Touching Lives - Spring 2019

After a “perfect” pregnancy, Sarah Gilliam gave birth to her daughter, Lily, at a small Wisconsin hospital in April 2014. But Sarah’s joy quickly turned to fear as Lily struggled her first night and was airlifted to a specialty children’s hospital. She nearly died during the flight.

Unknown to Sarah and her obstetrician, Lily had been exposed during birth to a common bacterium, Group B strep. Her newborn immune system overwhelmed, Lily developed a life-threatening infection that caused inflammation of tissue around the brain and spinal cord, seizures and respiratory failure. Scans of Lily’s brain showed multiple areas of infection and bleeding.

With antibiotic treatment and 31 days of neonatal intensive care, Lily pulled through, but not before great damage had been done. Follow-up brain scans showed dead tissue where the infection once raged. According to Sarah, Lily’s doctors believed it likely she would never walk or talk.

CRISIS BEHIND, MOVING AHEAD

A hopeful neurologist suggested Sarah move nearer to the Twin Cities so Lily could see specialists at

Gillette Children’s Specialty Healthcare. Some months later, that’s just what Sarah did.

Settling not far from Glencoe in Green Isle, Sarah tapped Gillette for Lily’s orthopedic care and Minnesota Epilepsy Group for neurology. Friends recommended GRHS for primary care, so one-year-old Lily became a patient of pediatrician Alexandria Kalina, MD, FAAP

Dr. Kalina’s most crucial early interventions were setting Lily up with GRHS’ rehabilitation services department and assigning one of GRHS’ RN care coordinators to help Sarah navigate the social service system. She also recommended early childhood services through Lily’s school district, which provides additional in-home therapy sessions. Dr. Kalina works hard to get Lily the best care, says Sarah. “If I have a question, she will find the answer.”

THERAPIES YIELD RESULTS

When Lily started physical therapy with Jen Keenan, PT, MPT, at 13 months, she was just starting to roll over, but wasn’t sitting or standing. Now Lily walks using a wheeled therapy device called a gait trainer.

Lily Gilliam, age 4, has blossomed since she started working with physical therapist Jen Keenan, PT, MPT.

Sometimes kids need to have surgery. Procedures they commonly undergo at our hospital include appendectomy, tonsillectomy, ear-tube placement and removal of foreign objects (like marbles) from places they don’t belong (like noses).

“Surgery can be stressful for children,” says Stephanie Halverson, RN, CNOR, director of surgical services. “That’s why we take extra steps to help them – and their families – feel safe, calm and prepared.”

Having surgery is at GRHS child’s play

OUR KID GLOVES ARE ON

Upon arrival in the unit where patients get ready for surgery, children find a personalized welcome sign and a smiley-face balloon. Next, they pick out and change into colorful “surgery pajamas” and their very own souvenir cap sewn by a GRHS volunteer. The cap patterns include superheroes, dinosaurs, cartoon characters, puppies, sports teams and more. We also provide an age-appropriate explanation about the upcoming surgery, plus coloring books, DVDs, and other activities to keep kids busy (and distracted) until it’s time to go.

Thanks to a gift from the Sibley and McLeod County Farm Bureaus, the highlight of surgery for 99.9 percent of kids is traveling to the operating room (OR). They can go in a wagon, on a tricycle, or behind the wheel of a battery-powered toy tractor. Parents can go along and even stay in the OR until their child falls asleep under anesthesia.

10, 9, 8, 7…

Our nurse anesthetists help children feel at ease when they arrive in the OR. Kids get stickers to decorate the mask that covers their nose and mouth to deliver anesthesia. They also pick out a lip balm flavor and rub it inside their mask. A familiar

Lily’s in Bloom, continued from page 1

“Our goals are for Lily to stand and move from one spot to another without using her gait trainer or other supports,” comments Jen.

Lily’s sessions with occupational therapist Jenna Knudtson, OTR/L, focus on fine motor activities to improve her ability to cut, draw and write letters. “Lily is changing daily and her skills continue to progress in ways many people did not expect,” Jenna says.

At 16 months, Lily started working on prelanguage skills with speech therapist Leah Seifert, MS, CCC-SLP. “Now she communicates verbally nearly all of the time,” adds Leah.

Dr. Kalina explains, “Children’s brains are resilient and oftentimes find ways to ‘rewire’ around damaged tissue.”

LILY KEEPS GROWING

Today, the active almost-five-year-old with wispy blonde hair loves books, making friends and asking for hugs. She’ll start kindergarten in the fall. Lily knows her colors, shapes and numbers, and speaks in complete sentences. She follows her three-yearold brother, Grayson, anywhere he goes.

Dr. Kalina and Lily have become special friends. They take a walk together before each appointment. At a recent visit, Lily held Dr. Kalina’s “telescope” [stethoscope] and described each part. “Every day, Lily shows us something new,” Sarah says with pride.

“Lily is changing daily and her skills continue to progress in ways many people did not expect.”

scent eases the process of going to sleep. (The most popular is bubble gum.)

We encourage parents to bring their child’s favorite comfort item, such as a pacifier, blanket or stuffed animal, into the OR to help with falling asleep. Counting backwards from 10 helps, too. Whenever possible, nurses won’t start intravenous (IV) lines until the child has drifted off.

FUNDAMENTALS IN PLACE

“Parents can be assured that our surgeons and surgical nurses have advanced training to address any situation that might occur,” says Halverson. In fact, every member of GRHS’ surgical team is certified in pediatric advanced life support.

PRE-SURGERY TOURS

Not knowing what’s going to happen can make anyone feel anxious. That’s why we offer pre-surgery tours for patients of any age. Meet our friendly staff; learn what to expect before, during and after surgery; and see where it all happens!

To schedule, call 320-864-7724

Kids love to drive themselves to the operating room!

Nurse anesthetist Joslin Thiemann, MS, CRNA, uses childfriendly techniques to calm young patients before surgery.

WE’RE BIG on KIDS

Here’s a little advice from some of our pediatric providers

ALEXANDRIA KALINA, MD, FAAP | PEDIATRICS

What’s the best way to handle a toddler meltdown?

A tantrum usually means a toddler is tired, sick, hungry or scared, so make a quick assessment to see if any of these are the underlying problem and then fix it. If the answer isn’t obvious, I suggest you get right down to the child’s eye level, tell them you understand something doesn’t feel right, and ask how you can help. If this doesn’t work, I recommend a good pair of noise-canceling headphones. Stay calm and let it pass.

Favorite princess Belle

Childhood dream

To be a ballerina

KRISTINE KNUDTEN, MD | FAMILY MEDICINE

How do you get little kids to sit still when you are seeing them for care?

Licks to the center of a Tootsie-Pop

No idea. I bite every time!

My best trick works when an older sibling is along for the appointment. Kids always want to be like their older brother or sister, so I’ll look into the sibling’s ears first to show that it doesn’t hurt. Kids learn a lot by watching. I’ve also found that if I whisper while checking ears or doing another part of an exam, the child will often be still so they can hear me better.

Preferred dessert Chocolate, hands down!

Childhood toy

My little sister, Racheal

Best cartoon Wile E. Coyote

KRISTEN BUDAHN, MD | FAMILY MEDICINE

At what age should kids start seeing health care providers on their own?

Parents should attend clinic visits for as long as both parents and kids are comfortable. When a child is about 12 or 13, I will start asking parents to step out for at least part of the visit. This gives kids an opportunity to ask questions that they may not feel comfortable asking in front of their parents. It also helps them develop “seeing the doctor” skills, because someday they will be doing it alone.

Best cartoon Scooby-Doo

Knock, knock. Who’s there? Interrupting cow. Interru… MOO!!!

Favorite princess Mulan Go-to joke

KARI KNODEL VETTEL, MPAS, PA-C | FAMILY MEDICINE

How can parents help their kids develop healthy eating habits?

Your child will expect to eat the same things you do, so resolve to be a good role model. It’s important to engage your child in preparing healthy meals. Toddlers especially love to unload grocery bags and help in the kitchen. It’s a great time to talk about (and snack on) veggies and fruits. Also, banish digital devices from the dinner table and encourage your kids to practice their conversation skills instead.

Best super hero Wonder Woman

Sweet tooth Chocolate

Treasured toy Bionic Woman Barbie

BEST of YOUR ABILITY

Rehabilitation enhances physical function, quality of life

CAR D IAC Rehabilitation

A medically supervised program of education in risk-factor modification, stress management, nutrition and exercise that targets your most important muscle.

OCCUPATIONAL Therapy

Develops a child’s or adult’s ability to complete activities of daily living, such as bathing, dressing, eating, doing housework or school work, or performing job-related tasks.

Recommended after:

Heart attack

Coronary artery bypass graft (CABG) surgery

• Balloon angioplasty and stenting

• Valve replacement

Did you know?

Cardiac rehabilitation is also recommended for some people living with chronic heart conditions, such as heart failure and peripheral artery disease.

Do you need a physician’s referral to receive rehabilitation care?

Maybe not! See page 6 for details.

Did you know?

Occupational therapists also can evaluate and provide treatment to address problems with cognition — the mental function of acquiring and understanding information — that can result from traumatic brain injuries, tumors, strokes, as well as Alzheimer’s disease and other forms of dementia.

PHYSICAL Therapy

Helps patients of all ages recover from or adapt to conditions that cause pain and limit the ability to move and perform everyday tasks. It is used to help people recover from a wide variety of musculoskeletal and neurological conditions.

Did you know?

Our physical therapists can treat dizziness, spinning sensations, balance issues, blurred vision and nausea that are caused by problems in the inner ear. They can also treat incontinence and other types of bowel and bladder dysfunction.

Marilyn Dunbar, BSN, RN, CCRP, helps patients with heart problems to maintain active lives.

Kelsey Nowak, PT, DPT, treats lower abdominal and pelvic pain using a variety of methods including neuromuscular re-education and therapeutic exercise.

Jenna Knudtson, OTR/L, treats a patient using a swing in our specially equipped pediatric therapy gym.

Strokes, heart attacks, orthopedic procedures, developmental delays, back pain and sports injuries are all common reasons that patients seek care from our rehabilitation services department. We have 14 therapists representing four different rehabilitation disciplines. Each applies specific expertise to help patients recover from or adapt to a wide range of health issues and disabilities. In fact, you might be surprised to learn some of the concerns our therapists can help with! grhsonline.org/rehabilitation-services

SP EECH-LANGUAGE Therapy

Adults may need this type of therapy after a traumatic injury, stroke or disease changes their ability to communicate. Children may need it when they are delayed in reaching developmental milestones or have conditions that affect their speech.

It helps patients:

• Improve hand-eye coordination

• Gain strength in elbows, wrists and hands

• Reach developmental milestones

• Improve fine motor skills

Techniques include:

• Manual therapy

• Muscle control exercises

• Balance training

• Muscle retraining and strengthening

• Body posture education

Symptoms therapy can address:

• Difficulty producing certain speech sounds clearly

• Hoarseness, loss of voice, or nasal tone

• Stuttering or problems speaking smoothly

• Difficulty expressing thoughts in speech or writing

• Problems understanding what people say or write

Did you know?

Speech-language therapists can help to improve muscle strength and coordination during swallowing.

Soft-tissue mobilization is one of the methods Michelle Becker, OTR/L, uses to facilitate her patient’s recovery from a wrist injury.

Mattie Tegels, MA, CCC-SLP, shows a young patient how to shape his mouth to create a desired sound.

Leah Seifert, MS, CCC-SLP, uses technology that sends small electrical impulses to her patient’s throat during therapy to improve his swallowing strength and coordination.

Jenni Keltgen, PT, MPT, performs the canalith repositioning maneuver, a very effective treatment for the most common cause of dizziness and vertigo.

NEED TO Bounce Back? TAKE THE Fast Track

When you’ve got a musculoskeletal problem –a bad back, a bum knee, a pain in the neck –it literally hurts to move. However, the wisdom of taking a wait-and-see approach before seeking care has been challenged by recent studies that show starting physical therapy right away may reduce your costs and improve your outcomes.1

Take lower back pain, for example. It’s the number-one reason GRHS primary care providers refer patients to our rehabilitation services department.

“We tracked more than 225 patients who completed physical therapy for low back pain during the last three years. On average, patients were seen for seven sessions,” explains Clark Christianson, PT, ScD, COMT, director of rehabilitation services. “We asked them to rate the change in how they felt from the start of treatment to the end. Most patients reported they felt ‘quite a bit better.’”

TWO-WEEK WINDOW

Clark says research shows that starting physical therapy within 14 days of the onset of low back pain delivers the best results. Accessing physical therapy care within two weeks has also been shown to reduce the patient’s risk of needing additional physician visits, expensive imaging tests, opioid prescriptions, injections and surgery.

Most people with musculoskeletal complaints wait a while to see if the pain gets better. If it doesn’t, they make an appointment with their primary care provider, who writes a referral to physical therapy. It’s a good process, says Clark, but it takes time.

“If you miss the golden window during which physical therapy is most effective, the possibility that you’ll need a more complex, painful and expensive intervention starts to increase,” Clark says.

DIRECT ACCESS TO PT

A strategy for speeding up the process is taking the “fast track” directly to physical therapy, Clark notes. “GRHS lets you choose. If you have low back pain or another type of musculoskeletal pain and want to see a primary provider first, you can do that. But if you want to go directly to a physical therapist, and your insurance allows it, you can. Either way is fine. Just remember it’s important to have your first therapy appointment within two weeks of the start of symptoms.”

CHECK YOUR COVERAGE

All 50 states have laws that allow patients to see a physical therapist without first obtaining a referral from a physician. However, there’s a difference between what state law says is permissible and what insurers permit:

Medicare and Medicaid do not allow direct access to rehabilitation services. If you have this type of coverage, you must get a referral order from your primary provider before you can be seen by a physical therapist.

Many of the insurance plans you can buy on your own or get through an employer will provide coverage when you go direct to physical therapy without a referral. But it’s always a good idea to call the number on your insurance card to confirm your benefits before making an appointment.

If you enjoy meeting new people and are fulfilled by helping others, we’d love to have you join the volunteer squad at our new nursing home, GlenFields Living with Care.

See the list of opportunities to the right. No experience is required; training is provided. The only equipment you’ll need is a smile!

To inquire, call Denise Lemke at 320-864-7703 or toll free 1-888-526-4242, ext. 7703. Or send Denise an email from grhsonline.org/volunteer

Denise

Wednesdays & Thursdays: 9 am – noon

Tuesdays & Thursdays: 2:30 pm – 3:30 pm

Saturdays: 10 am – 11 am GIFT

Lemke, GRHS volunteer coordinator

Physical therapy is a very cost-effective way to feel better fast.

– CLARK CHRISTIANSON, PT, SCD, COMT

Think Prevention, TAKE ACTION

We understand that, for a variety of reasons, some people are less than eager to have preventive screening exams like mammograms and colonoscopies. Some avoid or delay because they are uncomfortable with tests involving private body parts, others are worried about discomfort during the exams, and others think screening tests aren’t urgent if there’s no family history of cancer.

If this sounds like you, or someone you care about, we’d like to introduce Bob McKimm and Colleen Otto.

BOB

growths or polyps,” says general surgeon Chad Robbins, DO, FACOS.

In Bob’s case, colonoscopies had yielded only benign growths until 2014, when Dr. Robbins removed three small pre-cancerous polyps. He also found a large flat mass that couldn’t be removed with the colonoscope. He took a tissue sample, which showed the mass had cancerous potential.

OPTIONS EXPLORED

At Dr. Robbins’ suggestion, Bob consulted a cancer specialist about the best way to remove the mass. Together they decided it was best for Dr. Robbins to perform surgery.

Know your screening GUIDELINES

Your health care provider will talk with you about recommended preventive health screenings, but they are easy to find online.

Retiree Bob McKimm walks the talk about a healthy lifestyle. When knee pain at age 30 changed him from a runner to a walker, he kept up his mileage by heading out two or three times a day! He’s just as serious about getting preventive health screenings. He started regular colonoscopies at age 50, even though he had no family history of colorectal cancer.

“Colonoscopy allows us to detect cancer at a treatable stage and actually prevent a colorectal cancer from starting by removing pre-cancerous

Dr. Robbins removed the mass, as well as 10 inches of Bob’s colon. Once removed, the mass tested positive for early-stage colon cancer.

APPRECIATES HIS GOOD FORTUNE

Bob tells anyone who’ll listen not to avoid having a colonoscopy because it’s a bit uncomfortable. “It’s probably human nature to want to avoid it,” he says, “but it’s necessary. You don’t do it to have fun. It’s about prevention.

“Just because no one in your family has had cancer doesn’t mean it won’t happen to you.”

taken by surprise in 2011 when her scan indicated a possible cancerous mass. Because she’d had regular scans, no family history of breast cancer, and dense breast tissue that normally feels lumpy, she didn’t believe the preliminary diagnosis until a biopsy two weeks later confirmed it was cancer.

CANCER SPREAD RAPIDLY

A 37-year employee of GRHS, nurse Colleen Otto, LPN, often wears a pink ribbon-themed top while working at the Lester Prairie Clinic. Her interest in promoting mammograms is more than professional – it’s personal.

When she found a lump in her breast 17 years ago, Colleen immediately scheduled a mammogram, which was followed by an ultrasound. Fortunately, these tests showed the lump was not cancerous. It was fibrocystic tissue, which is a common, benign condition that can cause breasts to feel lumpy.

After that experience, Colleen scheduled a screening mammogram like clockwork every year. She was

The biopsy showed her cancer had been detected early, at stage 1. However, by the time Colleen had lumpectomy surgery 31 days later, it was stage 3. The cancer had rapidly spread to seven of the 16 lymph nodes that were removed and tested. As a result, Colleen needed both chemotherapy (16 sessions, scheduled every other week) and radiation therapy (33 sessions).

To the amazement of everyone at the clinic, Colleen never missed a day of work. She credits that feat to strong faith and supportive coworkers. Colleen scheduled chemo every other Friday, became “sicker than a dog” the following Sunday, but felt good enough to work on Monday.

TAKE THE OUNCE, NOT THE POUND

Whenever a patient tells Colleen she’d rather not have a mammogram to avoid the test’s brief discomforts, Colleen replies that it feels much worse to have chemo and radiation therapy.

GRHS follows guidelines recommended by the U.S. Preventive Services Task Force. The Centers for Disease Control and Prevention (CDC) supports the task force’s screening guidelines for breast, cervical, colorectal (colon), and lung cancers.

A summary can be found here: cdc.gov/cancer/dcpc/prevention/screening.htm

Dr. Robbins recommends the American Cancer Society’s breast cancer screening guidelines: cancer.org/cancer/breast-cancer/screeningtests-and-early-detection

“I’m a private person,” Colleen says, “but when it comes to cancer, I’m a speaker because I don’t want anyone else to go through what I did.”

RISE & SHINE, it’s mammogram time!

To serve you better, we’ve expanded our business hours for screening mammograms.

Appointments are available beginning at 6:15 am Monday through Friday. We also perform the exam until 6:30 pm on select days each month.

To schedule, call 320-864-7080 or toll free 1-888-526-4242, ext. 7080

For information on options and what to expect, visit grhsonline.org/mammograms

Care & Services

MEDICAL SPECIALTIES

Audiology

Cardiology

Emergency Medicine

Family Medicine

General Surgery

Hematology

Hospitalists

Internal Medicine

Midwife Services

Nephrology

Neurology

Obstetrics and Gynecology

Oncology

Orthopedics

Otolaryngology (ENT)

Pediatrics

Podiatry

Pulmonology

Urology

MEDICAL SERVICES

Acute Care Unit

Ambulance

Anticoagulation Clinic

Best Beginnings Birth Center

Cardiac Rehabilitation

Diabetes Education

Emergency Room

Health Care Home Program

Infusion Services

Laboratory

Medical Imaging

Occupational Therapy

Physical Therapy

Preventive Health Services

Respiratory Therapy

Sleep Study Clinic

Speech-Language Therapy

Transitional Care

Urgent Care

Vascular Consultations

Ventilator Care and Liberation

Wound Care

SKILLED NURSING CARE

GlenFields Living with CareSM

INDEPENDENT SENIOR LIVING

Orchard Estates

from the

by Jeff Mason, MBA, BSN, RN, FACHE President & CEO

Health News

LISTEN TO HEALTH UPDATE

Sponsored by GRHS

Airing on KDUZ-AM 1260

DATE: Second Tuesday of the month

TIME: 2:35 pm

MyChart

GET CONNECTED WITH MYCHART

MyChart provides a convenient way to view test results, access portions of your medical record, message your provider and even schedule appointments online.

To sign up, visit grhsonline.org/mychart or ask the receptionist or nurse at your next clinic appointment or hospital visit.

In support of our community’s health

Sanken-Hatz scholarships will be awarded to qualified high-school seniors and post-secondary students who will be enrolled during the 2019-2020 academic year in approved programs for:

Certified Nurse Practitioner Dentist (and Pre-Dentistry)

Dental Hygienist

Medical, Surgical or Medical Laboratory Technician

Nuclear Medicine Technician

Occupational, Speech or Respiratory Therapist

Paramedic

Pharmacist or Pharmacy Technician

Physical Therapist or Physical Therapy Assistant

Physician (and Pre-Medicine)

Physician Assistant

Radiologic or Ultrasound Technologist

Registered Nurse or Licensed Practical Nurse

Visit grhsonline.org/scholarships to review eligibility rules and download an application packet. Complete the documents and mail to the address shown. Applications are not complete until we receive the applicant’s most recent official transcript and applicant appraisal forms from two references. All materials must be postmarked no later than March 31, 2019

No matter what kind of work you do, you’re probably dealing with change right now. That’s just the world we live in today. Health care providers are adapting to rapid advances in information technology, medical devices and pharmacology that should enable us to deliver better results for patients more efficiently than ever. It’s an exciting time, but a challenging one, too.

In response to our changing environment, the GRHS board of directors recently completed a planning process to help us identify and focus on a few key priorities. Many community members, patients and employees provided input to this process through a survey we hosted on grhsonline.org last fall. If you were among the respondents, I thank you. We heard loud and clear that you support the board’s goals to:

1. Ensure that GRHS is financially stable and positioned to provide excellent patient care and service to the community for decades to come;

2. Maintain significant local input to GRHS’ strategic direction; and

3. Continue to provide employment for GRHS’ talented and dedicated workforce.

In line with these objectives, we are embarking on a growth strategy that will increase your access to specialty care and surgical services right here in Glencoe. We’re fortunate to have excellent medical providers, a caring staff, modern facilities and a stable financial position to help us in this endeavor, but your continued support will be greatly appreciated as well.