eliminate many minor sleep problems by adopting healthy sleep habits. They include: - Create a comfortable sleep environment that is dark and quiet. - Avoid caffeine including coffee, tea, soft drinks and chocolate close to bedtime. - Avoid alcohol close to bedtime. - Avoid nicotine products close to bedtime. - Maintain a regular sleep and wake schedule. - Establish a calming bedtime routine. - Exercise regularly but make sure you complete your workout at least three hours before bedtime.
Dr. Nidal Alkurdy joined the Mankato Clinic in September 2011. Dr. Alkurdy attended medical school at Damascus University. He completed his neurology residency at the University of Illinois at Chicago and a fellowship in clinical neurophysiology at Brown University. Dr. Alkrudy is board certified in neurology, neuro electrodiagnostic medicine(EMG) and pain medicine. His clinical interests include clinical neurophysiology (EMG, EEG), Botox treatment for neurological diseases, sleep disorders, multiple sclerosis, Parkinson's disease and general neurology. In Dr. Alkurdy's free time, he enjoys traveling, sports, and spending time with his family.
Dr. Lisa Davidson joined the Mankato Clinic in 2001. She received her medical degree from the University of South Dakota. She completed a transition residency at the University of South Dakota and a neurology residency at the University of Wisconsin, Madison. Dr. Davidson is board certified in Neurology and Sleep Medicine.
It is common for children to occasionally forget their homework, fidget in their chair or act impatiently. But, excessive inattention, hyperactivity and impulsivity are also signs of ADHD, or Attention Deficit Hyperactivity Disorder, that affects over five million children today. ADHD is a disorder that is first diagnosed during childhood and often lasts into adulthood that may cause trouble with focus, patience and over-activity. The good news is that there is treatment for ADHD and the earlier it is diagnosed and treated the more successful a child will be in school and life.
Distinguishing between ADHD and typical childhood behavior may be difficult. The three primary characteristics of ADHD are inattentiveness, hyperactivity and impulsivity. The most common type of ADHD is a combination of all three.
"All children at some point don't pay attention, listen or sit still," said Dr. Sreelatha Spieker, psychiatrist at Mankato Clinic. "But, it is important to recognize all of the signs of ADHD because if left undiagnosed and untreated, it can affect functionality at school and in life."
Dr. Spieker says that if kids show just a few signs and symptoms that appear occasionally in isolated situations, it is probably not ADHD. But, if they show numerous symptoms of ADHD across many different settings including home, school and activities, it is worth seeking an evaluation from a professional. Symptoms are most commonly detected by teachers when squirming, daydreaming and disruptiveness are affecting learning at school.
Symptoms include:
Inattention/distractibility- inability to play close attention to details make careless mistakeseasily distractedinability to listen when spoken to inability to complete assignments or choresdifficulty organizingfrequently loses or misplaces homework forgetfulness in daily activities Hyperactivity-This is the most commonly noticed symptom of ADHD. fidgets with hands or feet squirms in seatinappropriately leaving seat in classroom or other placesinability to engage in quiet play or activities excessive talkingconstant movement Impulsivity- acts without thinkingblurts out answers before questions are completed has difficulty waiting his or her turninterrupts others
Diagnosis There is not one single test to diagnose ADHD. Dr. Spieker estimates that five to 12 percent of all children are diagnosed with ADHD which means in a classroom of 25 to 30 kids, at least one is likely to be diagnosed with ADHD.
ADHD typically presents in elementary school-aged kids before the age of seven. "At this time, kids are beginning to sit all day and have learned how to listen to others and be patient," said Dr. Spieker. "So when kids with ADHD reach elementary school the inattentive, hyperactive and impulsive activity begins to stand out." She says it is possible for kids with only the inattentive symptoms of ADHD to be overlooked because they are quiet in class and do not cause trouble. It is not until they start to fall behind in school work and social situations that a teacher may start to suspect ADHD. ADHD may be detected at preschool age but because behavioral expectations are less at this age, it is the impulsive behavior at this age that may be a red flag.
"Any child can be hyperactive but when the symptoms are affecting learning, family functioning and social functioning, and a child is not performing up to his or her potential, it is time to seek help," said Dr. Spieker. "With proper treatment, parents will find their child can function much better."
Treatment If your child shows symptoms of ADHD, don't wait to get help. Left untreated, your child may suffer academically, socially and emotionally. They may struggle in school and family situations, develop low self-esteem, have problems driving, and can be at risk for substance abuse. Children with ADHD may also have associated behavior problems, learning disabilities, and mood and anxiety disorders.
A positive, long-term prognosis depends on effective treatments which vary by child, based on need. Even though children may have the same diagnosis of ADHD, their symptoms and treatment needs may be different. Treatment may include medication, cognitive behavioral therapy, parental management training to manage symptoms at home, educational support or a combination of these. Close monitoring, follow-ups and adjustments are all part of the treatment process. Treating ADHD symptoms will help children grow, learn and feel better about themselves.
Causes of ADHD The exact causes of ADHD are unknown but research shows that the disorder runs in families indicating a genetic cause. Other possible causes include an imbalance in neurotransmitters, and physical differences in the brain. Several different factors could increase a child's likelihood of having the disorder including low birth weight, children whose mothers used cigarettes or alcohol during pregnancy, and environmental toxins such as exposure to high levels of lead. Overall, the outlook for those with ADHD is good. With the right treatment and plenty of support, kids with ADHD will thrive.
ADHD has three different subtypes: ADHD-I which is predominantly inattentive. ADHD-H which is predominantly hyperactive-impulsive. ADHD-C which is a combination of the two. This is the most common subtype.
ADD or ADHD? While some people may still refer to the medical condition as ADD, it is no longer the current medical term. The terminology of the diagnosis of ADHD has changed over time, since the mid-nineteenth century. By 1980, medical professionals began recognizing inattentive symptoms as part of the diagnosis leading to the term ADD or "attention deficit disorder." Today, ADD would be referred to as ADHD-I which is the predominantly inattentive subtype.
Dr. Sreelatha Spieker joined the Mankato Clinic in 2005. She received her medical degree from Kurnool Medical College in Kurnool, India. Dr. Spieker completed a residency in Psychiatry at the University of Kansas Medical Center, Kansas City, Kansas. She completed a fellowship in Child and Adolescent Psychiatry at University of Kansas Medical Center, Kansas City, Kansas. Dr.Spieker's hobbies are gardening, scrapbooking, reading, and cooking. She enjoys traveling and spending time with her husband and two daughters. Dr. Spieker is a member of the American Psychiatric Association and American Academy of Child and Adolescent Psychiatry and is board certified in General Psychiatry and Child and Adolescent Psychiatry.
Backpack Strategies for Parents and Students Aching backs and shoulders? Tingling arms? Weakened muscles? Stooped posture? Does your child have these symptoms after wearing a heavy school backpack? Carrying too much weight in a pack or wearing it the wrong way can lead to pain and strain.
Parents can take steps to help children load and wear backpacks the correct way to avoid health problems.
Loading a Backpack
•A child's backpack should weigh no more than about 10% of his or her body weight. This means a student weighing 100 pounds shouldn't wear a loaded school backpack heavier than about 10 pounds.
•Load heaviest items closest to the child's back (the back of the pack).
•Arrange books and materials so they won't slide around in the backpack.
•Check what your child carries to school and brings home. Make sure the items are necessary for the day's activities.
•If the backpack is too heavy or tightly packed, your child can hand carry a book or other item outside the pack.
•If the backpack is too heavy on a regular basis, consider using a book bag on wheels if your child's school allows it.
Wearing a Backpack
•Distribute weight evenly by using both straps. Wearing a pack slung over one shoulder can cause a child to lean to one side, curving the spine and causing pain or discomfort.
•Select a pack with well-padded shoulder straps. Shoulders and necks have many blood vessels and nerves that can cause pain and tingling in the neck, arms, and hands when too much pressure is applied.
•Adjust the shoulder straps so that the pack fits snugly on the child's back. A pack that hangs loosely from the back can pull the child backwards and strain muscles.
•Wear the waist belt if the backpack has one. This helps distribute the pack's weight more evenly.
•The bottom of the pack should rest in the curve of the lower back. It should never rest more than four inches below the child's waistline.
•School backpacks come in different sizes for different ages. Choose the right size pack for your child as well as one with enough room for necessary school items
reprinted from the CDC website Seventy-one million American adults have high cholesterol, but only one-third of them have the condition under control. Too much cholesterol in the blood is one of the main risk factors for heart disease and stroke—two leading causes of death in the United States. One way to prevent these diseases is to detect high cholesterol and treat it when it is found.
What is cholesterol? - Cholesterol is a waxy, fat-like substance that your body needs. But when you have too much in your blood, it can build up on the walls of your arteries and form blockages. This can lead to heart disease, heart attack, and stroke. There are two kinds of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is also called "good" cholesterol. LDL is called "bad" cholesterol. When we talk about high cholesterol, we are talking about "bad" LDL cholesterol.
What role does screening play? Screening is the key to detecting high cholesterol. Because high cholesterol does not have symptoms, many people do not know that their cholesterol is too high. Your doctor can do a simple blood test to check your cholesterol level.
How can you prevent or treat high cholesterol? - Make therapeutic lifestyle changes by eating a healthy diet. - Avoid saturated fats and trans fats, which tend to raise cholesterol levels. Other types of fats, such as polyunsaturated fats, can actually lower blood cholesterol levels. - Eating fiber also can help lower cholesterol. - Exercising regularly. - Physical activity can help lower cholesterol. The Surgeon General recommends that adults engage in moderate-intensity exercise for 2 hours and 30 minutes every week. - Maintaining a healthy weight. Being overweight or obese can raise your cholesterol levels. Losing weight can help lower your cholesterol. - Not smoking. If you smoke, quit as soon as possible. - Be sure to follow your doctor's instructions and stay on your medications, if prescribed, to control your cholesterol.
Fulda native, Laura Wendorff Meyer, Nurse Practioner in Mankato Clinic's Neurology was inducted into the Blazer Hall of Fame on Friday June 28th, 2013 at the College of St. Benedict, St. Joseph, Minnesota. Laura Wendorff Meyer closed her basketball career on the hardwood as the Blazers' all-time leader in both points and rebounds with marks of1,775 and 1,053 respectively, records that still stand today. The Blazers never finished below second in her four years, but it was her junior season of 1998-99 that stands the test of time.That season she led her team to a 28-2 overall record, while winning back-to-back Minnesota Intercollegiate Athletic Conference titles for the first time in program history with identical 21-1 conference records. Advancing to the NCAA Tournament for the 11th straight year Wendorff Meyer and the Blazers played in CSB's first national championship game, eventually falling 74-65 to defending national champion and unbeaten Washington-St. Louis. She was the Minnesota Intercollegiate Athletic Conference Player of the Year in 1998-1999 and was named All-American, an honor that also included receiving Honorable Mention All-American accolades in both her sophomore and senior seasons, making her the only three-time All-American in program history. During her junior season she was also named the Columbus Multimedia West Region Player of the Year.Her name continues to dot the record books13 years after her stepping off the court for the final time. In addition to being the only player with over 1,000 career points and rebounds, she holds the marks for career scoring average (16.6),career rebounding average (9.8), career field goals(745), and career blocks (208). Under Coach Mike Durbin, the Blazers went 94-15 in Wendorff Meyer's four seasons, with a 77-10 mark in the MIAC, two championships and two runner-up finishes. She capped her career with her third Team MVP honor, and became the first four-time All-MIAC honoree in program history.While setting numbers on the court, she was equally as dominant in the classroom, earning CoSIDA Academic All-American honors as a senior.She graduated cum laude from CSB with a degree in nursing in 2000, and in 2003 earned her master's degree in nursing from Minnesota State University, Mankato. Today she is a certified family nurse practitioner and multiple sclerosis nurse.A native of Fulda, Minnesota, she and her husband Nick currently reside in New Prague,Minnesota, with their three children.
Protect them against serious diseases! August is National Immunization Awareness Month and is a reminder that we all need vaccines throughout our lives.
As they get older, kids are at increased risk for some infections. Plus the protection provided by some of the childhood vaccines begins to wear off, so kids need a booster dose. You may have heard about pertussis (whooping cough) outbreaks recently. Vaccine-preventable diseases are still real. The vaccines for preteens and teens can help protect your kids, as well as their friends, community and other family members.
There are four recommended vaccines that preteens should get when they are 11 or 12 years old. If you have an older kid like a teen, they'll need a booster dose of one of the shots. Plus it's not too late to get any shots they may have missed. You can use any healthcare visit, including sports physicals or some sick visits, to get the shots your kids need.
The vaccines for preteens and teens are:
Talk with a doctor, nurse, or clinic about the vaccines for preteens and teens. Even though they may not realize it, your kids still need you for more than a ride somewhere. They need you to continue protecting their health by getting them these important and life-saving vaccines.
Click on the links below to download and print the Minnesota State High School League Sports Physical Clearance Form and Sports Health Questionnaire. Bring the completed forms to your sports physical appointment.
Sports Physical Clearance Form
Sports Physical Health Questionnaire Form
MyHealthInfo is Mankato Clinic's Patient Portal, which provides patients with access to their health information anywhere there is an internet connection. This innovative approach is built on the idea that managing your healthcare information can be intuitive, efficient, and maybe even fun!
MyHealthInfo is free and can be accessed 24 hours a day, seven days a week.
ONLINE ACCESS-ANYWHERE, ANYTIME View your health information electronically via a web browser.
THE COMFORT OF A SECURE ENVIRONMENT Your health information is posted to a highly secure data repository.
YOUR INFORMATION View your health history and personal health record online. Get real-time health updates including lab results, medications, diagnoses, and immunization records.
SIGN ME UP! If you would like anytime, anywhere online access to your health records through the Mankato Clinic's MyHealthInfo, please fill out a form and to ensure your privacy and security, return in person to any Mankato Clinic location or at your next appointment. Because we have to verify your identify when you return the form before we enroll you, we can only accept forms that are returned in person; please do not mail sign-up forms.
Click here for the sign-up form that you can download, print and fill out
Click here for answers to Frequently Asked Questions about MyHealthInfo
If you are currently enrolled in MyHealthInfo, Click here to log into MyHealthInfo
reprinted from the CDC website
Heat-related Deaths Extreme heat events, or heat waves, are the most common cause of weather-related deaths in the United States. They cause more deaths each year than hurricanes, lightning, tornadoes, floods, and earthquakes combined. The number of heat-related deaths is rising. For example, in 1995, 465 heat-related deaths occurred in Chicago. From 1999 to 2010, a total of 7,415 people died of heat-related deaths, an average of about 618 deaths a year. Heat Stress Heat stress is heat-related illness caused by your body's inability to cool down properly. The body normally cools itself by sweating. But under some conditions, sweating just isn't enough. In such cases, a person's body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs.
Several factors affect the body's ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions related to risk include age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use.
Heat stress ranges from milder conditions like heat rash and heat cramps, to the most common type, heat exhaustion. The most serious heat-related illness is heat stroke. Heat stroke can cause death or permanent disability if emergency treatment is not provided.
Anyone can develop heat stress. However, the following groups of people have higher risks for experiencing heat stress or heat-related death:
Prevention Heat-related death or illnesses are preventable if you follow a few simple steps.
Mankato Free Press readers recently voted three of Mankato Clinic's family practice providers the top three "Best Family Practice Providers" in its annual "Readers' Choice Awards." The newspaper invites its readers to fill out a ballot and vote for their favorites around town in many different categories including "Best Family Practice Providers." Congratulations to the Mankato Clinic's first, second and third place winners! 1st Place: Dan Anderson, MD – Family Practitioner, North Mankato Family Practice Clinic This is Dr. Anderson's second consecutive year voted "Best Family Practice Provider" in the "Readers' Choice Awards." Dr. Anderson says he enjoys family practice because it gives him an opportunity to connect with people during healthy times as well as times of illness or crisis. "I appreciate seeing patients throughout many years of their lives and developing a mutual trust and respect for each other," said Dr. Anderson. "Forming relationships is an important part of my practice." He also credits his success to the excellent nurses that have worked with him throughout his years of practicing. Dr. Anderson keeps an active and busy schedule yet feels it is important to avoid rushing or getting behind.
2nd Place: Deb Schilling, PA-C, Physician Assistant, North Mankato Family Practice Deb Schilling was humbled yet honored to be named one of the top three family practice providers in the area. "I am very proud of my profession and feel truly blessed to touch so many lives every day," said Schilling. "I strive on a daily basis to provide the best health care and connect with my patients in all facets of their lives. When I know their whole story, the better I can develop a trusting relationship with them." Schilling loves to celebrate the accomplishments of her patients, no matter how big or small; from passing their driver's test, having a positive pregnancy test, quitting smoking, to losing 75 pounds. "As many of my patients know, I love to laugh," said Schilling. "But I am also not afraid to shed tears with them, as I truly feel their pain, sorrow, frustrations and fears."
3rd Place: Caroline Baerg, MD- Family Practitioner, Main Street Clinic Dr. Baerg didn't realize the impact she was having on her patients until she learned of her ranking in the "Readers' Choice Awards" and saw the excitement of people around her. She appreciates being welcomed and recognized in the Mankato community that she claims as her home away from home which is Nigeria. "My patients are human beings like me with a spirit, body and soul that needs to be addressed," said Dr. Baerg. "I strive to maintain a relationship that fosters trust and enjoy the opportunity to interact with people, serve to figure out their health challenges and help provide guidance to the best of my ability." She is privileged to work in primary care and proud to be recognized with this award. Congratulations to these providers and their teams!
Sunshine! Barbecues! Fireworks! Who doesn't love a good July 4th celebration? Well, your hearing for one, and your stomach after your third helping of BBQ, and your skin if you leave off the SPF...See what we're getting at? Not to worry; we've got the best tips to make sure this is your best—safest!—Independence Day ever. Bring some earplugs- the sounds of summer—such as fireworks and marching bands—can actually damage your hearing. When noise is too loud, it begins to kill the hair cells and nerve endings in the inner ear; so the longer (and closer) you're exposed to loud noise, the more likely you are to permanently damage your hearing. Toss some plugs in your bag or use your hands to cover your ears in a pinch. Swim in clear water- whether you're planning on making a splash at the beach, pool, or even lake, a good rule of thumb is to only dip into clear, good-smelling water. For lake goers, make sure there isn't any blue-green algae, or slimy, smelly green film floating on the lake's surface. Some forms of this can produce a toxic bacteria (called cyanobacteria) that's bad news for your health. Practice safe eating- keep from throwing your diet to the (hot) dogs. If you're manning the grill, designate different plates for raw and cooked meat, and don't leave food out in the sun for more than two hours (one hour if the temps are high). SPF in advance- applying your sunscreen a few hours in advance means you can significantly improve your skin's protection from harmful rays- and reapply, reapply, reapply. Follow the heat & humidity rule- to keep from dehydrating, implement the 70/70 rule: When the temperature and humidity are both above 70, you enter the dehydration danger zone. Stay safe by sipping frequently from a water bottle, and drinking plenty of water before, during, and after activity.
reprinted with permission from the Mankato Free Press
Mankato Clinic expands ultrasound capability For more than 30 years, when a Mankato Clinic patient needed an ultrasound done, they mostly were sent to LCM, a small lab just off Madison Avenue in Mankato. LCM is just few minutes by car from the clinic, and thousands of mothers around the region got their first glimpse of their children through the careful work of an LCM sonographer. But over the course of the last few years, LCM and the Mankato Clinic have come to an understanding that LCM would be phasing out its ultrasound work. At the same time, the clinic made plans to ramp up its ultrasound capabilities. The result is that the clinic now has one of the most technologically advanced ultrasound setups in the state. The clinic has spent roughly $ 1 million on ultrasound equipment and added more rooms, meaning they can accommodate more patients in the imaging department. The upgrades signal a new era for the clinic. But they're quick to remind how well their relationship with LCM worked for so many years. " We owe a huge debt of gratitude to LCM," Mankato Clinic gynecologist Mark Taylor said. " They saw a need and said they'd take it upon themselves to learn it." Having said that, Taylor said there are times when they need to have high- quality diagnostic imaging done immediately. For that reason, he said, it will be nice to have state- of-the art technology on site. Plus, he said, it's simply much more convenient for patients this way. "It will be nice to have it done in the same building," he said. "Patients have to dance around us a lot, and occasionally they have to wait. If we can minimize that, that's huge." Jana Hanson, the clinic's diagnostic imaging systems and ultrasound manager, said the clinic does roughly 700 ultrasounds each month, and pulls clients in from southern Minnesota as well as Iowa and South Dakota. Once LCM discontinues doing ultrasounds completely, Hanson said she expects that number to jump to about 1,000. All ultrasounds are read by a radiologist. Hanson says the clinic guarantees to have all ultrasounds read within 24 hours, but almost all are read within an hour. That kind of turnaround can mean a lot to a young mother, like Sarah Bouldin. If Bouldin needs to bring her kids along with her to an OB appointment that will include an ultrasound, any parent knows that having to make an extra stop can sometimes be a hassle. Plus, Bouldin says, the clinic's new ultrasound setup shows they're making patient comfort a priority. " The lighting, the atmosphere," she said. "It's definitely nice." Another plus: Right inside the ultrasound rooms, just a few feet away from the chair where the exam is done, is a bathroom. (Guys: Women in the earlier trimesters of pregnancy must have a very full bladder for an effective ultrasound.) "Patients have to dance around us a lot, and occasionally they have to wait. If we can minimize that, that's huge."
Summers are about fun car trips to Grandma's house, long-distance drives to fun destinations, road trips for sight-seeing, and driving from one sporting event to another. According to the CDC, placing children in age- and size-appropriate car seats and booster seats reduces serious and fatal injuries by more than half. Guidelines for Parents and Caregivers Parents and caregivers:
Know the stages: Birth through Age 2 – Rear-facing child safety seat. For the best possible protection, infants and children should be kept in a rear-facing child safety seat, in the back seat buckled with the seat's harness, until they reach the upper weight or height limits of their particular seat. The weight and height limits on rear-facing child safety seats can accommodate most children through age 2, check the seat's owner's manual for details.
Between Ages 2-4/Until 40 lbs – Forward-facing child safety seat. When children outgrow their rear-facing seats (the weight and height limits on rear-facing car seats can accommodate most children through age 2) they should ride in forward-facing child safety seats, in the back seat buckled with the seat's harness, until they reach the upper weight or height limit of their particular seat (usually around age 4 and 40 pounds; many newer seats have higher weight limits-check the seat's owner's manual for details).
Between Ages 4-8 OR Until 4'9" Tall – Booster seat. Once children outgrow their forward-facing seats (by reaching the upper height and weight limits of their seat), they should ride in belt positioning booster seats. Remember to keep children in the back seat for the best possible protection.
After Age 8 AND/OR 4'9" Tall – Seat belts. Children should use booster seats until adult seat belts fit them properly. Seat belts fit properly when the lap belt lays across the upper thighs (not the stomach) and the shoulder belt fits across the chest (not the neck). When adult seat belts fit children properly they can use the adult seat belts without booster seats. For the best possible protection keep children in the back seat and use lap-and-shoulder belts.
Other important things to remember:
The Mankato Clinic offers free car seat safety classes to help you learn to install your child's car seat properly for the highest amount of safety. Click here for more information.
Water is important to the body at all times, but especially in warm weather. It keeps the body from overheating. When you exercise, your muscles generate heat. To keep from burning up, your body needs to get rid of that heat. The main way the body discards heat in warm weather is through sweat. As sweat evaporates, it cools the tissues beneath. Lots of sweating reduces the body's water level, and this loss of fluid affects normal bodily functions.
Signs of dehydration include:
The best way to beat dehydration is to drink before you get thirsty. If you wait until after you're thirsty, you're already dehydrated.
According to the American College of Sports Medicine, to avoid dehydration, active people should drink at least 16- 20 ounces of fluid one to two hours before an outdoor activity. After that, you should consume 6 to 12 ounces of fluid every 10 to 15 minutes that you are outside. When you are finished with the activity, you should drink more. How much more? To replace what you have lost: at least another 16 to 24 ounces (2- 3 cups).
One way to make sure you are properly hydrated is to check your urine. If it's clear, pale or straw-colored, it's OK. If it's darker than that, keep drinking!
Some beverages are better than others at preventing dehydration. Water is all you need if you are planning to be active in a low or moderate intensity activity, such as walking, for only an hour or less. If you plan to be exercising longer than that, or if you anticipate being out in the sun for more than a few hours, you may want to hydrate with some kind of sports drink. These replace not only fluid, but also chemicals like sodium and potassium, which are lost through perspiration. Too much or too little sodium and potassium in the body can cause trouble. Muscle cramping may be due to a deficiency of electrolytes, such as sodium and potassium. Alcoholic and caffeinated beverages, such as coffee, teas, and colas, are not recommended for optimal hydration. These fluids tend to pull water from the body and promote dehydration. Fruit juice and fruit drinks may have too many carbohydrates, too little sodium, and may upset the stomach. If you're going to drink fruit juices while exercising, you may try diluting them with 50% fruit juice and 50% water first.
Adequate hydration will keep your summer activities safer and much more enjoyable. If you need to increase your fluid intake, keep an extra pitcher of water with fresh lemons, limes, or cucumber in the refrigerator.
Mankato Clinic Podiatrists, Dr. Lynn Gustafson and Dr. James Nack were highlighted in the Winter Edition of the Minnesota Podiatric Physician magazine. What the public may not know about these colleagues is that they are married! Sit back and enjoy the article here.
reprinted with permission from the Free Press
At Mankato Area Public Schools, the idea of what lunch is remains a concept that is in flux. Case in point: At the beginning of the year, new guidelines put in place for schools by the Food and Drug Administration prompted the schools to shrink the size of the hamburger patties to 2 ounces, an ounce less than the burgers were the previous spring. "We got feedback from parents," said Ron Schirmers, food service director at Mankato schools. "You can't take a senior high football player and feed him the same as a seventh-grader who doesn't play sports. We were getting some calls that said, 'My kid's not getting enough to eat.'" Mid-year, with the blessing of the FDA — which was flexible and willing to listen to parents and school concerns — the size of those burger patties was bumped back up to 21⁄2 ounces. That change illustrates how the school district's menu is a work in progress but definitely heading down the road to helping students eat more healthful lunches. Students saw a lot of changes in their menu this year. In addition to the different burger patties, they were greeted last fall with a lot more fruits and vegetable than they've ever seen, and a significant decrease in some things they'd seen on a regular basis. More carrots have been on the menu. Sweet potatoes have been on the menu. Romaine lettuce has been more frequent in place of iceberg. French fries have become scarce. And Schirmers said that students appear to like it. "We haven't had any complaints at all," he said. The FDA put in place calorie limits on lunches. For students K-5, the calorie limit was 350-500. For grades 6-8, 400-550. And in grades 9-12, 450-600. Because of those limits, some of the work-around solutions available to hungry students were gone. Schirmers said that, in previous years, students who finished their meal and were still hungry had access to peanut butter and bread. The calorie limits, however, have removed that option. This was part of what some parents had complained about. Erin Gonzalez, a dietitian with the Mankato Clinic who works with the school district on its menu, said the complaints she heard about came from parents of high school students who probably should have been taking a more active role in what their students were eating. "School lunch isn't meant to fuel all day long; it's one meal, and 650 calories is perfectly adequate for one meal," she said. Parents should be providing their student athletes with snacks between meals. "You can't expect school lunches to feed an athlete," she said. Schirmers said the big changes in the school lunch menu were implemented this year, and next year students won't see much change. The school will continue to taste test new foods, though, and to teach kids about healthful eating. "Our goal is to educate kids in the classrooms and in the cafeteria so they understand everything that's available to them," Gonzalez said.
The Mankato Clinic will be breaking ground later this spring on the Mankato Clinic Children's Health Center. The new 56,000 square foot facility will include the Clinic's pediatrics department as well as Gillette's Children's Specialty Healthcare and Pediatric Therapy Services.
The Mankato Clinic is teaming up with Gillette Children's Specialty Healthcare based out of St. Paul to offer services in Mankato that have never been available locally. Pediatric Therapy Services of Mankato will also have space in the new Center. The facility will be designed specifically for children and adolescents including kid friendly waiting areas, exam rooms and an outdoor courtyard.
"We're very pleased to be involved in this project, and to provide better access to specialty care for patients in southern Minnesota. The Mankato Clinic and Pediatric Therapy Services will provide a collaborative approach that will enhance the services we provide patients, "said Kathryn Wardrop, Gillette's vice president of strategic planning and specialty/support services.
"We have been providing therapy services to children for over 20 years here in Southern MN and work closely with many providers including the Mankato Clinic and Gillette. By sharing actual building space with them we will be able to offer more comprehensive care to families with young children, particularly those that may have special health needs or developmental concerns. It will be a very child and family friendly facility and we are thrilled to be a part of it," explained Nancy Dobson, PT/Clinic Director of Pediatric Therapy Services. "Our goal is to be the premier pediatrics center in the region by enhancing access to pediatric care in south central Minnesota in a kid friendly environment," explained Randy Farrow, CEO of the Mankato Clinic. "Our collaboration with Gillette Children's Specialty Healthcare and Pediatric Therapy Services is just a sign of things to come. We plan to add additional services at this new facility as well." "We know how important it is to our patients and their families to be able to offer pediatrics services close to home. With the addition of Gillette to our community many families will no longer have to travel to the Twin Cities for services such as assistive technology including orthoses (specialized braces), specialized seating systems and mobility devices. This is very important for our community;" share Dr. Don Putzier, pediatrician with the Mankato Clinic.
The new Mankato Clinic Children's Health Center will be located south of the Mankato Clinic's existing building on the Wickersham Health Campus, which is located on the corner of Highway 22 and County Road 26. The lower level of the new facility will house some of the Mankato Clinic's support services such as IT, health information, and business office services. The expectation is to break ground in late May/early June and offering pediatric care at the new Children's Health Center by mid- summer of 2014. The Wickersham campus is owned jointly by the Mankato Clinic and the Orthopaedic & Fracture Clinic.
reprinted with permission by The Free Press Several months ago a south- central Minnesota woman had traveled to the Twin Cities and found herself in a medical emergency. She needed to know the names and doses of the medications she was taking but couldn't remember them all. But she did remember one thing: She's a patient at the Mankato Clinic and had been using the clinic's patient portal. So she logged into a computer, pulled up her patient portal account and there, under the medications tab, was a full list of every medication she'd ever been prescribed as a Mankato Clinic patient, complete with dosage. " That one's kind of close to our hearts," said Cheryl Jones, director of health information and electronic health records. It's a classic example of the good that can come when patients have better access to their records. The clinic's patient portal has been up and running since January 2012. Since its launch, the clinic has experienced a swell of buyin from patients. As of mid-February:
Jones says one of the most popular features has been the appointment reminder. The portal automatically, if you want it to, lets you know when your appointments are coming up. It lets you know via email or text message. One patient contacted them recently and said the reminder saved her from missing her appointment because she'd written down a different time. " That was a win for us," Jones said. Pat Lueck, office manager at the Kearney International Center at Minnesota State University, said she's been a user of the patient portal almost since its launch. She said she likes to go into the portal after an appointment to read her doctor's notes. " Sometimes when you're there, it doesn't all sink in," she said. She also likes the fact that now you can correspond directly with your doctor. "I've been asking for it for a long time," she said, "and we finally got word that it's going to happen." Soon, there will be an upgrade to the portal, and the upgrade will be browser based and no longer require users to download software. It will come with a video tutorial on how to use it, easy ways to print, fax or email anything within the portal and, eventually, they hope to a function where patients who need to fill out forms for specific services — such as care for young children — can fill them out at home in the portal electronically. The completed forms would then be available when to the doctor and nurses when the patient comes for his or her visit.
reprinted with permission from The Free Press, Mankato
"Bear down!" the doctor says, and a room full of young women (and two or three guys) obeys. "Bear down! One, two, three, four, five, six, seven, eight, nine, ten," he says. "Quick breath, do it again, push! One, two, three, four, five, six, seven, eight, nine, ten. Quick breath, do it again, push! Bear down, bear down, bear down! I don't see any red faces!" The group laughs and giggles. Is this guy serious? "Uh-huh," Dr. Mark Taylor says. "Now try doing that for two hours." Whoa. Reality. Two hours of bearing down is roughly what a woman goes through when she's trying to push a fetus through the birth canal. Taylor's point, well taken by the group, was this: Childbirth (news flash) isn't easy. It's incredibly painful — an experience Taylor likened to having the largest bowel movement of your life. How large? Try bowling ball large. The group assembled is the early childhood class from Mankato West High School, a group made up of all grade levels. This is the fourth year Taylor, of the Mankato Clinic, has taken a morning to show the high schoolers the reality of childbirth. It was part scared straight, part anatomy lesson, part stand-up comedy. Taylor — who it was revealed had delivered about 20 percent of the students in the room — knows how to keep an audience engaged. He began by introducing a woman named Melanie Runge, who looked to be in her early to mid-20s. Runge was pregnant with her second child and had agreed to have Taylor perform an ultrasound on her in front of the class. By the way, Runge's first ultrasound didn't go so well. Taylor couldn't see the baby, and her body was producing less than ideal levels of ACG, the chemical doctors look for to confirm pregnancy. " We had a bleak conversation," he said. "It looked like it was a miscarriage. ... I had already been preparing my what- do you-want-todo- about-this speech." Added Runge, " That was a rough weekend." But a week later, the baby was 66 centimeters. "Now look at it!" he said, gesturing to Runge's beautifully protruding belly. After giving the kids the back story on Runge, Taylor prepared to perform the ultrasound. As the ultrasound gel splurted out of the tube, girls around the room jockeyed for position. Within seconds, an image appeared on the monitor that was unmistakable. Girls giggled, gasped, held their hands to their hearts, while on the screen, a series of rapid flutters showed everyone exactly how healthy the baby's heart was. " You can see the valve opening up, sending blood out," Taylor said. "One, two, three four chambers. If you see four chambers, that rules out 90 percent of heart defects. ... That looks wonderful." Time to quiz the kids. "Can you guys see this? Does anyone know what this is?" " That's the butt. There's a cheek. There's another cheek," he said. "And it is a cute little butt." And later ... "Can you see this? Anybody got a guess as to what this is? Anybody? It's toward the butt? It's filled with fluid? Can anybody guess?" The kids giggle. "It's the bladder," he says, and they giggle some more, as if they were thinking of something else. Runge's baby was very mobile. "Can you tell the kid to stop moving around so much?" he joked. " This is the most entertaining baby we've had. Others have been kind of sluggish." One more quiz: "Anyone know what this little round thing is?" Silence. " That's her little boy," he said. " That's a scrotum. So (Runge's first child) Kale's got a brother. I was hoping we might able to catch that. You gotta have a cooperative baby." Late ... "Here's the baby's teeny testicles ... There's the liver ... This here is the intestines." Then it was movie time. If Taylor's frank talk about pain and blood and bags of water exploding in his face started the task of conveying the messy reality of childbirth, the movies he brought in on vaginal and cesarean section births finished it up. The vaginal birth scenes were enough to prompt a few students to get up and leave the room and a few others to turn their heads. But when the woman's abdomen was opened to reveal a lot of stuff few people in the room had ever seen before, gasps filled the room, heads darted away in disgust and a few more people left the room. "It was the most effective birth control I've ever seen in my life," said Tim King, one of the few boys to take Laurie Hagberg's early childhood class this quarter. Students Katelyn Furst and Maria Soroka were very impressed with it all. " That was cool," Furst said. Added Soroka, "It was amazing." Rebecca Gurney disagreed. "It was kind of gross," she said, before uttering the phrase organizers hoped to hear: "I kind of don't want to have a baby." Teacher Laurie Hagberg said part of the point of visiting Taylor is to give kids a dose of reality, to remind them that childbirth has little to do with glamour and everything to do with major life change. "It's real life," Hagberg said. "From this, they get a clear understanding and awareness that they're not ready for this." To send them off with a vivid reminder of their day with him, Taylor invited them to don rubber gloves and get line to touch a freshly harvested placenta. Just about all the students answered the challenge, many of them proclaiming it "gross," but curiously poking it and holding it anyway.
The Mankato Clinic and its Mankato Clinic Foundation have donated $500,000 to fund the signature exhibit for the Southern Minnesota Children's Museum. The Tree of Forts Climber, a monstrous vertical maze of forts and play areas, will be known as the Mankato Clinic Tree of Forts Climber when the museum opens. When that will be remains to be seen, but the Mankato Clinic's donation — which will be spread out over 15 years — increases the momentum on a project that already has been embraced by the public and business community. So far, the Children's Museum has raised $2.5 million, including the Clinic's donation. With $2 million more, museum executive director Peter Olson says, they'll be able to break ground. The museum, which is currently in its temporary home in the former Family Bank location at the corner of Second and Cherry streets, is slated to be built at the site of the former Embers Restaurant. "I can't think of a better initiative than this," said Randy Farrow, CEO of the Mankato Clinic. " There's momentum going now. This is something that will be a great asset to the community." Here are some of the highlights of the museum's facility plan: Great Big Gallery — The facility's basement will be filled with what's called the Great Big Gallery. This is where the exhibits dedicated to water and rock quarries can be found. Having such exhibits, Olson has said, is important so that the museum can tie learning to the natural resources of the region. Main floor — The distinguishing feature of this floor will be an iconic feature called the Tree of Forts Climber, a safe climbing structure reminiscent of the Swiss Family Robinson. Olson said this area could possibly be available for gatherings such as weddings or company parties. Second floor — The so called Whiz Bang area will be here. It will focus on science, technology, engineering, art and math. Because it will be away from the toddler-focused areas, Olson said it will be ideal for older kids. Work areas will be taller, again catering to the older end of their birth-12 target audience for a children's museum. This will be an ideal area, Olson said, to incorporate adult volunteers who want to give back to the community. Quilters, for example or woodworkers can come and demonstrate their craft for kids and teach them basics, hopefully fostering an interest in such hobbies. Rooftop Farm Park — Olson said this could be one of the biggest draws of the museum. They plan to have live animals here. They're also considering what kind of programming they can structure around the idea of a farmer's growing season. (Visit the museum's website for more information about the future site and about the capital campaign.) Getting sponsorshiplevel funding for the museum's signature exhibit, Olson said, was a big deal. "It's been a long time coming," he said. " This is the No. 1 exhibit our families have been asking for."
reprint courtesy of KEYC-TV
Mom Concerned About Vitamins Found In Trick-Or-Treat Bags
When the Frank family went trick–or–treating at the mall last night, they got plenty of candy...but they also got a different treat—vitamins. Danielle Frank found chew–able adult vitamins from GNC in her kids' bags. She was concerned when she found one in each of her kids' bags last years, so this year she paid close attention. Frank says, "I saw they were handing out handfuls, so my 4 children we came home with 14 vitamins." She looked them up online and found her kids had 10 multi–vitamins, a vitamin D... Frank says, "And 3 of them are collagen supplements, so I don't know why they would be handed out to a child." A spokesperson for GNC told News 12 that they don't believe there would be any health issues for anyone who consumed these products as labeled, regardless of age. Frank's biggest concern, it's hard to tell they are even vitamins. Frank says, "If he had the opportunity he would take these just like others, because he doesn't know the difference, they look like candy, they came with candy." We talked to registered dietitian Erin Gonzalez to get her take. Gonzalez says, "Most of our kids are over fed but malnourished so they aren't getting the right amount of the nutrient, but you can't assume that." She says one or two wouldn't be a big deal, but if kids get too much of some vitamins, it can become harmful. Gonzalez says, "It certainly does look like candy, so to a child they might eat all of them at once without even being aware that it was a multi–vitamin, or a vitamin D. The biggest concern is the child getting in more than they need." Frank says, "It could be in your big bag of candy when you get home and you could have a small child dive into it and eat all of them in one sitting." Gonzalez says it would probably be a good idea to go through your kids' bags to see if there are any vitamins. Gonzalez says, "If they are it would be something to take out and maybe take to the physician or pedestrian if it is appropriate for the child." This mom told us as a possible solution, she would have appreciated GNC handing the vitamins to her, not her children.
reprint courtesy of the Free Press, Mankato
New mammography machine provides BETTER IMAGE Mankato Clinic second in country to get new device To put it crudely, the biggest advantage of the Giotto mammography machine is this: Instead of bringing the breast to the machine, Giotto comes to the breast. The folks in Mankato Clinic's radiology department are all smiles these days about the newest additions to their technological arsenal. One is Giotto, a mammography machine that looks nothing like a traditional machine. It's defining characteristic is the circular frame that can be twisted, turned, raised or lowered to accommodate anyone in a chair or laying on a bed.
What this means for patients is no more sitting in uncomfortable positions remaining perfectly still for extended periods of time. Giotto also allows doctors to perform biopsies, eliminating the need for a separate machine and separate appointment to do what is normally an additional procedure. In addition to the Giotto machine, they've also got a new Fuji, high resolution imaging machine that allows doctors to view mammography images in the highestpossible resolution. This gives doctors a much better image to look at and allows them to spot irregularities much sooner, such as pre- cancerous areas known as ductal carcinoma in sutu. Radiologist Maureen Magut said addition of the machines is an important step for the health of Mankato Clinic patients. " This is a very big deal," she said. The Mankato Clinic is just the second location in the country to have installed a Giotto machine, and the first to have actually used it. It's been in operation for a few weeks. Another feature of the Giotto machine is the ability to do biopsies on calcifications so small that previous technology made it nearly impossible to detect much less pull a sample for testing. Glenda Beeck, a registered technologist in radiology and mammography and manager of the imaging department, said the clinic got in on the Giotto movement early because they were in the right place at the right time. A salesman who used to work for Kodak and made sales calls to the clinic contacted them to see if they were interested in hearing about his newest client's latest product. Of course they were. Magut said that when she and Beeck decided the department needed these two machines, they sat down with the Mankato Clinic CEO and CFO and explained their situation. And that was it. She said that, at a larger health care provider with more bureaucracy, it would have taken much longer to have such a purchase approved. The amount of time needed for a mammogram visit, Magut said, will be cut in half. They'll be able to send folks on their way within 15 minutes.
Your health means everything to us. That's why we want to you know just how important early detection is in the fight against breast cancer. The Mankato Clinic is now providing the latest in digital mammogram technology and we want you to be the first to see it! Plan on attending an open house to see our new state-of-the-art, "patient-friendly" mammography equipment and take a tour of our Mammography department. Our knowledgeable staff will be on hand to explain how important this new technology is in early detection of breast cancer.
This event is free and open to the public. Refreshments will be served! When: Friday, October 19, 2012 7:30am-9:00am Where: Mankato Clinic @ Main Street 1230 East Main Street, Mankato The Mammography department is located on the lower level in the Diagnostic Imaging Department.
As a precaution, the Mankato Clinic as well as the Mankato Surgery Center has confirmed their pharmaceutical supplier does not purchase and has never purchased any products from the New England Compounding Center, the manufacturer in question regarding the recent fungal meningitis outbreak. Patients should know that any injections provided by the Mankato Clinic or at the Mankato Surgery Center are safe. Both organizations use pharmaceutical supplies from other vendors and will continue to do so. Also, neither location uses the type of medication in question regardless of manufacturer. Patients at the Mankato Clinic and the Mankato Surgery Center should feel comfortable and confident receiving care.
If you have further questions about the injectible steroid, fungal meningitis, or the pharmacy where the steroid was manufactured, you can find that information on the Minnesota Department of Health's website:
reprint courtesy of The Free Press, Mankato
Several area clinics fared well in a first-of- its kind Consumer Reports magazine analysis of Minnesota's clinics in the areas of diabetes and cardiovascular disease care. Mankato Clinic in Lake Crystal earned the highest ranking in the state for cardiovascular care, while the Mankato Clinic in Mapleton was among the top 15 for diabetes care. The clinic's North Mankato office was in the top 50 for cardiovascular disease care as well. Mayo Clinic Health System in Mankato Northridge was in the top 50 for diabetes care, and Mayo Clinic Health System in Mankato Eastridge landed in the top 100 in cardiovascular care. The rankings are the result of a unique situation of medical transparency. Minnesota is the only state for which Consumer Reports has compiled a ranking because it's the only state in which it can. "Minnesota has done a good of coming to agreement on what we're going to measure," said Mankato Clinic Chief Medical Officer Dr. Julie Gerndt. The magazine, which is available at newstands, rates 552 Minnesota physician group practices and analyzes Minneapolis-St. Paul medical groups focusing on cost and quality of care. The ratings were compiled in collaboration with the Robert Wood Johnson Foundation and Minnesota Community Measurement (MNMC), a nonprofit organization that has worked since 2004 to improve health care and cut unnecessary cost. Consumer Reports and MNCM found clinics delivering high- quality care for diabetes and cardiovascular disease throughout the state, and 37 practices earned the magazine's highest rating in both categories. Other practices didn't fare as well. Sixty-six practices earned the magazine's lowest score for diabetes care, 50 got the lowest score for cardiovascular care, and 24 for both. Gerndt said the Mankato Clinic's main clinic did OK, but not nearly as well as some of its smaller clinics. The main clinic, though, is where the majority of its sickest patients receive care. And because some of the measuring guidelines deal with outcomes, clinics with sicker patients will tend to score lower. Why, then, would clinics in Lake Crystal and Mapleton — small rural communities with higher percentages of elderly patients — have high rankings? "In these rural practices — those that have a very high percentage of geriatric patients — you'd expect they'd be more ill and have a hard time managing good outcomes," Gerndt said. "It's all about relationships with patients. One of the key aspects in getting good outcomes is relationships, and (Mapleton's) Dr. Becker has that kind of relationship with the patients there." Gerndt said the clinic takes this survey very seriously because they like to work as if they're accountable for results. " You don't make improvements if you're not measuring," she said. "In medicine we're driven by data because that shows us how we're doing. We don't dismiss these results."
About 10 times each year, Henry Winkler — yes, that Henry Winkler — takes a break from filming movies and writing children's books to do something very different. He travels the country making stops in towns big and small to talk about a disease most people probably haven't even heard of: upper limb spasticity. But Winkler's heard of it. After his mother suffered a stroke, she spent 10 years living with the disease. Upper limb spasticity results in uncomfortable muscle stiffness and muscle tightness in the elbow, wrist and fingers. People living with it may have an arm pinned against their chest, a flexed elbow or wrist that can't be straightened without discomfort or force, or a clenched hand in a tight, balled-up fist. Winkler's appearance was sponsored by the Mankato Clinic. At a presentation at the Madison East Center Friday, the clinic's Dr. Lisa Davidson presented information about the disease as well as insight into the newest Botox treatments being used to mitigate its effects. Winkler remembers his mother going through this and being able to do little to help her. "I know all too well the toll upper limb spasticity can take on a person," Winkler said. Back then, though, they didn't have some of the treatments they have today. That's why Winkler does the advocacy work. He wants to raise awareness about the use of Botox to help people live with upper limb spasticity. " When my mother had her stroke, she didn't have the opportunity to use Botox," Winkler said. If she had, he said, her life would have been a lot better. She might have been able to continue playing cards with her friends or working at the local synagogue. And maybe she wouldn't have given up hope. " The goal here is to let people know that this is a possibility," he said of Botox. Winkler said that when he's not traveling the country raising awareness about treatments for upper limb spasticity, he's just as busy now as he ever was. Life in the celebrity limelight didn't end with cancellation of "Happy Days," in which he played the The Fonz. He's getting ready for the reconvening of the cast of "Arrested Development," where he plays attorney Barry Zuckerkorn. He's also plugging a film coming out soon starring Kevin James and Salma Hayek called "Here Comes the Boom." Winkler calls it a romantic comedy about a high school biology teacher who becomes a mixed martial arts fighter to raise money to save extracurricular activities from getting cut at his school. He's also busy continuing with his "Ghost Buddy" series of children's books.
If you or someone you love may be affected by upper limb spasticity, we encourage you to come meet special guest, famed actor and best-selling author Henry Winkler. Join us as he shares his personal story about his late mother's struggle with upper limb spasticity at the Madison East Center- Main Corridor on Friday, September 14th beginning at 3pm. This event is free and open to the public. Often described as uncomfortable muscle stiffness or tightness in the elbow, wrist or fingers, upper limb spasticity is a debilitating condition that impacts a person's life. Upper limb spasticity is severely under-recognized and under-treated, because it can occur weeks, months or even years after the person's original injury – after discharge from the hospital or when patients are no longer seeing specialists familiar with and specifically trained to treat the condition. It is crucial to have access to resources that can help you or your loved one recognize the symptoms of upper limb spasticity, understand why the condition occurs, and, importantly, how it's diagnosed and managed.
To address the low awareness and under-diagnosis of upper limb spasticity, Henry Winkler and coalition of nine national patient advocacy organizations, including National Stroke Association, Brain Injury Association of America, National Spinal Cord Injury Association, United Cerebral Palsy, United Spinal Association, MSWorld, Can Do Multiple Sclerosis, Multiple Sclerosis Association of America and Paralyzed Veterans of America have joined together to support the "Open Arms Campaign: Raising Awareness of Upper Limb Spasticity."
Don't miss this opportunity to meet an iconic American actor who knows all too well that life doesn't always stay on script.
Click here for a flyer with all of the event details.
Formulating an influenza vaccine is a bit of a guessing game. Scientists do the best they can to determine which strains may come up in the flu virus that circulates through the human population. But here's something that doesn't take any guesswork: It's a good idea to get immunized because the alternative can be hell. " If you get influenza, you're going to be sick. Sick, sick, sick. For a week. You'll feel like you've got meningitis," said Dr. Richard Peller of the Mankato Clinic. " If you ever get the real flu, you won't ever forget it." Flu shots are the No. 1 recommendation from doctors on how best to avoid contracting the virus. But even the guys who create the vaccine aren't ever exactly sure what they'll be up against. That vaccine is based on what flu strains have circulated in prior years. They learn this by conducting tests on people with confirmed flu cases. Based on those results, they not only get a handle on the strains doing the most damage, but which new strains are coming up. When a strain seems to be picking up stream, they add it to the vaccine. Sometimes, however, a strain comes along that the scientists never saw coming. This was the case several years ago when the H1N1 strain hit, otherwise known as "swine flu." That year, because of the severity of H1N1, the Centers for Disease Control and Prevention decided to issue a second vaccine, and that's why many people got two flu shots that year. This year there is new concern about swine flu. Two children contracted a new strain known as H2N3, a strain usually contracted through contact with swine. In addition to the Minnesota cases, there have been more than 200 other cases of H3N2 flu. (H1N1, the swine flu strain from a few years ago, is already included in this year's vaccination.) " The shot changes year to year because it is a matter of using the most recent strains," said Dr. Scott Helmers of Mayo Clinic Health System in Mankato's Eastridge office. This year there are three strains in the vaccine, but Helmers said next year the vaccine could contain four. Vaccinations work in several different ways. Injections put inactive viruses into the body that essentially trick the body into thinking a virus is in the house and it needs to fight to get it out. There are also nasal sprays available that apply a modified live virus to the nasal passages. Like the injection, the body gets wind of its presence and sets about the task of eliminating it. Helmers said it's a very weakened virus that elicits a very minor infection. This kind of vaccination is good for children, but not children whose immune systems maybe compromised in any way. The best way to deal with the flu strains is by doing whatever is necessary to avoid contracting them. ■ Wash your hands — This is still the No. 1 way to avoid the spread of virus that is often spread from person to person via the hands. ■ Avoid crowds — Walking through crowded areas puts you in close proximity with a lot of people. If any of them are carrying the virus, it could spread easily in a crowd. ■ Cover that cough — This is a no brainer anyway, but it's especially important during flu season. Don't cough on others, cough into your elbow, and avoid chronic coughers. ■ Avoid people who have the flu — Another no brainer, but one many people seem incapable of following. "I would emphasize the hand washing," Helmers said. " So often we acquire infections hand to mouth." In addition to passive ways, people who have contracted the virus can take medication if they've got confirmed cases of influenza. The most popular is Tamiflu, which can mitigate the symptoms of influenza but not cure it. The best advice, though, is to get that shot. "It's never too late to get the flu shot," Peller said. Influenza kills 36,000 Americans a year. "Every time I read that number I think, 'Can it really be that many?'" Pharmacies are already advertising flu shots. Both the Mankato Clinic and Mayo Clinic Health System in Mankato will have vaccinations available soon.
A large group of medical practitioners and athletic coaches were engaged in some pretty basic memory exercises Tuesday morning, matching shapes by memory and clicking on numbers backward from 25 as fast as they could. But actually, in the relatively new world of concussion study, the demonstration of Immediate Post-Concussion Assessment and Cognitive Testing was fairly complex.
" We're looking for accuracy, but we're also looking for reaction time," said Jamie Pardini, a clinical neuropsychologist and assistant professor in the Sports Medicine Concussion Program at the University of Pittsburgh Medical Center. Physicians, nurses, athletic directors, trainers and coaches from Minnesota and Wisconsin gathered in a conference room at Madison East Center for the daylong Concussion Management/ImPACT Training Workshop, led by Pardini and hosted by Mankato Clinic. A certified ImPACT trainer, Pardini said the testing is the first, most widely used and most scientifically validated computerized concussion evaluation system. The idea behind the testing is to give medical practitioners another way of assessing whether athletes are ready to return to their sport following concussions. Pardini said recovery times vary significantly from player to player, and sometimes when concussion symptoms have subsided, brain function still isn't quite back to normal. The ImPACT testing, aimed at 10- to 60-year- olds, helps identify those patients. "It captures part of concussion recovery that a symptom report does not," she said. "It really underscores the importance of using multiple tools." The testing was developed by Drs. Mark Lovell and Joseph Maroon in the 1990s. The test takes 20 minutes and includes computerized exercises that shed light on brain function. For example, a person being tested is asked to look at a screen image with a mishmash of Xs and Os, and three of the letters are highlighted. After a few seconds away from the page, the testee is asked to click on the three letters that had been highlighted. Pardini said speed and memory are being tested by the exercise. The tool can be administered by athletic trainers, school nurses, athletic directors, team doctors or psychologists who have completed ImPACT training. The Mankato Clinic Foundation has underwritten the annual cost of ImPACT for seven area high schools, including Mankato East and West, Loyola, St. Peter, St. Clair, Mapleton and Lake Crystal.
Nearly $160,000 Awarded in 2011, nearly $1 million in the last 6 years.
Thanks to the Mankato Clinic Foundation, over 35 area organizations received grants and funding totaling nearly $160,000 in 2011. Organizations supported include; Feeding our Community Partners – Backpack Program, Lake Crystal Area Recreation Center, YMCA,VINE, YWCA – Walking in Two Worlds, Greater Mankato Diversity Council, Creative Play Place in St. Peter , Children's Museum of Southern MN, Special Olympics, Greater Mankato Early Learning Initiative, area school districts, and several other organizations including scholarships for the nursing programs at both South Central College and Minnesota State University- Mankato.
The physicians at the Mankato Clinic provide the majority of the Foundation funding as a means to give back to the community by providing support to organizations which strive to improve health and wellness. The Mankato Clinic Foundation has given $914,148.00 to area organizations over the past six years in an effort to support the health and well-being of local communities.
Mankato Clinic Foundation president, Marcia Bahr said, "The Mankato Clinic Foundation is thrilled to be able to support the areas we serve by providing local organizations with funds that enhance the health and wellness of the community."
The Mankato Clinic Foundation provides resources to organizations and endeavors that effectively promote and improve community health and wellness. Since the primary focus of the Foundation is to support the health and well-being of the community, projects and programs supported include education and scholarships, initiatives focused on health care, health education and wellness.
Grants are awarded on a quarterly basis and are considered only through the application process. Applications and more information can be obtained by clicking here. The next grant application deadline is March 1, 2012.
The Mankato Clinic was honored to have recently been recognized by the Mankato Area Council for Quality (MACQ) at the 22nd Annual Quality Recognition and Awards Banquet, which was held on Thursday, October 20, 2012.
The Mankato Clinic is honored to receive the MACQ Corporate Quality Award for our service improvement efforts geared toward achieving better clinical outcomes, service, and overall patient satisfaction. The health care industry is undergoing significant transformation and the Mankato Clinic is proud to be recognized by the MACQ for its leadership in bringing about positive change for the benefit of our patients. The Mission of the Mankato Clinic is "To improve the health of the people in our region through compassionate, patient-focused care and education.
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Mankato Clinic implements iD5 initiative to improve diabetic control in diabetic patients
Just 25 years ago, a diagnosis of Type 1 diabetes in adolescence meant a life expectancy of around 40, and a diagnosis of Type 2 diabetes in adulthood meant limb amputations, blindness, kidney failure or even early death. But, times have changed. Today, thanks to advances in research, education and technology, better diabetes health can be attained. One way Mankato Clinic is working to help its diabetic patients attain better diabetic control is with a new initiative at its' North Mankato Family Practice Clinic called iD5. iD5, or Initiative Diabetes 5, seeks to improve diabetic control by pinpointing five target goals. The program benefits both Type 1 and Type 2 diabetics.
The five goals for living well with diabetes are: 1. Control blood pressure - High blood pressure makes the heart work too hard. It can cause heart attack, stroke and kidney disease. Ideal blood pressure in a diabetic patient is less than 130/80. 2. Lower bad cholesterol – LDL, or bad cholesterol, can build up and clog blood vessels and can cause heart attack and stroke. HDL or good cholesterol helps remove cholesterol from blood vessels. Diabetics should strive for LDL less than 100. 3. Maintain blood sugar - High blood glucose levels (too much sugar in the blood) may harm the heart, blood vessels, kidneys, feet and eyes. Hemoglobin A1C, which measures the average blood sugar level over a three to four month period, should ideally be less than 7 percent in diabetic patients, which is equivalent to a daily average blood sugar of 154 mg/dL. 4. Be tobacco-free - Smoking doubles the risk of heart disease. It may also damage the blood vessels in the legs, increasing the risk of amputation. Smoking increases the cardiovascular complications associated with diabetes including heart disease, stroke and peripheral vascular disease. 5. Take an aspirin daily – Taking aspirin every day can help to reduce the risk of heart disease and stroke.
Christie Nelson, registered nurse and chronic care coordinator at Mankato Clinic-North Mankato Family Practice, works with the clinic's diabetic patients and tracks their well-being. "Following and meeting the iD5 goals is important for patients managing diabetes long term," said Nelson. "There is evidence-based data that shows following these goals helps reduce the risk of heart attack and stroke in individuals with diabetes. Because diabetes is a chronic disease and individuals with a chronic disease will never be cured, those who manage their disease in a healthy way have a good chance of living a long, quality life."
Nelson is part of a team including the provider, the primary nurse and the department specialist that provides a medical home to coordinate all of the patient's diabetic needs. She says patients sometimes need a little extra motivation, like a phone call to keep them on track. "The team keeps a registry of diabetic patients and if any of them do not meet any of the five targeted goals, we ask to see them back within a certain amount of time," said Nelson. "The electronic registry alerts us if any patients are overdue and we give them a call to check in and schedule an appointment. I serve as a patient contact and inquire about side effects, make changes to medications per the patient's provider, motivate patients in their efforts to achieve weight loss and healthy eating goals, and coordinate with medical specialists and community resources to support patient needs."
Shirley Zimpritch, a 74-year-old Type 2 diabetic from Elysian, began working with Nelson and the medical staff at North clinic over six months ago after experiencing dangerously high blood sugars as a result of taking prednisone prescribed by another medical facility. She began taking insulin to control her blood sugars and Nelson, in conjunction with the physicians at North, began following her two to three times a week to make sure she was staying on track.
"My experience with the medical staff at North Mankato Clinic has been super," said Zimpritch. "It makes me comfortable knowing that Christie is going to call and check in on me to see if my needs have changed and that I can call the medical team at any time when I need them. They simplify what I need to do in order to stay in good diabetic health and encourage me to stay under control. I am feeling better as well as seeing on paper that my complications are improving."
Dr. Andy Miller, family practitioner at Mankato Clinic-North Mankato Family Practice, says that the iD5 concept stemmed from the health care home model and is part of the clinic's team approach to diabetes care. "iD5 came from the idea of getting a nurse coordinator involved to keep better track of diabetic patients and in the end, get more patients to reach their goals and achieve better control overall," said Dr. Miller. "Our medical home team is able to spend extra time with patients who need a little more attention which provides a team approach to medical care. Patients seem appreciative of the extra time and follow-through."
Stacy Hogan, a Type 1 diabetic for 20 years, uses an insulin pump to help control her diabetes and has additional diabetic complications to manage. She says iD5 has helped make her goals more understandable and taught her how to implement the five goals into everyday life. Her blood pressure and A1C have both come down since she started following the goals.
"iD5 helps simplify what I should be shooting for to get better control of my diabetes," said Hogan. "The last 15 years I was in denial about having diabetes and I blew it off thinking I was invincible. I really thought it would be a long time before I would start seeing complications. But because I didn't do the things I needed to do to keep my diabetes in control, I am now suffering from kidney disease, neuropathy, seizures and visual problems. Christie follows me closely, coordinates my specialty care and actually breaks down my condition and needs into one summary so I can better understand it all."
Dr. Miller says having specific goals to shoot for makes diabetic control more manageable for many patients. "iD5 helps clarify for the patient what we think is important for living healthy with diabetes," said Dr. Miller. "It is geared toward the diabetic patient who is not at goal but is helpful to any diabetic patient to make sure they are sustaining goals. Meeting these five targeted goals, helps lead to successful diabetic control."
Diabetes Mellitus is a condition in which a person has a high blood sugar (glucose) level as a result of the body either not producing enough insulin, or not responding to the insulin that is produced. Insulin is a hormone produced in the pancreas which enables body cells to absorb glucose and convert it to energy. If the body cells do not absorb the glucose, the glucose accumulates in the blood leading to hyperglycemia and various potential medical complications. Most people have heard of diabetes, but many may not realize that there is more than one kind. The two most common types of diabetes are: Type 1: Type 1 results from the body's failure to produce insulin, and requires a person with diabetes to inject insulin to move sugar from the bloodstream to survive. This type of diabetes is an autoimmune disorder, which may be triggered by a virus or other factors. Type 1 can start at any age but many cases begin in childhood, adolescence or early adult years. It is usually diagnosed before age 40. Only 5 to 10 percent of people with diabetes have this form of the disease.
Type 2: Type 2 is the most common form of diabetes. It results from a relative deficiency of insulin and insulin resistance, a condition in which cells fail to use insulin properly. Type 2 diabetes occurs when insulin that the body produces is less efficient at moving sugar out of the bloodstream resulting in a high blood sugar. Experts once considered Type 2 diabetes as the adult onset type of diabetes. However, many children are now being diagnosed with Type 2 diabetes as the obesity epidemic grows. Diet, exercise, weight loss, and, in some cases medications and insulin, are the treatment for this type of diabetes. This type is often associated with physical inactivity and obesity.
For more information about iD5 or to schedule an appointment with a member of the medical team at the Mankato Clinic please call 507-625-1811.
Mankato Clinic helps make a difference in the lives of those with bipolar disorder by hosting support groups
One in four Americans lives with a mental health condition that is treatable. Studies show that one of the best ways to treat and live well with a mental health condition including bipolar disorder is with the love and support of family and friends. Mankato Clinic is helping to make a difference in the lives of bipolar sufferers and their loved ones by providing the support they need by hosting bipolar disorder support groups twice a month. Mary Beth Trembley, registered nurse in the department of psychiatry at Mankato Clinic, facilitates the support groups on the first and third Wednesday of every month, from 6:30 p.m. - 8:00 p.m., in the Mankato Clinic conference room, located at Madison East Mall in Mankato. Sessions are free and open to the public, age 18 and older. Reservations are not required.
"There is evidence-based data that shows people who attend support groups for illnesses have better overall health outcomes and gain valuable insight and information from others," said Trembley. "Support is vital. One of the most powerful things a person can hear or say is that they have been there and understand what another is going through. Bipolar can be an isolating illness and support groups break down barriers and stigma."
The ups and downs in life can be hard to tolerate for both the bipolar sufferer and their loved ones. Therefore, Mankato Clinic bipolar support groups give hope to not only those who suffer from the illness but to those whose lives are affected by the illness of another. Thirty percent of bipolar support group attendees are there as part of a support system including children whose parents are bipolar, parents whose kids are bipolar, spouses, family, friends, neighbors, work colleagues and even students from Minnesota State University looking to learn more. The groups are there for anyone who wants to learn more about illness and wants to receive support or give support. About half of attendees come alone and half are accompanied by friends or family.
"Those whose lives are touched by bipolar disorder need support from people who have been there and who understand the bipolar journey," said Trembley. "Our support groups offer an opportunity for others to share their experience, provide ideas and meet other people in the community who can relate to their experience in a confidential setting."
Sessions are facilitated by Trembley and are completely confidential. The group is open for sharing dialogue and ideas, seeking validation and information, asking questions and finding comfort and direction. "The sessions are very dynamic and upbeat,t and offer practical ideas for managing illness," said Trembley. "It is common for attendees to bounce ideas off of each other and get feedback from group. I provide education about treatment and diagnoses. I have 25 years of psychiatric nursing experience which is unique to a peer-facilitated group."
Those attending the bipolar support groups are finding that it is making a difference in their lives. One bipolar sufferer said "because of the support groups, I now have a better relationship with my spouse because he has more knowledge about bipolar disorder and I have a better understanding for what he is going through living with my illness." Another says "I have found it helpful to hear others' perspectives and experiences and it is comforting to know that I am not alone."
Carole Milner, a support group attendee who has been living with symptoms of bipolar disorder since childhood, says the support groups have helped her manage her illness through education and insight. Milner also says the support of others helps keep her on track when she begins to go off course. "When I am having a bipolar episode and feeling depressed, others at the meetings remind me of what has worked for me in the past because I tend to isolate and forget," said Milner. "A simple reminder from a peer to journal is an effective way to work through the episode."
She says it is also therapeutic for her to help others. "I attend the support groups both when I am feeling well and when I am struggling," said Milner. "When I am feeling well, it makes me feel good to go to the meetings and see what kind of support I can provide to another. It gives me a feeling of self worth to provide my insight and help someone else who is struggling with bipolar."
Bipolar disorder, formerly known as manic depressive illness, is a medically diagnosed and treatable disorder marked by extreme changes in mood, energy, thought and behavior. The disorder causes a person's mood to alternate between the highs of mania on one extreme to the lows of depression on the other.
The cycles of bipolar are more than just a temporary good or bad mood and may last for days, weeks and months. And unlike ordinary mood swings, mood changes associated with bipolar disorder are so intense that they may disrupt the ability to function in daily life. It may affect work and school performance as well as personal relationships.
The mood swings between mania and depression may be very abrupt or subtle. During a manic episode, a person might feel refreshed and energized after only a few hours of sleep and impulsively engage in erratic behavior like spending sprees. On the other hand, that same person may feel like sleeping all day, feeling hopeless and worthless.
The signs of bipolar vary largely from person to person by pattern, severity and frequency. The first episode generally occurs in late adolescence or early adulthood although the initial presentation may occur in childhood.
General symptoms of bipolar disorder include patterns of sleep disturbances, variations in energy like having restless energy one day and no energy the next. A manic state may include racing thoughts and an abundance of ideas at once which are hard to sort through. Depressive states reflect lack of creativity and spontaneity. There are four types of bipolar episodes including mania, hypomania, depression and mixed patterns. Each type has its own unique symptoms.
Symptoms of mania or "highs" of bipolar • Heightened mood and exaggerated optimism • Little need for sleep • Excessive agitation or irritation • Inflated self-esteem and self-confidence • Noticeably elevated moods including hyperactivity, increased energy, racing thoughts and lack of self-control • Reckless behavior including impaired judgment, reckless spending, sexual promiscuity and binge eating and drinking • Tendency to be easily distracted • Delusions and hallucinations
Symptoms of depression or "lows" of bipolar • Low moods daily • Difficulty concentrating, remembering or making decisions • Fatigue, loss of energy or listlessness • Prolonged sadness or unexplained crying spells • Persistent thoughts of death or suicidal thoughts • Changes in appetite or sleep patterns • Withdrawal from friends and activities normally enjoyed • Feelings of worthlessness and guilt and loss of self esteem • Unexplained aches and pains
Please visit the bipolar alliance website at dbsalliance.org or call Mankato Clinic at 625-1811, for more information.
LeSueur-Henderson High School Senior Winner of Fourth Annual Dr. J. Scott Sanders Memorial Scholarship
Mankato Clinic Foundation Awards $2,000 Scholarship
The Mankato Clinic Foundation has selected Jamie Schlarbaum, a senior at LeSueur Henderson High School as the fourth recipient of the J. Scott Sanders, M.D. Memorial Scholarship. Dr. Sanders' sound character was recognizable in all aspects of his life and positively impacted others. Applicants of the award provided an essay describing how character has been important in achieving their accomplishments and how it will be a key cornerstone in their future. The winner is selected solely on this personal statement of character, academic standing has no bearing.
"Character can be elusive in its definition. Jamie gave it life in his perception of the quality of choices, personal awareness of those around him and in his own journey", commented Barb Sanders, wife of Dr. Sanders.
Stacy Carpenter, counselor at LSH High School says "Jamie is an exceptional student, a thoughtful learner, and an articulate young man. Jamie is known at our school for being a hard-worker. His friends and teachers know they can count on him to not just meet expectations, but to exceed them. Jamie is goal-oriented and responsible. He makes thoughtful decisions, and he is a student who will easily find his place at college. I have consistently been impressed with Jamie."
LSH High School Principal, Kevin Enerson, describes Jamie this way, ""Jamie has always pushed himself to excel in whatever he does, be it academics, fine arts, or speech. He has achieved at some of the highest levels, but that is not as important as the character he demonstrates in his friendships or through his demonstration of respect and caring for others. Jamie is a truly good person and has made his family, friends, and community proud by all of his accomplishments."
Jamie is the son of Steve and Sue Schlarbaum. During his high school career, Jamie has participated in Speech, Fall/One Act Play, LifeSmarts, and Knowledge Bowl. He has volunteerd for Habitat for Humanity, Red Cross, and was a Junior High Knowledge Bowl Volunteer Coach. Jamie has been accepted for admission to Georgetown, University in Washington, D.C.
Effective immediately, Mankato Clinic will unite with Open Door Health Center (ODHC) and begin providing low income, uninsured patients in the Mankato area with high quality, much needed specialty health care services. With this partnership, Mankato Clinic will offer ODHC patients a complete array of medical assistance beyond the primary care services currently available at the ODHC facility.
"The Open Door Health Center is a safety net in the region for those who do not have access to medical services," said Sarah Kruse, CEO of Open Door Health Center. "While we see patients with insurance, the vast majority of our patients are uninsured or underinsured. For those without insurance, financial barriers frequently result in difficulty accessing specialty care. Our collaboration with Mankato Clinic helps eliminate those barriers. Patients who don't have the resources to get the specialized treatments they need now have access to these services at Mankato Clinic and may get the complete care they need."
The ODHC mission is to increase access to quality, affordable, culturally appropriate, patient centered health care, and to maximize the overall well-being of its patients. As a Federally Qualified Health Center, ODHC provides a full gamut of primary and preventive health services to the medically underserved in south central Minnesota. Now, a patient who visits ODHC whose medical needs extend beyond primary care services may turn to Mankato Clinic for help. These services include specialty care, advanced lab work and radiology.
For example, primary care services at ODHC may manage a patient with diabetes on a regular basis but if that diabetic patient begins to have foot complications, a podiatrist at Mankato Clinic will be available to consult the patient. And, that patient will have access to specialized lab work or radiology services if necessary.
"We feel the Open Door Health Center's mission is an important one," said Randy Farrow, CEO of Mankato Clinic. "We applaud their efforts. It is an important obligation on our part to support their efforts and provide complete medical access for patients with financial challenges. Our collaboration is the perfect fit. It is a win-win for everyone."
Mankato Clinic and ODHC hope this collaboration will improve outreach in the community. Many of ODHC patients are poor and less likely to receive preventive care, such as immunizations or cancer screening, or to avoid hospitalization for serious conditions by receiving regular office-based care. These patients often end up with a disease that could have been managed and now need emergency care or advanced care that could have been prevented.
"We hope that by being proactive, we will help underserved patients in the Mankato area get a better handle on their medical needs and live a better quality of life," said Farrow. "Many times, due to financial constraints, these patients choose not to access the care they need and let their conditions get out of control. We want to eliminate the emergency room as their last resort when their condition worsens. This puts stress on the system as a whole and is not in the best interest of anyone."
"We are delighted that Mankato Clinic has a heart for our mission and a strong commitment to the community for the health-related goodness of all," said Kruse. "Out of compassion, their physicians sought to serve the needs in the area and stepped up to the plate to offer their services in the best interest of the community."
Over $160,000 Awarded in 2010, nearly $1 million in the last 6 years
Thanks to the Mankato Clinic Foundation, over 30 area organizations received grants and funding totaling more than $160,000 in 2010. Organizations supported include Children's Museum of Southern MN, Feeding our Community Partners – Backpack Initiative, Lake Crystal Area Recreation Center, YMCA, Open Door Clinic, Greater Mankato Diversity Council, St Peter Early Childhood Initiative, American Red Cross, Special Olympics, ECHO Food Shelf, area school districts, and several other organizations including scholarships for the nursing programs at both South Central College and Minnesota State University- Mankato.
The physicians at the Mankato Clinic provide the majority of the Foundation funding as a means to give back to the community by providing support to organizations which strive to improve health and wellness. The Mankato Clinic Foundation has given $915,152.00 to area organizations over the past six years in an effort to support the health and well-being of local communities.
Grants are awarded on a quarterly basis and are considered only through the application process. Applications and more information can be obtained at www.mankatoclinic.com.
Area seniors eligible for $2,000 J. Scott Sanders, MD Memorial Scholarship
Mankato, Minn. (Jan. 11, 2011) – The Mankato Clinic Foundation's J. Scott Sanders, M.D. Memorial Scholarship is available to area seniors. Recipients will emulate Dr. Sanders' unforgettable character, his kindness and his passion for helping others. To be eligible high school seniors must reside within the Mankato Clinic service area, which includes Mankato, North Mankato, St. Peter, Lake Crystal, Mapleton, and the surrounding area. Students must plan to obtain secondary education after graduation.
Student selection is based solely on the content of the students' 1,000 word personal statement. Academic standings will have no bearing on selection. . The application deadline is March 1st. Applications for this $2,000 scholarship are available from area high school guidance counselors or can be accessed by clicking here.
The Mankato Clinic notified 3,159 patients of a breach of unsecured protected health information after discovering the following event:
• November 2nd the Mankato Clinic was notified that a laptop computer belonging to an employee was stolen out of a vehicle sometime between November 1st and 2nd; the laptop contained a spreadsheet which included personal health information of 3,159 patients and is considered a breach of unsecured protected health information.
• Patient information involved includes; patient's full name, date of birth, medical record number, healthcare provider's name, encounter date, and diagnosis information. Fortunately, Social Security numbers and addresses were not included in the information. Log-in access to the computer was password protected. This breach did not include the Mankato Clinic's electronic health record.
"The Mankato Clinic understands the importance of safeguarding our patients' personal health information and takes this responsibility very seriously. We have safeguards in place to ensure the privacy and security of all patient health information. To further mitigate this situation the Mankato Clinic is implementing encryption software to all mobile computers, establishing a more stringent mobile computing device security policy and a mandatory staff education program related to improving privacy protection measures," comments Randy Farrow, CEO of the Mankato Clinic. "The Mankato Clinic regrets that this incident occurred and we sincerely apologize to our impacted patients for this situation and are doing everything possible to rectify the circumstances".
Patients impacted by this information breach will receive a letter by mail detailing the situation. The Mankato Clinic has trained staff available for those patients to call with any questions related to the data breach. Patients may call 1-800-657-6944 – extension 8633, or 625-1811 extension - 8633 during normal business hours, Monday – Friday from 8am – 5pm, the Clinic is closed on December 24th. No steps by the patients are suggested to protect them from potential harm resulting from the breach of this personal health information as the data involved in this breach did not included any financial information.
Mankato Clinic, in collaboration with The Orthopaedic and Fracture Clinic (OFC), have begun providing patients in the Mankato area with the most state-of-the-art breast imaging services and cancer detection care by offering 3T Breast Magnetic Resonance Imaging (MRI), which is unsurpassed in the region. The new, high-quality breast imaging service is a non-invasive procedure used to evaluate breast problems, primarily to diagnosis breast cancer, by using powerful magnets and radio waves to generate computer images of the breast.
"Mankato Clinic and OFC's collaboration to bring 3T Breast MRI to Mankato truly offers patients the best in breast imaging," said Julie Johnson, supervisor of MRI at OFC. "We are striving to meet patient expectations by providing a comfortable environment that brings together the technology, imaging skills, expertise, responsiveness and excellent care that physicians require and patients deserve."
Used in conjunction with mammography and ultrasound, breast MRI is fast becoming a powerful tool in the detection, diagnosis and management of breast cancer in select patient populations. Breast MRIs are more sensitive than traditional mammograms which use low dosage x-rays to image breasts. Breast MRI is generally used as a complement to diagnostic mammography and is not a replacement for traditional mammography screening.
American Cancer Society guidelines recommend breast MRI, in addition to mammograms, for women at high risk including:
• A strong family history of breast cancer including a mother, sibling or child • A diagnosis with the BRCA1 or BRCA2 genetic mutation which gives them a 60 – 85 percent lifetime risk of acquiring breast cancer • A previous diagnosis of breast cancer in one breast by mammography or ultrasound • Radiation to the chest between the ages of 10 and 30 • Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalca syndrome or may have a close family history of one of these diseases in a first-degree relative
"Breast MRI is not recommended for routine screening or as a replacement for mammography, but is an important tool in clarifying inconclusive findings from a previous mammogram or ultrasound," said Dr. Maureen Magut, radiologist at Mankato Clinic. "It is commonly used to evaluate for surgical planning because nearly five percent of women with breast cancer in one breast develop a new tumor in the opposite breast, even though nothing is found on a mammogram or physical breast exam at the time of original diagnosis. Finding these cancers earlier may help women make treatment decisions and may spare them from additional rounds of chemotherapy or radiation in the future."
Because of its high sensitivity, breast MRI is useful in imaging dense breast tissue, which is often found in younger women, and in viewing breast abnormalities that can be felt but are not visible with conventional mammography or ultrasound.
MRI is also an effective tool for imaging the augmented breast, including the breast implant itself and the breast tissue surrounding the implant which may be obscured by the implant on a mammogram.
It is useful for staging breast cancer, determining the most appropriate cancer treatment and for patient follow-up after breast cancer treatment. MRI may be useful in determining whether breast cancer has spread into the chest wall which often requires the patient to undergo chemotherapy before breast cancer surgery.
In addition to its superior diagnostic ability, researchers have been investigating whether breast MRI may be useful in screening younger women at high risk of breast cancer. Most women under 40 do not require any breast imaging. However, the American Cancer Society recently recommended that women at very high risk of developing breast cancer have annual breast MRI exams in addition to annual mammograms to increase the likelihood that breast cancer will be detected early, when the chances of survival are greatest.
The most useful MRI technique uses a contrast material called Gadolinium DTPA, which is injected into a vein in the arm during the exam to improve the quality of the images. This contrast agent helps produce a stronger and clearer image and highlights any abnormalities.
During a Breast MRI, a patient lies face down on an exam table, keeping still and breathing normally. A physician may prescribe a mild oral sedative to help the patient rest comfortably in the scanner and reduce any feeling of claustrophobia. Unlike mammography, the breasts are not compressed during the exam so there is no discomfort. The table then moves into a cylinder shaped machine with the magnet where the images are taken. The test does not use any harmful or dangerous radiation. The exam is performed at OFC and a Mankato Clinic radiologist interprets the images and sends a report to patient's ordering physician.
"Because patients in Mankato can now receive the best in breast imaging care here at home, it is more convenient for the patient and her physician," said Dr. Magut. "This allows for better coordinated care between a woman and her healthcare team."
3 Tesla (T) MRI is the best in breast MRI imaging because of the strength of its magnet, a 3 Tesla, which is twice the strength of the more commonly available 1.5 Tesla. The magnetic field produced by the 3T yields exceptional anatomic detail and offers higher signal to noise ratio, better image resolution and faster scan times. It is the highest strength scanner currently available in the Mankato area.
"3T breast MRIs have been shown to improve patient outcomes due to its high sensitivity magnet," said Dr. Magut. "MRI, coupled with mammography, detects almost all cancers at an early stage; therefore, a smaller size, which reduces the incidence of advanced stage breast cancer in high-risk patients."
This system, with its 70 cm Open Bore, is one of the largest scanners available being at least 10cm wider than the average scanner. It is made for patients of all shapes and sizes and improves patient comfort and reduces incidents of anxiety and claustrophobia.
To find out more about breast MRI, contact a breast health nurse at Mankato Clinic at 507-389-8781.
Story reprinted from the Mankato Free Press, Sunday, August 1, 2010
Camp gives youngsters the
Day camp for kids with diabetes to become annual event
Story and photos by John Cross
email@example.com The day camp held Friday at the Norseland Scout Camp in Nicollet County was like most any other with youngsters hiking down the paths, playing camp games, geocaching and sitting around the campfire.
The only notable difference was that when lunch time rolled around, every one of the 27 campers took the time to check their blood sugar levels before lunch was served.
The campers age 5-13 were participating in the first- ever Camp Sweet Life, a day camp for youngsters with Type 1 Diabetes.
Youth from six area counties attended the camp sponsored by the Mankato Clinic Foundation and Medtronics.
And while they were participating in outdoor camp activities, their parents were able to learn from representatives from the Juvenile Diabetes Research Foundation about support systems and resources they can access for help in dealing with their children's disease. Camp Sweet Life Director Vickie Parsons, a nurse practitioner at the Mankato Clinic, said the camp will become an annual event.
"It's all about kids having fun outdoors just like all the other kids," she said. " They shouldn't be denied from enjoying the outdoors just because they have diabetes."
Mankato Clinic's North Mankato Family Practice has been named as a 2010 Minnesota Bridges to Excellence award winner by the Buyers Health Care Action Group (BHCAG). The award honors health care providers that deliver "optimal care to patients with diabetes, vascular disease and depression," according to the organization. The Minnesota Bridges to Excellence program, which was established by BHCAG in 2005, relies on data that is publicly reported to identify clinics that qualify for an achievement reward for meeting or exceeding optimal care standards for a specified percentage of patients or have experienced substantial improvement. "We are proud to receive recognition from BHCAG for the Minnesota Bridges to Excellence program," said Randy Farrow, chief executive officer of the Mankato Clinic. "Diabetes care is a key focus for us and our North Mankato Clinic has shown more than a 10% increase in their diabetes care performance over the last year. They were also recognized for substantial increases in their care performance in vascular disease. The Mankato Clinic's goal now is to bring this same level of quality improvement across our entire system to make a positive difference in the quality of life for more and more of our patients." "When health care providers share their performance outcomes with the public and everyone is working from a common set of standards and measures, we can create positive change in the marketplace," said Carolyn Pare, president and CEO of the Buyers Health Care Action Group, the organization that developed the Minnesota Bridges to Excellence Program. "Medical groups and clinics that are receiving Bridges to Excellence rewards have shown their commitment to transparency and to delivering quality care to their patients. They should be applauded for these efforts." To be eligible for a reward, clinics had to have a certain percentage of patients at optimal levels of care or a 10% improvement over last year. For diabetes, measurement components included levels of blood sugar, cholesterol, and blood pressure, along with non-smoking status and daily aspirin use for patients over 40. Vascular disease measurements included cholesterol, and blood pressure, along with non-smoking status, and daily aspirin for all patients. Clinical criteria for the Minnesota Bridges to Excellence program are developed by the Minnesota-based Institute for Clinical System Improvement (ICSI).
Mankato Clinic Purchases Now Care The Mankato Clinic has finalized an agreement to purchase the Now Care Clinic located at 1809 Adams Street in Mankato from North Memorial Medical Center. Transition of ownership and operations was effective March 1, 2010. Plans to rename and remodel the former Now Care location will be developed in the coming weeks.
Services offered by the Mankato Clinic at the new location will include urgent care and occupational medicine. The Clinic will continue to offer urgent care services at their Main Street location as well. "The addition of the Now Care location to the Mankato Clinic's current locations will give our patients a convenient option for urgent care and occupational medicine services. Patient volumes at our Main Clinic urgent care have continued to increase over the past few years. The addition of a second urgent care option at the former Now Care location on Adams Street will allow us to improve access for our patients," commented Randy Farrow, CEO of the Mankato Clinic. "The Now Care Clinic has filled a strong niche with convenient access to urgent care and occupational medicine services for many years and we are excited to maintain and expand these services as they become part of the Mankato Clinic. " All occupational medicine services will now be housed out of the new Adams Street location giving current and new patients convenient access to walk –in services as appointments will not be necessary for most occupational medicine needs. Additional occupational medicine services not offered by Now Care will now be offered such an travel and immigration services. The new location will focus on walk-in health care services. No appointment will be necessary for all urgent care services and most occupational medicine services.
The Mankato Clinic will also be utilizing electronic health records at the new location which will assist in providing patients with continuity of care. Medical records can instantly be shared by multiple physicians simultaneously regardless if a patient is being seen by their primary provider or an urgent care provider. Important patient information regarding previous visits, lab and radiology test results, and current medications, are available within the electronic health record to assist the provider in delivering the highest quality of healthcare. When accidents, incidents, and illnesses arise, finding the best type of health care provider for your needs can be confusing. Primary care providers such as a family practice physician are a great place to start for most undiagnosed health issues. The Mankato Clinic suggests all patients have an established primary care provider. If your primary care provider is not available and you need quick medical attention for a non-life-threatening problem, visit an urgent care center. No appointment is required at Mankato Clinic's Urgent Care locations which are open extended hours for patient convenience: 8:00 am – 8:00 pm – Monday – Friday, 8:00 am to 5:00 pm on Saturday and 11:00 am – 5:00pm-on Sunday. Urgent care centers also provide a significant cost saving over care in an emergency department. A retail clinic such as the Mankato Clinic Express in the Riverhills Mall is another option for minor illnesses such as colds, ear infections, and pink eye for patients over 18 months old.
As part of Mankato Clinic's commitment to its patient-centered healthcare home model, the clinic will take the model a step further by focusing on patients with depression and launching the DIAMOND initiative, at its North Mankato Family Practice and Wickersham Family Practice locations this month. Mankato Clinic is the only clinic in the region to offer DIAMOND services at this time.
DIAMOND, or Depression Improvement Across Minnesota, Offering a New Direction, is a new model for treating patients with depression in primary care by taking a team approach. It was developed in 2008 by the Institute of Clinical Systems Improvement (ICSI). ICSI is a non-profit organization that works with medical groups, hospitals, health plans, purchasers, policy makers and consumers to deliver patient-centered and value-driven health care services in Minnesota and its surrounding areas. Mankato Clinic is a member of ICSI and is part of the fourth group of clinics in Minnesota and Wisconsin to participate in the DIAMOND initiative.
"At Mankato Clinic, we sought a more effective way of providing depression care that takes the sole responsibility away from the primary physician and expands it to a team of care providers with the patient at the center," said Julie Gerndt, chief medical officer at Mankato Clinic. "By taking a collaborative approach and integrating care managers and medical health professionals into primary care, outcomes of patients with depression are significantly improved compared to results seen under the standard care."
DIAMOND helps overcome barriers to successful depression treatment in primary care clinics. It offers a scientifically-sound framework and training program to establish evidence-based, collaborative, measurable and actionable solutions.
There are six components of the DIAMOND model that distinguish it from traditional depression care including: • A validated screening tool or checklist that helps the health care team detect and manage symptoms of depression • A way for the care team to regularly track patient progress • A proven medical guide with stepped-care approach for treatment modification or intensification • A relapse prevention plan with tools to keep a patient who is improving from relapsing and move them out of the care management program • A care manager to educate, coordinate and troubleshoot depression services and who serves as a liaison between psychiatrist, primary care provider and patient • A consulting psychiatrist who reviews patient cases with the care manager and may consult with the primary care physician
Barb Anderson, CGRN, Quality Management specialist and DIAMOND initiative project manager at Mankato Clinic, says the use of a care manager is an important aspect of DIAMOND. "The involvement of the care manager is integral to the success of the initiative," said Anderson. "The care manager has special training and works together with the patient to best support their depression treatment needs." Typically, a care manager has a nursing or mental health care background; and in collaboration with the entire health care team, is responsible for education, self management support, primary care mental health care coordination and relapse prevention.
The consulting psychiatrist collaborates with the care manager and reviews the clinic's DIAMOND patient caseload weekly and recommends changes in treatment for patients not improving. The primary care physician makes all final treatment decisions and initiates changes in treatment plans. "If we are not getting desired outcomes and the patient is not making progress at certain steps, we get additional care providers involved," said Gerndt. "It has proven effective just by changing the model of care."
After tracking patients who followed DIAMOND care for 12 months, ICSI states remission rates were 49 percent surpassing goals by 19 percent and response rates, or the decrease in the severity of depression, were 72 percent exceeding goals by 22 percent.
According to ICSI, more than 37 DIAMOND trials have shown this method improves patient health. Patients had more depression-free days, fewer suicidal thoughts, stated they felt better physically and liked the care they received more. Employers benefited also because patients missed fewer days of work and were happier and more productive at work. And, health care costs decreased compared to costs under usual primary care.
DIAMOND also offers the Clinic an opportunity to enhance treatment models of other chronic diseases that are typically difficult to treat. "Depression is the first specific chronic disease that we have expanded our medical home model into," said Gerndt. "We are excited and encouraged by the results of other clinics who have implemented DIAMOND. We hope to replicate those outcomes and expand the model to other Mankato Clinic sites as well as use DIAMOND to develop a model of care for other chronic diseases."
Now is the perfect time to schedule your child's back to school or sports physical- before your summer gets away from you!
Click here for more information
Reston, Va. – The Mankato Clinic has been awarded a three-year term of accreditation in Ultrasound as the result of a recent survey by the American College of Radiology (ACR). The Mankato Clinic's Ultrasound Department is the ACR's only accredited facility in South Central Minnesota. The ACR, headquartered in Reston, Va., awards accreditation to facilities for the achievement of high practice standards after a peer-review evaluation of its practice. Evaluations are conducted by board-certified physicians and medical physicists who are experts in the field. They assess image quality, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance program. The surveyors report their finding to the ACR's Committee on Accreditation, which subsequently provides the practice with a comprehensive report. The ACR is a national organization serving more than 32,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs for focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services. The Mankato Clinic was founded in November 1916, by five area physicians who believed that a comprehensive, multi-specialty group practice offered the best means of providing quality health care to the residents of southern Minnesota. The Mankato Clinic has grown to over 110 physicians and practitioners located in Mankato, North Mankato, St. Peter, Mapleton, and Lake Crystal. The Mankato Clinic and its satellites employ over 700 people, and ranks among the top 15 employers in the region.