MyNorth Medical Insider, 2022

2022

Medical Insider Professionals • Hospitals • Practices • Technology

A NEW APPROACH TO RESTORATIVE YOGA Get Healthy, Be Strong: Mathieu Boldron & Ashtynne Hudecz’s approach to yoga

“I can’t run a marathon.”

Actually, you can

New Tech Makes Dental Work a Breeze Less stress and discomfort for patients Innovative Infrastructure Inside McLaren’s new state-of-the-art hospital wing

From Rock Bottom to Recovery

Munson’s addiction program offers hope, help, success

Petoskey neurosurgeon meets needs of aging population Nephrologist Dr. John Stanifer brings life-changing procedure to Traverse City

A SUPPLEMENT TO

How family doctors are using telemedicine to improve patient care

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State-of-the-art Holistic Therapy Here in Northern Michigan!

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Two Chambers To Serve Your Needs

In a hyperbaric oxygen therapy chamber, the air pressure is increased to three times higher than normal air pressure. Oxygen is dissolved into all of the body’s fluids, the lymph, and the bone and can be carried to areas where circulation is diminished or blocked. In this way, extra oxygen can reach all of the damaged tissues and the body can support its own healing process.

HOCATTTM-Hyperthermic Ozone & Carbonic Acid Treatment The HOCATT delivers an incredibly powerful session that boosts energy, and detoxifies the body down to the cellular level, improves circulation, and strengthens the immune system. The main modality is Transdermal Ozone, which is generated from pure Oxygen.

Functional Medicine and Functional Neurology Dr. Tony Aboudib, DC

3337 South Airport Road West, Suite 2 • Traverse City, Michigan 49684 231-421-5213 • www.MichiganHealthAndWellness.com 2022_MEDICAL INSIDER.indd 1

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Plastic and Reconstructive Surgery

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A MyNorth Media Publication PRESIDENT/EDITOR IN CHIEF

Deborah Wyatt Fellows

CHIEF OPERATIONS OFFICER

Michael Wnek

Table of Contents MI 4 | The Unstoppables

SENIOR EDITOR

Elizabeth Edwards

ASSOCIATE EDITOR

Carly Simpson

MANAGING EDITOR

Allison Jarrell

PROOFREADERS REGULAR CONTRIBUTORS

ART DIRECTOR PRODUCTION DIRECTOR

Elizabeth Aseritis, Caroline Dahlquist

Two courageous women refuse to give up on their dream: running a marathon.

MI 9 | Dream Machine

Kim Schneider, Cara McDonald, Kandace Chapple

Nephrologist Dr. John Stanifer brings a life-saving treatment to Northern Michigan, helping patients fight autoimmune disorders, cancers and more.

Tim Hussey

MI 13 | Brains and Heart

Theresa Burau-Baehr

GRAPHIC DESIGNER

Claire Houser

Dr. Justin Thomas is no ordinary small-town doc.

This Petoskey neurosurgeon tailored his training specifically for the needs of the North.

DIRECTOR OF SALES

Julie Parker

MI 15 | A New Perspective on Yoga

Tabatha VanWingerden

From France to Traverse City, two instructors share their passion for physical, mental and emotional wellness.

ASSOCIATE ART DIRECTOR, SPECIAL SECTIONS

SALES ACCOUNT COORDINATOR ACCOUNT EXECUTIVES

MARKETING DIRECTOR MARKETING COORDINATOR OFFICE MANAGER BOOKKEEPER

Rachel Watson

Mike Alfaro Ann Gatrell Julie James Meg Lau Kirk Small

MI 18 | The Future of Medicine How to best utilize telehealth services—from the technology required to best practices and protocols.

Erin Lutke Ashlyn Korienek Libby Stallman Kim Stewart

MI 22 | Opioid Treatment Program Returns Munson’s successful residential program is once again available after a pandemic-induced pause, along with new recovery coaches.

MI 26 | Innovation in Infrastructure

A SUPPLEMENT TO

Impressive building and equipment expansions at two local hospitals elevate patient care.

MI 29 | Great First Impressions New technologies are lessening the pain of major dental work, and making it more beautiful, lasting and speedy.

MI 30 | For Kid’s Sake

Editorial & Advertising Offices 125 S Park Street, Suite 155 Traverse City, MI 49684 Phone: 231.941.8174 | Fax: 231.941.8391 Subscriber Services Visit MyNorth.com/Account to renew your subscription, change your address, or review your account.

Munson Healthcare recruits visiting pediatric specialists from top hospitals to help care for the region’s youngest critically ill patients.

Please email other subscription inquiries to info@mynorth.com or call 800.678.3416 between 8:30 a.m. and 5 p.m. EST. Medical Insider is produced by Heritage Broadcasting Company of Michigan.

All rights reserved. Copyright 2022, Heritage Broadcasting Company of Michigan.

Reproduction in whole or in part without permission is prohibited.

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THE UNSTOPPABLES Defying the odds and breaking down barriers— these courageous people never give up.

by Anne Stanton photos by Michael Poehlman

Amy Spegele On a snowy, cheek-blasting evening, Amy Spegele, a volunteer coach for the Traverse City Track Club, explained to her two mentees—me and a 20-something runner—that instead of running, she run/walks. Forty-five seconds of running, 30 seconds of walking. And she meant a leisurely, chatty kind of walk. Hmmm.

I remembered triumphantly running my first straight three miles.

So back to run/walking? But, hey, I was open.

As the wind bit our foreheads along the Boardman River Trail, Amy called out, “Start!” “Stop!” During one of the walking intervals, she casually mentioned that she suffers from two medical conditions that cause her to blackout when pushing too hard. But not to worry. She only has to stop running and there’ll be no need to call 9-1-1.

So naturally, I was surprised to learn she not only is a running coach but also teaches yoga, holds a third-degree black belt, MI 4

and founded and runs a nonprofit martial arts school. Intrigued, I talked to her a few nights later about her unstoppable approach to exercise.

Amy agrees, it is surprising that she’s so active, given all her physical challenges. In fact, her health problems began in early childhood, when she suffered from vesicoureteral reflux (VUR), a malady caused by cockeyed neurons that sent urine from the bladder back to the ureters, and sometimes all the way to her kidneys. Her condition caused recurring urinary tract infections, not to mention embarrassing accidents.

“I couldn’t run, jump or laugh without an accident, which makes you very uncool on the playground,” she says. “I never grew out of it, as the doctors hoped, so I finally had surgery when I was 12.”

With the operation, accidents and infections became maladies of the past. But it wasn’t so easy losing her ingrained self-image as a non-athlete.

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INSPIRATION STARTS HERE «

Her turning point came in her early 30s when she signed up for a martial arts class with her 5-year-old son. She was instantly enthused, but again, confronted obstacles.

“During one of my first days, I was working with a head instructor, and he was showing me how to punch, and he wanted me to do it quickly,” Amy recalls. “We were drilling over and over again, and my vision started leaving me. I told him, ‘I can’t see very well.’ He said, ‘Keep going! You can do it!’ So, I kept going. Then I told him, ‘The world is black. I can’t see a thing.’

He said, ‘Stop!’”

She did, and the world came back into focus. She later learned that she was afflicted with vasodepressor syndrome (VDS); her blood pressure plummets when her heart rate peaks at around 180. There is no cure for it, but she only has to stand still to avoid blacking out.

Despite the medical setback, Amy’s confidence was bolstered by her success in martial arts. So much so that she began running

with a friend. Knowing the risk of blacking out, she opted for the walk/run system made famous by Jeff Galloway. For months they enjoyed running together, but then her friend began pushing for speedier, longer run intervals. Amy exerted herself to keep pace, but then another medical malady popped up. On faster runs, she’d make an asthmatic, high-pitched sound, a symptom of paradoxical vocal cord dysfunction—essentially her vocal cords began closing off her air supply. Taken too far, she’d pass out.

The solution? Again, just stop.

As it turned out, her friend grew into a competitive racer, and they parted ways—at least when it came to running. Dejected, Amy stopped running altogether.

“I was hard on myself,” Amy says. “I thought, ‘This is horrible for my body,’ ‘Why can’t I keep up?’ ‘Why can’t I go faster?’ But then I realized, ‘This isn’t how I want to talk to myself, this isn’t how I wanted to feel about me.’”

Amy decided to place her ego firmly on the shelf, tie up her shoelaces and return to the shorter splits of 30/30.

“It was then that I realized I actually loved running,” she says. “I loved being out in the fresh air and everything else. And that I had to let go of my times. I am a person just running for myself. Even if I didn’t have these medical issues, I was never going to win anyway … It was ridiculous to put pressure on myself.”

Amy says she runs just as fast this way as she would without the restful walk intervals. But the benefit—above and beyond remaining conscious—is that she doesn’t get injuries. The 30-second walk provides her heart, her breathing and her running muscles with a calming break. She uses the “interval timer” app and bone conduction headphones so she can hear what’s going on around her or talk with a friend. On long runs, she takes time to drink or eat an energy gummy. Sometimes, she just stops altogether to take in a beautiful view.

Amy loves to share what she’s learned with others, envisioning a world where everyone runs, hikes, golfs, swims–whatever—in a joyous way without the mental baggage of judging themselves or others. Carina Conklin, 33, says she teamed up with Amy when she first started running and learned the mindset of running “happily.” But her husband took the opposite tack.

“He was trying to qualify for the Boston and was constantly injured. I just ran for me. That approach eventually clicked for him, too, and that’s how we both run together now,” Carina says.

In the last dozen years, Amy, now 45, has run 31 half marathons, three marathons and a 31-mile ultra, extending her splits into a two-minute run, one-minute walk. In one race, she clocked 10-minute miles.

She has this advice for folks who apologize on social media for their slow pace: Let go of people’s opinions and celebrate yourself for just getting out there.

“When somebody asks, ‘What was your time?’ I say, ‘I passed everybody on the couch. Every single person.’” 4 MyNorth Medical Insider 2022

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INSPIRATION STARTS HERE «

Nicole Enger When Nicole Enger took her maiden run in her Bass Lake subdivision, she decided to leave the house at midnight.

Like some folks who are overweight, she preferred to avoid people’s judgmental stares. She ran nearly a half-mile—lit by the stars and a bright full moon—and went unseen by anyone.

Night after night, she ran a little farther, alone with her thoughts and the sound of her feet hitting the pavement.

The beginning of her transformation was quiet and unannounced, and so were all of her runs that summer. But over the next nine years, she became loud and proud. She made many friends, explored new trails, raced her first sprint triathlon and is now training for her first, in-person marathon. Along the way, she’s lost 95 pounds and shrunk 10 sizes.

“It changed me as a person,” she says.

“For the better.”

The journey for Nicole began on a late spring day, looking out the office window of her family business, thinking she was 34 years old and it was time for a change.

“I got into a crappy relationship—this sounds so cliché—that was on its way out,” she recalls. “I had gained a bunch of weight. I thought, ‘You know what, I want to do something to fix the things that I can change.’ So, I started running, thinking it wouldn’t cost me anything.”

Nicole confesses to hating running in high school—she preferred to walk. But that first summer—each night after the sun went down—she donned a pair of running shoes, a loose cotton T-shirt and leggings, and willed herself out the door.

“I was too embarrassed for people to see my fat butt running,” she recalls. “I remember when I couldn’t get through half a mile, and it was so frustrating. In the beginning, I said negative things. I called myself a fat ass, things like that. But I stuck with it. ‘Gosh, I can run a mile now. Oh! Okay. This is good, this is a good thing.’

And I stuck with it.

“I came to a spot where I didn’t have to constantly reinforce negative thoughts with positive thoughts,” Nicole continues.

“It was more, ‘Hey, I did this! It was just a run, and I’m enjoying it. I’m running at night under the stars, no dogs, no cell phones, no barking, no kids screaming.’”

She had proudly reached the three-mile mark when a friend invited her to join the Wednesday “fun run” with the Traverse City Track Club.

“I thought, I’m a fat person, I run slowly. Runners are tall, they’re thin, they have decent bodies. I am not that,” Nicole says, a pretty brunette who’s on the shorter side.

“But I eventually did go and thought, ‘My gosh, why didn’t I run with these people sooner?’ On the first run, I was the last person to finish. But the people who passed me said, ‘Good job, good job, good job!’

I thought, ‘I don’t even know this person,

“ I’ve learned a lot about how I run and what kind of runner I am.” why are they saying this to me?’ People were so encouraging to me, so I stayed with it.”

Nicole believes many people allow their thoughts to stop them in their tracks. To overcome her own negativity, she told herself she didn’t have to fit a certain mold, that no one would persecute her for not being the fastest runner. So, she kept showing up for group runs and “met the most amazing people.”

Chats with friends made (and still make) the long hours fly by. Nicole talks about her side job as a makeup artist for movies, her two cousins she helped care for, past adventures as a “day roadie” for famous musicians and creating a campaign commercial for a congressional candidate.

Meanwhile, she cleaned up her diet.

Although a vegetarian for several years,

she knew she wasn’t eating a healthy diet.

“Vegetarians can eat a junk food diet too,” she says, laughing.

So she took a hard look at her cupboard, throwing out all the high-sugar, high-fat foods while cutting down on salt and foods with additives. She also reduced her portion sizes and began cooking at home nearly all the time.

“Once I cut out all the processed stuff, the weight fell off,” she says.

For Nicole, running is never boring.

Over the years, she’s tried different things— different race distances, exploring new trails, doing adventure runs.

“I’ve learned a lot about how I run and what kind of runner I am. I have friends who are very fast, but I’m great at running long distances for very long periods of time,” she says. “Right now, I’m at 19 miles. It feels good. ‘Gosh, that first two miles sucked, your body is not warmed up.’ But always at the end, I am so glad I did that.”

She remembers getting off course on a 5K race and accidentally running a 25K, long before she thought she was ready for that kind of distance. “When I crossed the finish line, someone took a picture of me and yelled, ‘How did that 25K feel?’

I thought, ‘What!’ You could see the astonishment and relief on my face all at once.

I never thought I could do something like that.”

Now she’s running longer mileages each weekend, with a 20-miler planned for the weekend after our interview. To keep it fresh, she tries to choose a different place to run each time.

“I’ll pick somewhere that’s absolutely beautiful, where I don’t have to worry about traffic. Not too busy,” Nicole says.

“I just go. Sometimes I’ll play music.

I enjoy the scenery, especially in the mornings. The sun is rising, and I get to see the change of day.”

Anne Stanton is a freelance writer and the editorial director of Mission Point Press, a Traverse City-based company that helps independent authors achieve literary excellence and publishing success.

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PA I D C O N T E N T

HE’S GOT YOUR BACK With a holistic philosophy and first-rate surgical skills, Dr. Alex Molinari brings hope to those with back pain.

by Cara McDonald

When orthopedic and spine surgeon Dr. Alex Molinari sees a patient with spinal issues, he knows he’s facing a puzzle that’s far more complex than identifying a problem spot and surgically correcting it.

“With spine conditions, there can be a lot of overlap with other orthopedic conditions,” he explains. “You could come in with pain in your neck that is actually originating from your shoulders.”

That’s why Dr. Molinari’s focus is on improving overall body alignment, in particular working with patients before they ever go under the knife.

As a surgeon, Dr. Molinari handles everything from degenerative disc disease, spondylolisthesis, revision surgery, adjacent segment disease, surgical disc replacement and fusions to spinal cord injuries from degenerative myelopathy and sacroiliac joint disorders. And, important for our aging community, he also has a passion for treating osteoporosis and bone density problems.

But as a Doctor of Osteopathy (D.O.), Molinari takes a holistic approach to medicine; not only treating patients when they need surgery but also leading up to surgery and following it. Generally speaking, holistic health looks at the mind, body and emotions as a whole—if a part of the body needs healing, it should be addressed as part of the whole and not isolated and treated independently.

“When you’re contemplating a surgical procedure, patient optimization is key,” Dr. Molinari explains. “For example, I may

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have them go through physical therapy before surgery. It helps with pain relief and surgical outcomes and gets them into the mindset of healing, which is beneficial as well.”

Care may also include making sure patients are working with pain management, weaning off narcotics and attending to mental health, as well as sharing mind-

fulness and breathing techniques shown to improve pain relief after surgery.

Taking a 360-degree view of patient needs is a key part of the philosophy at Great Lakes Orthopaedic Center (gogloc.com), which recently brought Dr. Molinari on board. The center is home to 13 physicians in varying specialties as well as a staff of physician assistants, nurse practitioners and physical therapists. “Our goal is to have one practice where a patient can go and be evaluated for any spine condition and

establish a continuity of care throughout their treatment,” CEO Jim Stilley says.

Dr. Molinari brings to the Center a breadth of experience in cutting-edge surgical techniques to complement the existing expertise in the region, such as spinal navigation, a more accurate way of placing screws and instrumentation, and extreme lateral interbody fusion, or XLIF, in which a small incision through a patient’s side enables the surgeon to place a larger area of titanium cage and/or bone graft in a more minimally invasive way that improves healing time.

Dr. Molinari completed his fellowship training at Texas Medical Center in Houston but was drawn to practicing in Northern Michigan with a hunger for small-town living and close patient relationships.

“A back condition can take a very long time to heal,” he says. “It’s not like a broken arm. A spine surgeon is going to have a long-term relationship with a patient; it’s going to be something that develops over months or maybe years.

Oftentimes, patients will have conservative treatment and eventually need surgery, and I’ll be able to have a good relationship with them and keep in close contact—then if something comes up, it’s easy to coordinate a path back to me.”

Cara McDonald is a freelance writer, creative entrepreneur and believer in the power of storytelling for small businesses and nonprofits. carawritescopy.com

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DREAM MACHINE Nephrologist Dr. John Stanifer brings a life-saving treatment to Northern Michigan.

by Cara McDonald photo by Michael Poehlman

When Interlochen’s Trish Marek arrived at Munson Medical Center’s Emergency Department last fall, she was seriously ill—a diagnosis of pancreatitis and high triglyceride levels. She was quickly admitted and treated, but her levels wouldn’t come down.

But, thanks to a newly offered treatment option at Munson, Marek was able to be the first patient to receive a life-changing procedure called plasmapheresis.

With the recent arrival of nephrologist Dr. John Stanifer, previously a faculty member at Duke University, plasmapheresis became a local treatment option. His specialized experience, and the cooperation of the nurses and dialysis staff, allowed him to leverage preexisting equipment and expertise to offer this extracorporeal treatment, which is similar to dialysis. With plasmapheresis, the patient is connected to a machine that filters the blood in a very specific manner to remove particular particles, cells, proteins or antibodies from the blood based on the type of filter used.

For Trish Marek, it paid off: after three treatments and 22 days, her levels dropped so significantly she was able to be released from the hospital.

Although plasmapheresis is available in other hospitals around the state, the travel and frequency required for suc-

cessful treatment can be an exhausting or expensive barrier for many patients who may miss out on the benefit it provides and opt for more widely available treatments instead. It wasn’t until Dr. Stanifer joined the staff that the program became a possibility locally.

The applications for plasmapheresis can be game-changers for patients battling all kinds of diseases, including autoimmune disorders and cancers like multiple myeloma.

“The idea is if you have an active disease, such as an autoimmune with immunoglobulins attacking the body, we will treat that disease with immuno-suppression treatments such as chemotherapy,” Dr. Stanifer explains. “But those treatments take time to reduce the level of diseasecausing agents in the blood. So, we use plasmapheresis to remove them in about an hour and a half. This stops the damage and serves as a bridge treatment until things like chemotherapy have time to kick in.”

The therapy is used most in neurological conditions, such as Guillain-Barré syndrome, which causes antibodies to attack the nerves and cause acute paralysis.

“We can reduce those damage-causing antibodies by as much as 60 to 70 percent,” Dr. Stanifer says. “If you do that multiple times, you deplete the circulating patho-

gens or antibodies down to undetectable levels in a few days.” However, the body will continue to make them, which is why recurring treatment and/or chemotherapy remains crucial.

“When I came in 2019, we’d often see patients where this was a therapy that would be beneficial, and the patients would invariably have to be transferred to Grand Rapids,” Dr. Stanifer says. “Once they leave our system, there’s a lack of continuity of care. So that was a major motivation to do it; we had the expertise and we had the need.”

For Marek, the procedure targeted her triglycerides and bilirubin. Three treatments brought her levels to a place where she could be safely discharged from the hospital. “Just the comfort of knowing that my family didn’t have to uproot and leave their jobs to be with me, that was huge,” she says. “Knowing that I am paving the way for others to be able to have this procedure done in Northern Michigan warms my heart, understanding it will ease some frustration for other families as well.”

Cara McDonald is a freelance writer, creative entrepreneur and believer in the power of storytelling for small businesses and nonprofits. carawritescopy.com MyNorth Medical Insider 2022

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Urgent Care From Your Favorite Chair Introducing the all-new Munson Healthcare Virtual Urgent Care for minor injuries and illnesses.

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BRAINS AND HEART

Dr. Justin Thomas is no ordinary small-town doc.

by Cara McDonald photo by Michael Poehlman

You can find Dr. Justin Thomas out and about in the Petoskey area, relishing the outdoors and small-town life that mean so much to him—hitting the slopes, hiking the trails with his Siberian husky or simply bumping into patients for a friendly chat at the grocery store.

For one of McLaren Northern Michigan’s newest docs, getting to know the community he calls home brings Dr. Thomas as much joy as serving it—in fact, the two are inextricably linked, as he trained specifically to work in underserved smaller communities. However, Dr. Thomas isn’t your typical rural physician: He’s a highly specialized neurosurgeon.

Like many of us, his love affair with the tip of the mitten began with childhood summers spent on the lakes. But as his studies at Michigan State University’s medical school progressed, Dr. Thomas knew he wanted to follow his heart and make a life and career Up North. Specializing in neurological surgery of the brain and spinal cord, he tailored his final years of training to fit patient needs in our region.

“I noticed there was not a lot of providers up here offering treatments for more challenging spinal disease, and I wanted to be able to offer treatment or a second opinion without patients having the burden of travel,” he says.

Additionally, our aging population is undergoing spinal surgeries that frequently need to be revisited for areas above and below the original surgery site, so Dr. Thomas focused on revision spine surgery techniques as well.

“The doctors who trained me took me under their wing,” he explains. “They knew I was going to the North, and they also have those attachments to the region, so they really helped me tailor my training to what I would be seeing in practice.”

In addition to general neurosurgery, Dr. Thomas was trained by his mentor Dr. Teck-Mun M. Soo to perform minimally invasive spine surgery and revision spine surgery along with other treatments for complex spinal deformity. He also has a passion for cerebrovascular neurosurgery and is looking to build the stroke and endovascular programs at McLaren.

The hospital recently invested in infrastructure upgrades, including a powerful operating microscope in order to accommodate the specialized treatment Dr. Thomas provides, enabling the surgeon to intra-operatively image the patient to allow for less invasive techniques.

It required a million-dollar-plus technology upgrade at the hospital, which was completed in 2021. “Now we can image the brain and the spine at very, very high resolution, and that means safer and more efficient surgery,” Dr. Thomas says.

He explains his decision to take his high-powered specialty North in this way: “When you are in a big city, you’re just a fish in a big, big pond. Here you get to know people, stories, family and history, and you are held to a high standard—you are known, and so are your patients. That always meant a lot to me.”

Cara McDonald is a freelance writer, creative entrepreneur and believer in the power of storytelling for small businesses and nonprofits. carawritescopy.com

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HEALING THROUGH ART «

A NEW PERSPECTIVE ON YOGA From France to Northern Michigan.

by Kandace Chapple | photos by Michael Poehlman

There’s a new yoga guy in Traverse City and he’s causing a buzz. His name is Mathieu Boldron, and if you’ve never tried yoga, he might just be the one to get you on the mat.

His wife, Ashtynne Hudecz, is also a yoga teacher, and they recently moved from France to Traverse City to raise their baby daughter, Luna. They now teach at Dharamsala TC (both in-person and online), offering a different approach to yoga in Northern Michigan. “They bring very different trainings to Traverse City because they’ve trained all over the world,” says Kay Epple, co-owner of Dharamsala.

Let’s start with Mathieu.

“Mathieu’s classes are not your typical American yoga with music and flowing pose to pose,” Kay says. “They are almost like a workshop because he breaks things down to strengthen your practice and truly connect. It’s really fresh!”

And that’s exactly how Mathieu describes his approach. “One thing I’ve noticed is that many people are rushed, they just want to move,” he says. “You can enjoy going fast, but you are missing a lot. I teach something a little softer, more restorative. Yoga is something to explore.”

He gives this example: In class, he will tell people to touch their mats like they would someone they love. “It’s a telling moment,” Mathieu says. “How do you touch the face of someone you love?

Are you stiff or are you cupping their cheek?”

He holds a hand to his face and smiles. It’s a quick moment of sincerity, then a flash of playfulness. “That makes people stop and think!” he says with a laugh.

There’s something else that Mathieu brings to the mat, which makes his classes different, too: His background is in musical theater. “He’s a performer at heart,” Kay says. “Plus, he’s got such a passion for what yoga can do for people. He’s got a high game—I’ve never seen him not deliver an amazing class.”

Mathieu credits his days of theater to his discovery of yoga.

“At the time, I wasn’t getting good roles in theater,” he says. “I was depressed and working a lot of hours, show after show, day after day in small roles.”

He was 21 at the time, and he was performing so much that his body was breaking down. However, not everyone on the set was suffering from the long hours. “I noticed the oldest woman on the set—she was in her 40s—was stronger than all of us. I had to ask her, what are you doing? She told me to go to yoga!”

He laughs as he tells the story: “I didn’t believe her, no way could yoga do that for you. But I went to one class and realized I was wrong. I thought there is no way I could keep doing yoga, it was that intense.”

But he kept going, and that’s where the change happened.

“The studio was full of mirrors and—well—looking at myself, I suddenly saw that I was capable.”

Soon thereafter, Mathieu decided to audition for a musical in Germany, for a bigger part. The only catch? He didn’t speak German. He convinced an ex-girlfriend (“She owed me, haha!” he says.) to record the entire audition for him with inflection so that he could memorize and mimic it word for word. 4

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HEALING THROUGH ART «

To his surprise, he got the part. And when the producers found out he didn’t actually speak German, they were so impressed, they gave him his choice of parts in several musicals. It was a dream come true: He played the lead in Disney’s Broadway musical “The Lion King” and in “Sister Act,” produced by Whoopi Goldberg.

Meanwhile, though, yoga had taken root in his heart.

He began to focus on his practice, taking trainings from master teachers all over the world. Mathieu taught his first training when a lead trainer broke her leg, and they recruited him to teach instead at the last minute. This sparked Mathieu to quit musical theater and start teaching yoga full-time.

He now co-owns a yoga teaching studio in France and has become a renowned teacher worldwide, having offered trainings in more than 16 countries and counting. He has since landed and started a home in Traverse City with his wife, Ashtynne, whom he met—of course!—at a teacher training.

“I was studying yoga and living in Michigan,” she says.

“I had saved up money for three years to go to Thailand and take a yoga teacher training. I met Mathieu, and we had a whirlwind love. Within a week, he asked me to come to Paris with him, and I decided to just go for it!”

Ashtynne grew up in Alma, Michigan, and had several relatives in Traverse City, a place she loved to visit. When they knew their daughter was on the way, the couple decided to move to Michigan to be closer to family.

Ashtynne’s practice is a bit different than her husband’s. She focuses on healing trauma in the body. Because her childhood was filled with trauma and bullying, Ashtynne says she was depressed for many years. “Growing up in the standard Midwest home, I had never been exposed to yoga,” she says. “I didn’t have

a lot of tools to regulate my emotions and keep my body healthy.

I thought going to the doctor was the only option, which was helpful at the time, but I needed more to lift my spirits.”

At 21, she read Julia Cameron’s book “Morning Pages” and began journaling. She also incorporated yoga. The combination began to help her heal. “I was initially just using medication to change the chemicals in the brain,” she says. “When I started to learn stream of consciousness writing with the addition of actually moving my body, I started to feel a great sense of release. A relief that medication never invoked.”

From then on, she says, her life purpose became to help others find that same sense of relief and understand the mind-body connection.

“You don’t have to feel helpless,” Ashtynne says. “Instead, feel hopeful. We have way more control than we know. You carry trauma in your body and you can bring it out. Yoga is very healing.”

Kay agrees, and loves the perspective Ashtynne brings to Dharamsala. “Her classes offer a mental health focus. They are very spiritual and calming and healing. It is amazing what happens so often in class—you’ll find yourself crying and you don’t know why, but it feels really good!”

Dharamsala TC recently opened a second studio at 319 E. Front St. in Traverse City and continues to expand its offerings for all ages and levels. Try Mathieu’s “Foundation” class if you’re a beginner. For more information visit dharamsalatc.com or mathieuboldron.com.

“ YOGA IS VERY HEALING.”

Kandace Chapple is a freelance writer and founder of the Michigan Girl Bike Club. She can be reached at kandacechapple.com.

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HEALTH CARE FROM HOME

Local physicians share what you need to know to utilize telehealth services— from the technology required to best practices and protocols.

by Allison Jarrell

While telehealth isn’t new, its uses and applications are constantly changing, and that can be, well, overwhelming at times.

When should you call in versus walk into your clinic? What level of service can you expect remotely? It can be a lot to sort out, especially if you’re already under the weather.

We caught up with Dr. David Klee, MD, who specializes in family and emergency medicine at Munson Family Practice Center in Traverse City and the Emergency Physicians Medical Group in Cadillac, and Dr. Kelly Flynn, DO, a family medicine physician at McLaren Northern Michigan’s Mitchell Park Family Medicine in Petoskey, to hear about how they use telehealth in their practice.

Most people see a primary care physician, whether it’s for an annual check-up or a symptom they’re concerned about. How are you using telehealth to manage that process in a way that works for both you and your patients?

Dr. Klee: Many of the patients we see through video have symptoms consistent with Covid, and to reduce potential risk of spreading that within our building, we’ll triage them and see them through video to decide whether they need Covid testing.

Beyond that scenario, there are a lot of medical issues that can be managed very well through video connections, such as mental health issues. I think it works really nicely for this situation.

We don’t have to wear masks. The patient can be in a place of comfort—whether it’s in their house or the car or wherever they feel like they can talk freely. I think that opens up better dialogues than it does sometimes within the office. We also do Medicare wellness exams and can manage a lot of preventive issues with our patients who are 65 and older and are at higher risk of getting infections coming into the office.

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Dr. Flynn: It’s really helped connect people who wouldn’t typically come in for an appointment—people who have certain health conditions that make it hard for them to get in to the typical physical office space, people with transportation issues or mental health issues. It’s really just opened up the door for a lot of people.

It’s great for things like doing a Medicare wellness exam, which is a yearly exam that patients over the age of 65 on Medicare are able to participate in that doesn’t require any sort of physical exam.

What’s your protocol for when a visit can/should be done via telehealth and when a patient should see a doctor in person?

Dr. Klee: I think the biggest question is how much of the physical exam is needed to make the diagnosis. You’re taught in medical school that 90 percent of your diagnosis comes from history, and you can obtain history just fine over video. There’s some good evidence that chronic medical care can be managed nicely through video, things like diabetes or hypertension. If patients have home blood pressure monitors—and we know that home readings are even more accurate than in-office readings—and we can have that data, then we can manage most of that through video. Musculoskeletal issues are harder to do over video though: Actually feeling somebody’s knee or examining their abdomen because they’re having acute belly pain—those are things that we need them to come into the office to do.

Dr. Flynn: At McLaren, we’re not having patients that are experiencing Covid symptoms come physically into the office. We always see them first in a telehealth appointment and assess them that way and then decide if they need an in-person evaluation or if they need testing, imaging labs or any sort of treatment.

So that’s what telehealth is best used for—to assess. But there

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are so many limitations with it. If it’s something that requires a physical exam, like an injury or a skin rash or you fell and hurt yourself, you should be seen in person. We can’t always make, in my opinion, an appropriate diagnosis through video because you don’t have a physical exam component with telehealth. I still feel people should be seen physically in the office at least once a year; twice a year if you’re on any prescription medication.

DR. DAVID KLEE, MD ›

How do you work with telehealth to create the same care and focus a patient would get in the office?

Dr. Klee: That’s a good question. One of the things that develops rapport with your provider is one-on-one time and connection. I think, right now, the fact that we have to wear masks, and the patient has to wear masks, that breaks down some of that normal communication we have through reading people’s facial expressions and body expressions. Over video, we’re able to maintain some of those more normal nonverbal communications. I also think it’s easier for us to stay on time when we’re seeing video patients, because we’re otherwise relying on our staff to have the patient roomed and they’re being pulled to get vaccines or run EKGs or do other things that sometimes delay us. So often my schedule runs more smoothly when I’m doing a full day of video patients than it does in the office.

Dr. Flynn: We all have training as far as keeping eye contact with the patient, where to look at the camera, that sort of thing. I think people feel less vulnerable

when they’re in their own home and they sometimes share different things. I’ve found it useful, too, that people will bring their medication bottles right up when I ask, “What are you taking?” “When are you due for a refill?” They can just grab their bottle really quick, which is nice.

What technology do patients need to properly utilize telehealth?

Dr. Klee: We use an app called Doxy.me that sends a link to a patient’s smartphone and all they have to do is click on the link and it connects directly to us—they don’t have to download anything else. We can also send [the link] to somebody’s home computer through email if their computer has video capabilities. One of the issues that we do run into in Northern Michigan is connectivity problems. If you’re in an area where you don’t have good cell coverage or you don’t have good internet coverage, that makes it more difficult.

There are places like a public library parking lot where people can go and freely access the internet. So, there are ways to combat that, but that’s probably our biggest struggle. We do have some patients that don’t have those technology resources at home. We can accomplish some things over just a telephone visit, but otherwise we’ll bring patients into the office.

Dr. Flynn: I think it’s been good. But when there are connectivity issues, it’s very frustrating for patients. Some people who are not very comfortable with technology will have family members with them, which works really well actually, because then I can talk to the patient and the family at the same time. And then there’s not having to travel—we serve a wide area up here.

There are people who were traveling from the U.P. to see us, so that they do not have to do that every time is nice.

Do you see the emergence and popularity of telehealth as a positive?

Dr. Klee: Yeah, I think it really is a positive. One of the things that we’re working at is becoming as patient-centered as we can. Typically, patients have had to follow whatever works best for the clinic and the provider and that’s how things are done.

But with the patient-centered approach, if we have somebody that has anxiety and feels like they can’t leave home or they’re having difficulties with transportation, a video works really well in those situations.

Dr. Flynn: McLaren has an app—McLarenNow—that the patient downloads that’s internet-based and we go on and connect to them that way.

What kind of feedback have you received from patients about their telehealth experience?

Dr. Klee: We’ve actually done some research projects over the past year that we’ve presented regionally looking at providers, thoughts about how well this platform of video visits works, what type of patient or conditions it works best with, and then also on the patient side. Both have shown this is a positive—for patients, you can take your appointment from wherever you are. If you’re at work, you can step out. You don’t have to take a half-day off to come to the doctor. You don’t have to travel if you’re living 30 minutes away—you can just jump on right from your home.

It’s convenient.

DR. KELLY FLYNN, DO ›

Dr. Flynn: I think so. I think it’s here to stay. Patients like it, but there are definite downsides. A lot of insurance companies and pharmacies like Walgreens offer visits that are telehealth-based, and I think sometimes patients really should be seen in person. Like for urinary tract infections, they need their urine tested and that sort of thing. I’ve certainly had things that are not correctly managed, so there are just those components. But for the most part, I hope it stays because there are benefits to it.

Allison Jarrell is the managing editor of Traverse Magazine. You can reach her at allison@mynorth.com.

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OPIOID TREATMENT PROGRAM REOPENS Residential treatment in Traverse City returns after a pandemic-induced pause, along with new peer recovery coaches.

by Kandace Chapple

Those in crisis for Substance Use Disorder (SUD) can once again seek residential treatment at Munson Medical Center in Traverse City. While their outpatient services have remained open throughout the pandemic—averaging 60-90 telehealth sessions per day—the residential program closed in March 2020 and reopened this January with a couple of noticeable changes. There are now Covid-19 protocols in place (i.e. fewer residents, masking, social distancing, being closed to outside visitors), as well as something that’s fairly new to the SUD field: Recovery Coaches.

The crisis “The opioid crisis keeps going up and up and up,” says Susan Kramer, outpatient behavioral health manager at Munson in Traverse City.

For the 12-month period ending in April 2021, more than 100,306 people died of opioid overdoses in the United States, MI 22

according to the CDC’s National Center for Health Statistics.

That’s an increase of 28.5 percent from the previous 12 months, per the CDC data.

To give it a local perspective, Susan says that Munson had 425 overdose visits in 2020. “And that doesn’t count the people who chose not to come in for treatment” she adds. “I would expect similar, if not higher, totals coming out of 2021.”

The Michigan Overdose Data to Action Team (MODA) reports overdose deaths in Michigan each year. In 2020, they reported 2,738 deaths. In the first quarter of 2021 (the most recent data provided), they reported 956 deaths, an upward trend from the same time period in the previous year.

Susan believes the increase is, in part, related to the pandemic.

“There are several reasons,” she explains. “People became more isolated throughout the pandemic, access to care decreased, community recovery meetings shut down, people got sick and lost their jobs and experienced increased stress.”

She notes that pre-pandemic, there were about 200 recovery meetings in Traverse City each week—people could get to AA, Smart Recovery and other programs. “They had so many options,

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but then everything shut down and many people lost their support overnight,” she says. “It took us a while to learn how to put together virtual meetings and services.”

The result? People were stressed and isolated.

“Even for someone without addiction, it was a stressful time and people looked for coping mechanisms,” she says. “Many would describe addiction as a disease of isolation.”

The program The return of Munson’s residential program, which treats all kinds of substance use disorders, is a welcome sight locally.

However, the reopening has its own scars from the pandemic.

Instead of the 14 beds they had before, they now offer 10 beds (one patient per room). In addition, it is now a “closed” program—meaning that no visitors are allowed. Instead, telehealth is used to include family members and loved ones in a patient’s treatment experience.

“Addiction affects the whole family, and it’s important for family members to receive education and be involved in the treatment experience based on the patient’s needs,” Susan says.

Other Covid precautions include testing, masking, social distancing and no travel to community support meetings. The program is considered short-term and high-intensity. It is a variable length of stay less than 30 days based on medical necessity, Susan notes. Munson helps patients secure insurance, Medicaid or other funding when possible.

“The program includes individual and group therapy, psychoeducation, wellness activities and more,” Susan says. “We look at the reasons that people began using. We teach coping skills, create a healing space for trauma and/or loss, family relationships, and chronic and mental illness, in addition to substance use disorder histories, emotional regulation and distress tolerance skills. We teach new ways to build a life in recovery.”

The coaches Part of that comes from the advice of those who have been there: Recovery Coaches.

“A Recovery Coach is different than a therapist, different than a 12-step program,” Susan says. “It’s focused on getting connected to resources, building recovery capital, helping with housing, employment and transportation, and showing people in the program the steps the coaches took to recover as well.”

Munson Behavioral Health has four Recovery Coaches. They have all lived their own recovery experience and gone through

a coach certification process. Jesse Lewit is a Recovery Coach who started last fall. He was in law enforcement for 30 years, then, after retiring, he says he slid into an alcohol use problem.

He eventually did the residential program at Munson, as well as an outpatient program.

“I’ve been completely sober now for two years and love it,” he says. “During my recovery, I tried out lots of things I enjoyed to spend my time on, but my desire to help others like I did in law enforcement resurfaced. I decided to take the training to become a coach.”

Jesse now works three days a week as a coach, mostly helping in the Emergency Department at Munson, meeting people there when they come in due to an overdose. “My role is uniquely suited to me as a former first responder,” he says. “I build a bridge from their hospital stay to treatment. I see people at their worst, and sometimes, later, at their best!”

Jesse says he visits people every day that they’re in the hospital, sharing his story of recovery, hoping to help them.

“I tell everyone about my substance abuse, which is something they may not have in common with anyone else in the medical system,” he says. Then with a laugh, he adds, “I don’t always tell them I’m a former police officer! But I do tell them what I think will help or provide them with an example or glimmer of hope.”

Jesse also helps patients navigate the system to get into residential care and receive medical assistance. “The best plan is to discharge from Munson and be admitted to a detox program the same day,” he explains. “You want to keep them from going back out into the environment that brought them here in the first place. When a person hits rock bottom and is fighting for their life, that’s a good time to get them to talk about improving their life.”

Susan adds that there are specific SUD and HIPAA laws that protect the confidentiality of patients while seeking treatment.

“You don’t need a referral,” she says. “We do a phone screening and help you determine the right level of care and look at how we can help you with funding.”

To learn more about the program, call 231.935.6382 or 1.800.662.6766. Online, visit munsonhealthcare.org/services/ behavioral-health/behavioral-health.

Kandace Chapple is a freelance writer and founder of the Michigan Girl Bike Club. She can be reached at kandacechapple.com.

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PAID CONTENT

Families Against Narcotics - Grand Traverse Your Connection for SUPPORT-EDUCATION-RESOURCES More than 274 people die from drug overdoses every day.

In 2018, prosecuting attorney Robert Cooney and local pharmacist Kathy Jones were troubled by the number of drug overdose deaths of young people in the area. As a result, Cooney and Jones, who had both become familiar with the nonprofit Families Against Narcotics (FAN), decided to form the Grand Traverse chapter of FAN with a group of other concerned community members. Their mission: to provide support and recovery resources for individuals and families in our area who have been affected by substance use disorder; to provide educational forums where people can also share their experiences; and to reduce the stigma associated with the disease of addiction.

Families Against Narcotics is a group of professionals, volunteers, parents, survivors, and other individuals who are concerned about substance use disorder (SUD) and have a passion for helping others.

EDUCATION: Substance use disorder today is no longer “someone else’s problem.” The sad reality is, it will probably touch all of us at some point. FAN educates the public about SUD and recovery in several ways. Many of the FAN volunteers have personal experience with the disease, either personally or through a loved one.

They are a valuable resource when it comes to questions about how to support and assist someone with SUD. They also provide a listening ear so people who have been impacted by addiction can share their stories and concerns.

sharing each other’s journeys. Through sharing, problem solving can begin. After each forum, there is time to meet and discuss with others at your own pace and comfort level in a non-judgmental atmosphere.

naloxone TRAINING opioid overdose reversal

STR NGER TOGETHER Family & Friends: An Addiction Support Group

Once a month, Grand Traverse FAN offers a public forum. These meetings are open to the entire community as a resource for navigating substance use disorder, and are truly a place to learn, listen, grow, and share. Each forum features a guest speaker from the Grand Traverse area who discusses an important SUDrelated topic and provides information and resources from their area of expertise or agency. Forums are the beginning of

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Wellspring Healthcare Foundation A Place for Everyday Miracles

SUPPORT: Families Against Narcotics supports families and helps guide them through the chaos that can accompany a loved one’s substance use disorder. They understand that when individuals and their families are struggling, there are important things they need and want to know.

Our Stronger Together family and friends support group helps families make a recovery plan that can move them from a life of despair to a life of hope and purpose. Participants benefit from the encouragement and experience of others who are facing, or have faced, similar circumstances.

RESOURCES: Grand Traverse FAN has an extensive list of SUD resources that can be incredibly helpful to families on their recovery journey. While we are not an agency, our goal is to provide a list of multi-faceted resources that is continually updated as new information becomes available. FAN Northern Michigan serves; Grand Traverse, Kalkaska, Leelanau, Alpena, Alger, Chippewa, Otsego, Crawford and Benzie Counties.

The Grand Traverse FAN chapter holds its forums on the first Thursday of every month at the Central United Methodist Church, located at 222 Cass Street in Traverse City. The meetings start at 6:30 pm and can be attended either in person or virtually (via Zoom). Check our Facebook page (www.facebook.com/grandtraversefan) one week prior to the forum date for that month’s topic and Zoom link. For more information, questions, or to sign up for our monthly newsletter, contact our coordinator at 231-883-9111 or email tccoordinator@familiesagainstnarcotics. org. You can also follow us on Facebook, LinkedIn, and Instagram, or visit our web page at www.familiesagainstnarcotics. org/grand-traverse.

Wellspring Healthcare Foundation is committed to providing evidence based mental health services, addiction treatment and education to the northern Michigan community.

Wellspring is committed to bringing education to the schools, community members and believes in addressing the needs of the rural communities. We are aware of the need for more treatment providers and the lack of centers for students to gain necessary knowledge and experience needed to become providers of mental health, psychiatric and addiction treatment. We are committed to taking students from the schools of social work, nursing, physicians assistance, and nurse practitioners to assist in facilitating the growth and education of future treatment providers.

We are committed to furthering the education of medical residents and medical students. As we grow, we will be reaching out to rural areas to provide education, screening, evaluation and treatment for mental illness and substance abuse.

We are also well aware of persons who are incarcerated have high rates of addiction as well as psychiatric and behavioral health needs. As such, Wellspring Healthcare Foundation is committed to serving mental health needs of the incarcerated and providing education and support to law enforcement in efforts to create improved outcomes for all.

Lastly Wellspring Healthcare Foundation is in support of the legislative agenda that addresses and funds these initiatives. With an eye towards a better future for all, may we all strive for the same outcome. www.wellspringhealthcarefoundation.com • 231-922-9625 • 501-c-3 Non Profit

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INNOVATION IN INFRASTRUCTURE Building and tech expansions at McLaren Northern Michigan and Munson Healthcare continue to elevate patient care in the region.

by Carly Simpson | photos courtesy of McLaren Northern Michigan

McLaren Northern Michigan Debuts Offield Family Pavilion In August, McLaren celebrated the opening of the Offield Family Pavilion in Petoskey—a $158 million expansion and renovation project focused on increasing patient comfort and privacy, improving wayfinding and enhancing physician and staff workflow. Those goals translated to a four-story, 182,000-square-foot addition that includes 104 private patient rooms, 10 state-of-the-art operating rooms with a sterile processing department, an expanded intensive care unit and new cardiovascular and orthopedic/surgical units.

“With the opening of our new wing, we are the first hospital in the region to have private rooms in all units,” says Todd Burch, McLaren Northern Michigan president and CEO. “We know the healing environment is just as important as the care a patient receives. The wing offers a more peaceful, private setting that complements the nationally recognized care provided by our team.”

Smart technology also plays a major role in enhancing safety and communication between patients, families and caregivers. In fact, Burch says the Offield Family

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Pavilion offers the most technologically advanced in-room experience anywhere in the country. “Our patients experience the future of healthcare today right here in Northern Michigan,” Burch adds.

So, what does the future look like?

Smart i-beds with safety alarms that are customizable for every patient’s condition to prevent injury; electronic whiteboards that display McLaren employees’ pictures and the care plan, plus provide the patient with verbal and visual safety alerts; bedside tablets with mobile apps for entertainment and health education that also connect to the patient’s call light, video chat camera, TV and web; a virtual nurse, available via the TV, who assists patients at the touch of a button; Smart Badges, worn by care team members, that are a hands-free way to connect patients to staff for immediate response; and operating room suites equipped with the latest 4K resolution technology—four times the resolution of high definition—to provide surgeons superior image detail and video streaming to collaborate with experts around the globe in real-time during surgery.

One of the more visual elements of the expansion is the added artwork. More than 3,000 studies conducted over the past

several decades have revealed the positive impact of art on health and well-being, such as measurable changes in blood pressure, heart rate, muscle tension, respiration rate, cortisol levels and brain activity, explains Capital Campaign Officer Patricia Jones.

The Offield Family Pavilion is decorated with more than 200 pieces from nearly 100 Michigan artists, many from Northern Michigan. McLaren worked with an art consultant who is certified in evidencebased design and who works exclusively within the health care industry to select pieces for their therapeutic properties that serve as a visual comfort to patients and families. McLaren also partnered with regional organizations, including Crooked Tree Arts Center and the Northwest Michigan Arts and Culture Network, who helped to broadcast the call for artists. “Along with the smart room technology, we have created an environment of healing with the use of art, coordinated color schemes and large, open common areas,” says Vice President of Operations Shari Schult, who oversaw the expansion.

In addition, more parking was added by the new main entrance, now off Jackson Street. There is improved wayfinding with letter and color-coded signs that start from

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the parking lot and guide people to the right entrances and elevators.

And there’s even more to come in 2023.

The final phase of the construction project is the renovation of 70,000 square feet of existing hospital space that includes the surgery waiting area, pre- and post-operative areas, lab, pharmacy, community education room and the radiology waiting room. Special patient hallways and elevators will also be created for private patient transportation.

The wing is named the “Offield Family Pavilion” after a lead donation from the Offield Family Foundation, spearheaded

by Harbor Springs residents and capital campaign co-chairs Jim and Sujo Offield.

“My grandfather was one of the hospital’s original founders and my father served on the hospital board for many years,” Jim Offield says. “Providing the best hospital services for this community is a way for our family to give back to an area that has given our family six generations of memories. Our family has utilized every service the hospital offers, from birth to death. My own life was saved there. With a history of providing exceptional health care for an exceptional community, our family is proud to be in partnership with McLaren.”

Another key donation was made by Martin and Lisa Sutter. McLaren named the north surgery entrance the Martin and Lisa Sutter North Pavilion Entrance in their honor. In total, 1,500-plus individuals and organizations donated more than $38 million.

“One of the truly great things about this project is that it shows what a community can accomplish with great physicians, highly trained staff, excellent governance, an amazing foundation and our generous donors all working together,” Burch says.

“Generosity and commitment helped build this new wing, and generosity and commitment will sustain it.”

View a video tour of the Offield Family Pavilion on McLaren Northern Michigan’s YouTube channel.

Munson Medical Center Expands Surgical Services On Oct. 12, the first-ever robotic-assisted total knee arthroplasty was completed at Munson Medical Center in Traverse City by Dr. Michael VanWagner. This was made possible by Munson Healthcare’s recent investment in a robotic orthopedic

surgical assistant known as ROSA. The ROSA customizes the fit and approach to each patient by considering their individual anatomy through 3D imaging, bringing a higher level of precision and accuracy for a truer alignment.

“To date, Dr. VanWagner’s patients who choose to incorporate ROSA as part of their surgical plan are doing remarkably well postoperatively,” says Executive Director of Surgical Specialties Spencer Derenzy. “The interest in using this technology has grown and has resulted in on-site labs and training to further enhance the skills of current orthopedic surgeons within the community.”

In addition to ROSA, Munson recently purchased a new da Vinci Xi Surgical System to replace its original, 11-year-old da Vinci Si. The Xi offers significant additional capabilities, says Executive Director of Surgical Services John Cox. As part of its surgical services addition, Munson Medical Center has also added two general-purpose

operating rooms and one hybrid OR imaging room for vascular procedures. A fourth room is shelled and will be finished in the future as the system recruits additional vascular surgeons.

In Gaylord, Munson’s Otsego Memorial Hospital (OMH) replaced their da Vinci Si with a Xi last spring. The OMH robotic surgery program debuted in May 2017 and completed its 1,000th robotic surgery in April 2021.

“Implementing a robotic surgery program at OMH was a strategic initiative to further strengthen an already strong minimally invasive outpatient surgical program,” Cox explains. “This initiative developed a strong sense of team among Surgical Services staff, surgeons, anesthesia and administration. The dedicated team has built a best-in-class robotic surgery program with superior quality, efficiency, exceptional patient experience and innovation, providing life-enhancing care to the communities we serve.”

OMH’s robotic quality and efficiency benchmarks rank in the top quartile across the country. In some categories, the metrics are in the top 10 percent across all robotic programs. The success has led Otsego Memorial Hospital to pursue the Center of Excellence designation in robotic surgery.

“Becoming a Center of Excellence will assist in the recruitment of surgeons across specialties and attract patients throughout the region to receive the best care in a robotic surgery,” Cox says.

Carly Simpson is the associate editor of Traverse Magazine and editor of MyNorth’s email newsletter The Daily Splash. Subscribe free at MyNorth.com. You can reach her at csimpson@mynorth.com.

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GREAT FIRST IMPRESSIONS Digital imaging and new technology are making major dental work more beautiful, lasting, painless and speedy.

by Cara McDonald

The prospect of major dental work can be pretty rough—long afternoons spent in the dentist’s chair, weeks waiting for a lab to fabricate necessary crowns or implants and repeat visits are nothing to look forward to.

But digital imaging and new technologies have revolutionized procedures such as implants, bridgework, veneers, orthodontics and crowns, enabling dentists to do in a day what used to take weeks.

Dr. Phillip Yancho, of Yancho Family and Cosmetic Dentistry in Traverse City, explains that the traditional process for these procedures involves taking impressions with polyvinyl siloxane putty (a.k.a. “the mouth full of goo”) to create a mold that is sent to a lab where impressions are made and then the restoration pieces are fabricated. “But that process is time-consuming and intolerable for many patients, especially children,” he says.

Instead, Dr. Yancho utilizes digital intraoral scanning technology and the CEREC (chairside economical restoration of esthetic ceramic) method of creating dental impressions and restorations right in-office—no goopy mold, no shipping to a lab, no temporary crowns and no second visits.

“You can think of this process as ‘one and done,’” he says. “It’s highly accurate, so much more convenient and minimizes post-op discomfort.”

Dr. Yancho explains that CEREC procedures go through three primary steps:

1. The dentist numbs the patient’s mouth and prepares the tooth needing restoration, then scans the mouth with a tiny camera in a hand-held wand, which takes about a minute.

2. The image is uploaded to a computer with specialized software to design a customized model of the needed dental restoration.

3. The designs are sent to either an off-site lab or to the in-office milling equipment. These specialized machines use diamond burrs to mill the dental restorations (like a crown or veneer) from a solid block of porcelain, which takes about 12 minutes.

The restoration goes into a small kiln, and in Dr. Yancho’s case, his dental assistant, who is trained as a stain and glaze lab technician, customizes it to perfectly blend in with the patient’s teeth. It’s then fitted and bonded, and the patient walks out the door—typically within 90 minutes.

Dr. Lisa Siddall, of Lake Leelanau’s Lisa Siddall DDS Holistic & High-Tech Dentistry, was also an early adapter of CEREC technologies and is particularly excited about their applications for bridges and implants.

“There’s a newer procedure for implantsupported bridges that secures the teeth directly to the jawbone,” she explains.

She utilizes the digital scan and a type

of 3D X-ray called a cone beam, marrying the two images to find the best place in the bone for the implants to have the most stability.

In addition to working with implants, Dr. Siddall is excited to pair high-level imaging with a machine she recently purchased that allows her to mill zirconium restorations in her office—a more durable alternative to porcelain. “Zirconium is literally unbreakable,” she says, which will make it a natural for things like crowns on teeth that receive a lot of bite pressure, such as molars.

Sophisticated imaging allows her to provide orthodontics as well, creating perfectly fitting clear plastic aligners that are changed out weekly to move your teeth. “I had a patient for years with really crooked teeth,” Dr. Siddall says. “This technology was a game-changer. Her teeth were straight in about four months.”

The benefits of CEREC and new imaging techniques are undeniable—not just in the convenience, durability and quality of the dental work that results, but also in one more crucial way: “They create less discomfort and anxiety,” Dr. Yancho says. And less stress in the dentist’s chair is always something to smile about.

Cara McDonald is a freelance writer, creative entrepreneur and believer in the power of storytelling for small businesses and nonprofits. carawritescopy.com

MyNorth Medical Insider 2022

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“ BEING TREATED OR BEING ABLE TO RECOVER FROM AN ILLNESS OR MEDICAL ISSUE IN YOUR OWN COMMUNITY IS ALWAYS LESS TRAUMATIC.” —JOAN RIKLI

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FOR KID’S SAKE

Munson Healthcare brings pediatric specialists from top hospitals to complement care for Northern Michigan’s littlest critically ill patients.

by Cara McDonald

It started with a fall down the stairs and a broken arm. A trip to the hospital, some X-rays and eventually a cast got 9-year-old Ariah House on the path to healing her broken bone. But a few days later, the little girl wasn’t herself. She was having trouble walking, then standing. She started wetting the bed. Something was definitely wrong—beyond just a broken arm.

A trip to Helen DeVos Children’s Hospital revealed blood on her cerebellum and began an exhausting odyssey of monitoring, EEGs and a spinal tap, as well as trips in and out of the hospital.

After finally receiving a rare diagnosis—an autoimmune disorder of the nervous system—Ariah was not only able to get the help she needed, but she’ll also be treated close to home.

Instead of making the monthly 3.5-hour trip to DeVos, Ariah will receive her care from both her DeVos team and Munson Medical Center staff, thanks to an inspired partnership between Munson Hospital and downstate institutions such as University of Michigan and Helen DeVos. The partnership involves cooperation with Munson Healthcare and the sharing of downstate specialists—in particular pediatric specialists—who regularly visit patients in Northern Michigan.

Reaching Ariah’s diagnosis was no easy feat. Her grandmother, Diane House, who had adopted Ariah and her siblings when the child was 4, was beside herself after their initial hospital visit; she felt perhaps the little girl’s deteriorating condition was connected to her fall, but a definitive diagnosis eluded them.

In just a few weeks, Ariah ended up in a wheelchair. She couldn’t draw, write or color; her speech began to slur. Her medical team believed she was battling an autoimmune disease of some sort, but couldn’t determine precisely which one.

After numerous trips home, in and out of a rehab hospital and back to DeVos, Ariah was eventually diagnosed with opsoclonusmyoclonus-ataxia syndrome, or OMAS. It’s an autoimmune disorder of the nervous system characterized by new movements of the limbs and eyes, abnormal behaviors, sleep dysregulation and difficulty talking. OMAS is typically concurrent with cancer, and it’s incredibly rare—worldwide, there are only 1,700 currently known patients.

Although the two situations were unrelated, Ariah’s fall and broken arm happened to coincide with the onset of the disease, and her family credits it with putting her in front of skilled medical personnel that were able to help pursue a diagnosis.

With aggressive intravenous immunoglobulin and steroid treatments, Ariah’s condition has stabilized. However, the treatment required to help her improve will require monthly in-patient two-night stays over the next 18 months for her to receive the IV/IG fluids and steroids she needs.

That’s where the partnership between Munson Hospital and

downstate institutions comes into play.

A host of doctors including pediatric urologists, geneticists, cardiologists and sleep specialists make their way north once or twice a month for regularly scheduled clinics to see patients in need of care. Working in coordination with pediatricians and primary care doctors, these specialists provide critical intervention or follow-up care, allowing for local treatment and/or recovery at home instead of extended hospital stays far away.

The partnership facilitates continuity of care and the reassurance of a steady, unchanging medical team; even if a child is treated downstate, he or she can remain under the watchful eye of a specialist who can see them at regular intervals once they are home recovering.

“Being treated or being able to recover from an illness or medical issue in your own community is always less traumatic,” explains Joan Rikli, women’s and children’s service line executive director for Munson Healthcare. “This program allows not only convenience, but access to an extraordinarily high level of care and cutting-edge treatment.”

The collaboration is seamless, with pediatricians referring patients for specialized care. For example, a young child with cancer would have a visiting pediatric oncologist directing their care with the cooperation of the child’s pediatrician. Under the guidance of the advising specialist, the child would be able to receive their chemotherapy in the friendly environment of the pediatric floor at Munson Hospital, close to home.

“This sharing of resources changes the lives of children needing treatment in Northern Michigan,” explains Rikli. “And by treating our young patients locally, downstate hospitals can not only share their expert resources, but they can expand accessibility of care by freeing up capacity for other children in critical need.”

For Ariah, the program has added caregivers and doctors to her team that can treat her locally, giving her and her family much-needed respite from the distance and travel for the lifesaving treatment her rare condition would typically require. “The staff here in Traverse City have been wonderful, every bit as wonderful as the ones we’ve seen around the state,” Ariah’s grandmother says. With a clear and local treatment plan, Ariah’s family has high hopes that she’ll eventually reach complete remission.

For more information on how your child can access Munson’s specialty care teams, consult with your family pediatrician or visit munsonhealthcare.org.

Cara McDonald is a freelance writer, creative entrepreneur and believer in the power of storytelling for small businesses and nonprofits. carawritescopy.com

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