Health

Acupuncture

Joint Replacement

Sprained Ankles

Stroke survivors report benefits from treatment.

When is it the right option?

Common malady should not be ignored.

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THE JOURNAL, New Ulm, MN Tuesday November 13, 2018 Page Shopper, New Ulm, MN Tuesday, November 13, 2018

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Safe routes to school action team celebrates three years of improving safety for kids As you’re out and about in New Ulm during the mornings and afternoons, have you seen more kids walking or biking to school?

Have you seen drivers slowing down or making other efforts to drive a bit more safely? If yes, you’re probably seeing some of the many efforts of The Heart of New Ulm’s Safe Routes to School Action Team come to fruition.

The Safe Routes to School (SRTS) Plan was launched in June 2015 through a cooperative effort between St. Paul Lutheran and St. Anthony Elementary Schools, New Ulm Public Schools and River Bend Education District. Region Nine Development Commission facilitated the planning process and presented the written plan to SRTS planning committee.

Since that time, the SRTS planning committee has evolved into one of The Heart of New Ulm Project’s Action Teams and The Heart of New Ulm Project facilitates the meetings and monitors progress on the plan.

“Over the last three years, the SRTS team has been very busy and we’re extremely proud of all we’ve accomplished,” said Cindy Winters, project manager for HONU and facilitator for the SRTS team. “We would not have been so successful without the strong partnership and support from

all of the schools, the City of New Ulm, the Statewide Health Improvement Partnership (SHIP) serving Brown County, and of course, all our parent volunteers as well.”

Winters shared a recap of 14 SRTS team accomplishments since 2015, in no particular order: 1. Safe walking and biking routes: These routes were created in 2016 and have been printed and published in a variety of different places in New Ulm. The routes are posted on The Heart of New Ulm website and the various school websites for easy access for parents and children. Some of the biking routes include streets with painted bike sharrows that connect to the Bike Circle Route in numerous locations throughout town.

2. Annual Walk/Bike to School Day celebrations: Each May and October, all of the schools promote and participate in the National Walk and Bike to School Days. Rather than drop their children off at school, parents are encouraged to drop their children off at one of three remote locations that are manned by volunteers and parents. The children then walk in a “walking school bus” formation to their schools. The children love to participate in this event (when the weather cooperates) and often ask to do it more often.

3. Enhanced crosswalks near all schools: All of the schools now have at least one enhanced (diagonal) crosswalk painted at their location. These crosswalks are more visible to approaching vehicles and have been proven to increase yielding behavior.

4. City adoption of a Complete Streets Policy: In October 2016, the City of New Ulm adopted a Complete Streets Policy.

Complete Streets is a transportation network approach that considers the needs of pedestrians, bicyclists, transit users, motorists and commercial and emergency vehicles — generally referred to as all users. The goal of Complete Streets is a transportation system that is accessible, equitable and adapted to serve the needs of individuals regardless of how they choose to travel.

Placing a focus on all users when street work is done has allowed the city to think differently about how to move people through the community.

5. Traffic calming measures at key locations: The installation of the mid-block crossing on Garden Street near the Recreation Center is an example of a traffic calming measure; it has improved

Safe Routes Continued on page 2H

On Oct. 10, 2018, New Ulm participated in Walk to School Day for the third year. Despite the cold, windy and rainy weather, students from St. Paul Elementary walked in a Walking School Bus with their new principal, Pete Markgraf.

Endocrinologist Nour Sabha, MD, begins seeing patients at NUMC Jan. 2 Nour Sabha, MD, enjoys her chosen specialty of endocrinology, she said, because it is a dynamic field and requires lots of thinking and problem solving.

Dr. Sabha begins seeing patients at the New Ulm Medical Center (NUMC) clinic in January 2019.

“Endocrinology is not a one-size-fits-all management, and that’s what makes it a bit challenging,” she said. Endocrinology is

What’s Inside CCU Project Renovation project at New Ulm Medical Center nearly complete.

the division of internal medicine that is involved in diagnosis and management of hormonal disturbances, diabetes and metabolic disorders.

After earning her degree from the University of Jordan, Dr. Sabha completed her residency at the University of Texas Medical Branch at Galveston and went on to complete a fellowship at the University Hospitals Cleveland Medical Center.

Dr. Sabha is board certified in internal medicine

Nour Sabha, MD

and board eligible in endocrinology, diabetes and metabolism.

“My passion in endocrinology started during medical school,” Dr. Sabha said.

“My unceasing curiosity to learn more about it and practice in it grew over time with newer evolving medications and new updates in the field.”

Within the field of endocrinology, Dr. Sabha has a special interest in thyroid and adrenal disorders.

“Endocrinology requires a lot of understanding of

basic and clinical medicine; it requires thinking, and it is not just memorizing,” Dr. Sabha said. “It involves some dynamic testing, and sometimes things can be challenging. If patients adhere to the plan, they will see promising results that are rewarding.”

Dr. Sabha looks forward to building relationships with patients, she said. She prides herself on being a good listener and a hard worker as well as being friendly, dedicated and professional.

Dr. Sabha is a wife and

mother who enjoys balancing her private life with her professional life.

She and her husband, Anas Khanfar, MD, the medical oncologist at Virginia Piper Cancer Institute – New Ulm, have two sons: Omar, almost four years old, and Adam, eight months old. The family likes to travel together, and in her spare time, Dr. Sabha enjoys reading, cooking, and traveling.

To make an appointment with Dr. Sabha, call 507-217-5011.

Women with urinary incontinence don’t need to suffer in silence

A women’s health issue that is so common that it affects more than 25 million Page 3H people in the United States (per the National Association for Continence) Medicare Changes is one that almost nobody is willing to talk about: urinary incontinence.

Women A guide to the frequently suffer in silence sometimes confusing with this condition because changes taking place in they are too shy or Medicare coverage. embarrassed to talk about it, or they feel that it’s Page 4H something they just have to live with.

That is unnecessary, said Holiday Victor Khayat, MD, an Trimmings obstetrician and gynecologist at New Ulm Popular program is back Medical Center. Women should always feel that they for 10th year. can talk to their physician Page 5H about leaking urine when they laugh or sneeze or

having to run to the bathroom constantly. Often, this condition can be alleviated to help women improve their lives.

Bladder issues affect women of all ages, though it is more common in women over 40, Dr. Khayat said. It is often a condition that affects women who have no other health issues.

The two main types of incontinence are urge incontinence and stress incontinence. “They can overlap, and you can have a diagnosis of both called mixed incontinence,” Dr. Khayat says.

Women who have urge incontinence or overactive bladder feel a sudden and strong urge to go to the bathroom. They find it hard

Victor Khayat, MD

to get to a bathroom on time.

Women with stress incontinence leak urine when they laugh, run, cough, sneeze or do other daily activities.

Treatment depends on which type of incontinence a woman has. “If she has both, usually one is more dominant, and you try to treat that one first,” Dr. Khayat said.

Dr. Khayat performs a simple test to identify the problem. “We fill the bladder with sterile water and monitor the pressure in the bladder,” he said. “This gives us an indication of where the problem is and allows us to understand the bladder dynamics.”

Once the problem is diagnosed, sometimes exercises that Dr. Khayat and a physical therapist can teach will help reduce the frequency and severity of the incontinence. If stress incontinence persists despite

conservative treatment, women may consider an outpatient surgical procedure.

“A minimally invasive procedure has been around for many years to treat urinary incontinence,” Dr. Khayat said. “However, in just the last few years, newer procedures have been introduced that are even less invasive, which means that recovery time is quicker, and overall patient satisfaction is improved.”

Dr. Khayat has attended additional training to become proficient in the newer techniques. Overall, he has had great success for his patients for whom he has

Incontinence Continued on page 2H

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The Journal, New Ulm, MN Tuesday, November 13, 2018

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Acupuncture has significant benefits for stroke survivor The after-effects of a stroke can be permanent and debilitating. Often, the patient will be left with partial or full paralysis on one side of their body.

Depending on the severity of the stroke, there are several steps one can take to attempt to regain full use of their body.

Acupuncture is one of those treatments.

Sleepy Eye resident Lois Lendt suffered a stroke six years ago, leaving her with partial paralysis on her left side. An active baker and homemaker, Lois loved to bake dozens and dozens of

cookies to give away every year at Christmas time. She hosted all the holidays at her home. All of that became more difficult – some of it impossible – after her stroke.

Though the physical therapy as an inpatient at Abbott Northwestern Hospital and as an outpatient at Courage Kenny Rehabilitation Institute – New Ulm following her stroke helped her get back much of her function and movement, she still was unable to use her left hand or arm.

“I couldn’t lift things because I only had use of

Megan Pierson, MaOM, LAc

one arm,” she said.

As she settled into a new way of doing things and caring for her body post-stroke, Lois began to attend a Stroke Support Group at New Ulm Medical Center (NUMC). The group meets monthly and often brings in speakers from other NUMC departments or outside the facility to touch on topics relevant to the group. It was there she met acupuncturist Megan Pierson, MaOM, LAc. Pierson is one of two acupuncturists who sees patients through the Penny George Institute for Health

Safe Routes From page 1H safety for people crossing Garden Street. In September 2017, a demonstration curb extension project was tested at St. Anthony Elementary School at 5th North and Washington St. to make it safer for children to walk or bike to school. The demonstration project was a success in slowing traffic and improving safety, and the team is now working with the city to install permanent curb extensions when street work is planned for Washington St. Two “Stop for Pedestrians in the Crosswalk” signs were purchased and placed at 4th South St. and South Payne and 5th North St. and North Washington to remind drivers to stop for people waiting to cross the street.

This has helped improve yielding the right of way in both locations.

6. Annual Bike Expo to teach bike safety skills: For the past several years, The Heart of New Ulm has incorporated a bike rodeo into the Day of Play events, and more recently the Bike Expo. The New Ulm Police Department has volunteered their time and staff to teach children proper bike handling skills and how to ride safely on the road.

7. Bike fleet and trailer: With funding from SHIP, New Ulm Community Education was able to secure a fleet of bikes sized for students in grades 4 thru 6 along with a trailer to store the bikes and transport them between the schools and organizations offering bike safety skills training.

8. “Walk! Bike! Fun!” curriculum: The SHIP program has trained physical education teachers at most of New Ulm elementary schools in the Walk! Bike!

Fun! curriculum that teaches students in kindergarten thru grade 3 how to be safe pedestrians and students in grades 4 through 6 how to be a safe bicyclist. The curriculum is generally taught during the physical education classes and access to the bike fleet allows students to participate without having to bring their own bikes.

9. SEE.SAFE.SMART. campaign: To help ensure everyone’s safety on New Ulm’s sidewalks and streets, and encourage people to make smart decisions when encountering people walking and riding their bikes, the SRTS Action Team launched a year-long public safety campaign in September 2017.

The campaign reminded people to SEE people walking and

and Healing at NUMC. Kayla Bartlett, MaOM, LAc, also provides acupuncture services at NUMC. “She told me I would be a good candidate for acupuncture for the problems I was still having in my left hand and arm,” Lendt said. “After one treatment, I could feel my arm and hand again.”

Lendt went in for treatment a few more times to complete the series and also received acupuncture for headaches, which she found helpful, as well.

“I suddenly could fold my towels again, lift the coffee pot and the big roaster with a turkey in it,” Lendt said. “I’m back to baking Christmas cookies for the kids, neighbors, former co-workers and nursing homes.”

Lendt has become an advocate for acupuncture, she said, telling many friends and family members about her experience.

“I think everyone should try it,” she said. In addition to the physical benefits that Lendt received from her acupuncture experience, she

said, “It’s so relaxing.”

Pierson cautioned that not everyone’s body will respond in the same way.

“Acupuncture can be really beneficial for patients following a stroke and most people will find they regain their strength or mobility,” Pierson said. “However, there are many factors to take into account when considering how much function a person will gain back and how many acupuncture sessions may be required.”

Lendt also highly recommends the Stroke Support Group to those who have suffered a stroke, and their spouse and/or caregiver.

“We’ve had so many great speakers.

The nutritionist was very good and the doctor’s we’ve had speaking were very good,” she said.

For more information about the monthly Stroke Support Group, call 507-217-5685.

For more information about acupuncture or to make an appointment, call 507-217-5307.

Incontinence From page 1H

Wayfinding signs at five and 10-minute intervals remind parents and children it’s only a short walk from each location to their school.

bicycling, act SAFE, and be SMART. Each month, a different safety message reminded people to be aware of and alert to people who are out walking and biking in the community — especially kids. The safety messages featured photos of kids and adults from New Ulm and highlighted specific problem areas and all of the schools in New Ulm participated in the campaign.

The team plans to implement a similar campaign again in a few years.

10. Improved arrival and dismissal process at Middle School campus: Before construction started on repurposing the former New Ulm High School and Jefferson Elementary School campus, a demonstration project tested a new arrival and departure process for the schools. The purpose of the demonstration project was to separate the different modes of traffic and to improve safety in the area to encourage more walking and biking to school. After the project was completed, feedback was gathered from everyone involved and the process today is the result of testing and implementing lessons learned. Today’s process is more organized and safer for everyone involved.

11. Safe walking and biking tip sheet: To encourage more walking and biking, the SRTS team created a tip sheet with safety tips for parents to share with their children about safe walking and biking techniques. The tip sheet was distributed

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through all of the schools prior to the beginning of the 2018-19 school year.

12. Reflective zipper pulls: With the majority of the school year occurring during the darker months of the year, the schools felt it was important to provide the students with light reflective gear so they would be seen more easily when walking to the bus or walking and or biking to school. Reflective Minnesota-shaped zipper pulls featuring the SHIP logo were distributed to many of the students in New Ulm. 13. Wayfinding signs: Wayfinding signs were installed at five- and 10-minute intervals from St. Paul Lutheran Elementary, St. Anthony Elementary and the Middle School campus.

The signs remind parents and children that it’s only a short walk from each location to their school. The signs contain a QR code that can bring up a map on their smartphone of the identified safe route to their school.

14. New speed buggy: The SHIP program provided funding to the New Ulm Police Department to replace their old speed buggy and replace it with a new model that collects data as well as flashes the current speed.

The SRTS Action Team uses the information to identify which streets need further traffic calming measures to help reduce the speed of traffic. The speed of traffic is one of the main reasons parents in New Ulm have cited for not allowing their children to walk or bike to school.

Looking forward, the

SRTS team is working on updating the current plan so it includes the new high school, and several other activities are underway.

“We are working with the city to install a Rectangular Rapid Flashing Beacon at 4th South Street and South Broadway to give students living on the east side of town a safe place to cross South Broadway,” said Winters. “We also plan to work with a neighborhood this spring to test a neighborhood “walking school bus” that will be run by parents in the neighborhood on a regular basis in the spring and fall.

Lastly, we will continue to conduct parent surveys and student tally sheets on a regular basis so we can measure our progress and update our goals and objectives.”

Current SRTS Action Team members include Karen Moritz and Melissa Hoffmann (Brown County), Jeff Bertrang (ISD #88), Jen Maurer (New Ulm Medical Center), Dawn Brown (Washington Learning Center), Julie Hull and Adam Kluver (Jefferson School), Jamie Boelter (Middle School), Shelly Bauer (NUACS), Amanda Groebner and Sara Schauer (parent volunteers), Doug Hazen (River Bend Education District), Cindy Winters (HONU facilitator), Kristin Schrock and Dave Borchert (police department), and Pete Markgraf and Jean Schroeder (St. Paul Elementary).

performed incontinence procedures.

During one of the procedures, a sling made of mesh is placed under the midpoint of the urethra, the tube that carries urine from the bladder, to provide support for the urethra. In the past, this procedure required several incision points, but the new methods require only one incision in the vagina.

The surgical procedure takes about 30 minutes, not including postoperative observation. “You have the surgical procedure and go home the same day,” Dr. Khayat said. “You may be a little sore afterward, but the recovery is usually pretty quick.”

Between 80 and 90 percent of women who have this procedure for stress incontinence find they have better control of their urine afterward, said Dr. Khayat.

Losing weight and smoking cessation will also help to alleviate symptoms of urinary incontinence in those women who are significantly overweight or who smoke, Dr. Khayat said.

Women should not be afraid to speak up when they suffer from bladder issues, because “we are here to help improve their quality of life,” said Dr. Khayat.

To learn more about options for treating bladder issues, call 507-217-5011 and make an appointment with Dr. Khayat.

‘Health’ is a joint venture

Today’s Health issue is a joint venture of the New Ulm Medical Center and The Journal. It is published quarterly to update area residents on health care in general, particularly what’s happening in New Ulm.

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New Ulm Medical Center Critical Care Unit renovations completed Renovations in the critical care unit (CCU) at New Ulm Medical Center (NUMC) are wrapping up in November, bringing improvements in patient safety, privacy, efficiencies for staff, and overall aesthetics. “We are so excited to have these renovations completed,â€? said Med/Surg/CCU Manager Sharie Novak, RN. The project included: • Ensuring that every room has a private bathroom. • Updating flooring and walls that will help reduce fall risk. • Updating bathrooms with new tiling and flooring that will help reduce fall risk. • Adding piped-in medical gas. • Replace headwalls for improved functionality. • Replace footwall cabinetry for improved functionality. • Replace sliding glass doors.

With the CCU renovations completed, the project will continue on to the Med/Surg unit, where renovations are expected to be completed by the end of 2019. The project is supported by a $100,000 donation from the NUMC Foundation.

The project did not expand the current space that the CCU is in, but made better use of the existing space with efficiencies that were not available when the unit was last updated more than 20 years ago. Technology that has been introduced in the last 20 years and has been

Renovations in the Critical Care Unit at New Ulm Medical Center are nearly complete, bringing improvements in patient safety, privacy, efficiencies for staff, and overall aesthetics.

simply added to the rooms are now incorporated into the design of the rooms in a more streamlined way.

Additionally, the cabinetry has been made

more efficient to take up less space in the rooms.

Another significant improvement in the rooms is the flooring and wall updates designed to help

reduce fall risks.

The floor transitions in the rooms and the bathrooms mean that the color from the floor to the wall will be distinctively

different so that patients with poor eyesight will see the difference, and the risk of falling will be less.

To find out how you can help support the

renovations as they continue to the Med/Surg unit, go to allinahealth.org/numcfound ation.

NUMC staff, providers raise $30,000 to support mental health, addiction services New Ulm Medical Center (NUMC), part of Allina Health, focused their annual Community Giving Campaign this year on Mental Health and Addiction Services, raising $30,000 to help support patients and providers. Each year, NUMC chooses an emphasis for the campaign, though staff and providers always have the choice of supporting whichever fund they choose with their donation. “We chose Mental Health and Addiction Services as the focus this year because it’s in line with the focus of NUMC’s and the Heart of New Ulm

Project’s community support plan in which these two topics are one of a handful that rose to the top,� said NUMC Foundation Director Missy Dreckman. “Mental health and addiction issues are in the headlines across the country daily and the New Ulm community is not unaffected by the increase in these issues.� “We have people that have a higher mental health need, which also impacts the addiction issues – you can’t have one without the other, it seems like today,� said Lisa Barden, MS, LADC, LSC, an addiction counselor for NUMC at the

Five tips to decrease screen time for kids This article originally ran as a blog post Health Powered Kids™ Team, which can be found at allinahealth.org We live in a world full of electronics and screens. We can find screens everywhere, from the face of a cell phone to the big movie screen.

There are television, computer, tablet screens and more. People spend time in front of screens for work as well as play. While they are necessary, many people spend far too much time in front of a screen.

Screen time includes time spent: • watching television • using the computer or internet • texting • playing handheld games.

Our bodies are designed to move. When we sit in front of a television screen for hours, for example, we don’t get the amount of physical activity our bodies need every day. Plus, too much time in front of a screen can be harmful to our eyes. It’s important to look away from screens every 20 minutes so our eyes have a chance to focus on other objects before returning to the screen.

Most people can’t change how much time they spend on the computer for work or school, but you can decrease

your screen time during other times of the day and on the weekend. Try some of these tips to get you, and your kids, moving: 1. During commercials, do stretches, dance, do sit-ups or march in place. For even more ideas, try some Health Powered Kids™ Power Chargers.

2. Turn off the television if nobody’s really watching.

3. Plan ahead! Look at the shows that are going to be on and choose which one would be good to watch.

4. Avoid eating while at the computer or watching TV. Not only will this help keep your family from eating too much, it will also encourage conversation!

5. Set a timer to help your family remember to get away from the TV or computer or whatever screen they are using. It’s easy to lose track of time when you’re in front of a screen.

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outpatient offices in Mankato. “Addictions and mental health issues are non-discriminatory.

It doesn’t matter who you are, what your job is, or how you grew up. You could be the next person to struggle with addiction and mental health issues.�

The funds raised through the annual Community Giving Campaign will be beneficial in many ways. “Some of the resources we need in order to provide the best care for our patients are things like education and supplies for some of the children we see as well as time to educate ourselves on the best therapeutic approach that might help them,� said Bonnie B e r a n e k - F o r t w e n g l e r, LICSW, outpatient mental health therapist. “We’d like to use some of these funds to educate our providers in new therapeutic methods, and to create a community crisis team to support our community and employees during crisis events.�

Other plans for the funds raised include improving the aesthetics of the patient waiting area in outpatient mental health and supporting community education/events to improve awareness and reduce stigma around mental health and addiction issues.

Another beneficiary of the funds raised is the Patient Assistance Fund, Dreckman said. “The Patient Assistance Fund helps our patients during their most vulnerable times with things like prescription assistance, home medical equipment, or transportation to and from appointments,�

Dreckman said. In 2018, NUMC provided over $10,200 to help 70 patients needing emergency assistance. “It’s important to raise funds for our Patient Assistance Program because it’s highly utilized by all of our social work departments here at NUMC,� said Jennifer Eckstein, LSW, a social worker in the NUMC Emergency Department. “We use it for patients who are discharging who don’t have any money, for patients who’ve just come to a rough patch in their life and need to choose between groceries for their kids or medications for themselves.

We use it for people who can’t afford medical equipment.�

All three providers agreed that mental health and addiction issues are widespread and do not discriminate. “It can happen to

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• Fitness Centers • Fitness Classes 6 days per week

• Weight Lifting Programs Pre-registr ation • Personal Training packages for individuals for these programs required at and small groups Rec Ce • Lifeguard Training - December 26, 27, 28 newulmmn nter or .gov

Civic Center Activities:

• Skate with Santa and the Steel Day of Play Sunday, December 2 from 1-4 p.m.

• Open Broomball Wednesday 6:30-8 p.m.

For these and all our great programs, check brochure, website www.newulmmn.gov or call 359-8347 for details

anybody. It can be your neighbors, your friends, co-workers. It doesn’t just impact one specific group of people and it doesn’t matter your income, or where you came from. It impacts the community as a whole,� Eckstein said.

Similarly, therapy services can be a benefit to anybody. “Therapy is really for everyone and for anything.

Lots of people think that therapy is for people that have extreme symptoms of anxiety or depression or just extreme emotional health and really that is not the case,� Beranek-Fortwengler said. “We think that therapy could be for anything and for anyone in anyone in any walk of life. Parenting, new parents, relationships, empty nests, and just life-stressors.

I think therapy can be really beneficial and discovering so many things about yourself and getting the support to help you find the courage and the strength to make the choices that you need to make or just finding the inner strength to be able to support yourself through those difficult times.�

Because these concerns are so widespread, it really

falls on whole communities to gain a better understanding and to support those around them with mental health and addiction issues, Barden said. “It’s debilitating sometimes for people who have mental health issues to even get up out of bed and our expectation of them is to be able to complete forms for insurance, to continue to look for jobs, to take care of their children, when they can’t even take care of themselves,� Barden said. “I just wish that people would understand that instead of stigmatizing people we should be offering grace to them and helping them along the way because it can impact any of us.�

To learn more about Mental Health and Addiction Services at NUMC, go to allinahealth.org/newulm or call: 507-217-5168 for outpatient mental health; 507-217-5118 for addiction services.

To contribute to funding for these, or any services, at NUMC, go to allinahealth.org/numcfound ation or call 507-217-5180.

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The Journal, New Ulm, MN Tuesday, November 13, 2018

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A guide to complex 2019 Medicare changes Many changes are happening this year for individuals who are eligible for Medicare. In many of the counties around New Ulm Medical Center (NUMC), Medicare Cost Plans are being discontinued. Here’s a quick tip sheet on your Medicare options for 2019.

What should I do?

• Ensure New Ulm Medical Center and Allina Health are included as in-network providers if you select a Medicare Advantage plan.

• Meet with a local health insurance broker who can help you better understand what is available in your county and what health insurance best fits your needs while ensuring your

relationship with New Ulm Medical Center and Allina Health is maintained with in-network coverage.

• If you still have questions, Allina Health is pleased to offer a free Medicare insurance helpline in coordination with Medicare Compare USA*: A free and unbiased resource for comparing and enrolling in Medicare plans accepted by Allina Health providers.

Medicare insurance helpline: 1-866-ALLINA-0 (1-866-255-4620); Monday through Friday; 8 a.m. to 7 p.m.

Can you sum up the Medicare options I have?

For the most part, you have three different options

to get your Medicare coverage: Option 1: Get Original Medicare (Parts A and B) from the federal government and pay out of pocket for the costs not covered by Original Medicare Option 2: Get Original Medicare (Parts A and B) from the federal government and purchase a Medicare Supplement plan from a private insurer and/or purchase a prescription drug coverage (Part D) from a private insurer Option 3: Get a Medicare Advantage plan (Part C) from a private insurer for Parts A, B, and usually D, all in one plan — plus, possible extras. Of course, there are other factors that should play into your final decision.

What is In-Network vs.

Out-of-Network

Some Medicare Advantage plans have a network of providers, meaning you may pay a higher amount to see a provider who is out-of-network.

Please ensure that New Ulm Medical Center, part of Allina Health, is in-network in any Medicare Advantage product you purchase. New Ulm Medical Center and Allina Health are not in-network in the 2019 Blue Cross Blue Shield Medicare Advantage PPO plans offered in Brown, Nicollet, Blue Earth and Watonwan counties, so any non-emergent care you receive at New Ulm Medical

Center and Allina Health will be considered out-of-network in 2019. This was not Allina Health’s decision.

Overview of Medicare Advantage health plans offered in our area:

• In-Network - New Ulm Medical Center, part of Allina Health, is in-network with the following Medicare Advantage plans: • Allina Health | Aetna* only offered in Brown and Nicollet counties • Blue Cross Blue Shield - in-network in the following counties in our area: Sibley, Renville, Redwood, McLeod and Cottonwood.

• Humana • Medica • UCare

• Note: Supplement/ Medigap plans (which are different from Medicare Advantage plans) offered in our area do include NUMC as in-network, such as the Blue Cross Blue Shield Senior Gold.

• Out-of-Network - New Ulm Medical Center, part of Allina Health, is not in-network with the Blue Cross Blue Shield Medicare Advantage PPO plan offered in Brown, Nicollet, Blue Earth and Watonwan counties.

• Please note: There are exceptions, so to verify your specific doctor’s or hospital’s network participation with any Medicare Advantage plan, please contact your broker or the health plan directly.

Training for life: Functional fitness This article originally ran as a blog post on the Health Set Go Blog, which can be found at allinahealth.org/ healthysetgo.

Being physically fit does not mean you have to be an elite athlete. It does not mean you have to have muscles like Arnold Schwarzenegger, win an Olympic medal or scale a mountain. For most of us, these aren’t possibilities, anyway. What is possible is a basic fitness level, one that allows us to perform the activities of daily living. We need, at the very least, to be functionally fit.

Maybe in your day-to-day life you need to climb stairs, lift a toddler, carry a bag of groceries, put dishes away on a high shelf or vacuum up the dog hair.

Functional fitness training refers to exercises that help you perform these activities more easily, without pain or strain. Consider it training

Functional fitness means training and exercises that help you accomplish everyday tasks more easily, like lifting and carrying a bag of groceries.

for life, not for events.

A functional fitness exercise might mimic the activity that you need to do.

For instance, if you routinely find yourself picking up a

small child, you need to strengthen the muscles in your legs, hips, abdomen, spine and arms. You also need to improve your balance. While walking for

30 minutes on a treadmill will help you improve your cardiovascular health, as well as strengthen your legs, hips and buttocks, it won’t really help you in bending

and lifting. A better, more functional exercise is a squat where you lift a weight off the floor that is in front of you.

A functional fitness exercise might also involve strengthening opposing muscles. If your job requires that you sit for most of eight hours, over time the muscles in your buttocks and abdomen can become weak, while the muscles in your lower back and hips become tight. This can cause back pain and reduced stability. If you can’t routinely stand and break the habit of prolonged sitting, you need to incorporate exercises that strengthen your abdominals and gluts (butt muscles) while stretching the hips and lower back.

Functional fitness might mean strengthening a weakness. People who have a condition affecting their balance or muscle control, such as a stroke, may find one side of the body is

stronger than the other. They will need to isolate and strengthen the affected side for improved function.

Your first step toward improved functional fitness is to determine your goals.

Do you want to be able to climb stairs more easily?

Weed in your garden? Dance a two-step with your spouse? Put a carry-on bag in the overhead bin on a plane? Once you know what you want to achieve, you need to identify activities that will help you do so. If you haven’t exercised in a while, talk with your health care provider to find out if you are healthy enough to start an exercise program.

Your provider may recommend a physical therapy consultation or suggest that you meet with a personal trainer who can help you create a safe and appropriate exercise program that will achieve your goals.

Tips for packing a healthy lunch This article originally ran as a blog post on the Health Set Go Blog, which can be found at allinahealth.org/ healthysetgo.

Brown bagging it every day can be challenging.

Especially when you try to be creative and make healthy choices. But, I’ve found that it helps if you plan ahead.

Weekends are a great time to plan your lunches for the next week. Prepare a grocery list so you know what you have on hand and what you need to buy. When you can, make extra or use leftovers from dinner the night before for your lunches.

Planning ahead also involves doing prep work.

Working ahead saves precious time in your morning rush to get out the door. Wash and cut up fruit and vegetables, grate cheese and portion out sides and snacks as soon as you get home from your shopping trip. Then, prepare what you can the night before so you can grab and go.

Packing a healthy lunch is easy with a little planning.

To keep your lunches as healthy as possible: Incorporate whole grains whenever you can. You can now find whole grains in English muffins, tortillas, hamburger and hot dog buns, sub rolls and even naan.

Choose fresh seasonal fruits and vegetables. Eating with the seasons automatically can help keep you out of a meal-time rut.

Choose low-fat meat and meat alternatives and low-fat dairy items.

Limit items that are high in saturated fat, added sugars and salt.

Remember, it’s okay to reward yourself with an occasional sweet treat.

Here are some more tips and meal ideas to invigorate your lunches: Variety really is the spice of life. Vary your protein

with hard-boiled eggs, black or garbanzo beans, dry roasted edamame, nuts and seeds, low-fat cottage cheese, pre-cooked shrimp, imitation crabmeat and tuna or chicken salad made with low-fat plain Greek yogurt instead of mayo.

Try greens like bok choy, cabbage, spinach, butter lettuce, romaine, arugula and watercress or fresh herbs.

Ditch the grains altogether and top an avocado or leaf lettuce with egg salad.

Keep on hand a selection of condiments you like best.

Some favorites of mine are hummus, guacamole, horseradish, spicy brown mustard and ranch dip I make with plain Greek yogurt.

Keep some of these go-to speedy sides to add to your lunches: • Single serve containers of low-fat yogurt, cottage cheese, yogurt smoothies or pudding.

• Trail mix made with cereals, nuts, pretzels, dried

fruit or raisins.

• Low-fat cheese cubes or string cheese.

• Bananas dipped in pudding, vanilla wafers in applesauce or graham crackers in strawberry yogurt.

• Baked chips, whole-grain crackers or pretzels with various dips such as onion flavored low-fat Greek yogurt, mustard, low-fat cream cheese or peanut butter.

• Air-popped popcorn flavored with a sprinkling of parmesan cheese, dill, curry or nutritional yeast Here’s a week’s worth of sample lunch ideas to get you started.

Monday Cucumber sandwich with ranch (Greek) yogurt dip on whole-grain bread Apple slices with peanut butter String cheese 100% juice Tuesday Peanut butter sandwich on whole-grain bagel thins Sugar-free pudding with

banana slices Carrots with hummus Skim milk Wednesday Ham and cheese whole-grain English muffin with tomato slices Honeydew cubes Black bean salsa with cucumber slices instead of chips Water Thursday Salad with romaine lettuce, tomatoes, fresh mozzarella, turkey pepperoni slices and avocado Breadstick Skim milk Friday Cold grilled chicken strips with honey mustard dip Potato salad tossed with plain yogurt, dill and fresh herbs Sliced grilled peaches with goat cheese Fruit infused water

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Allina Health Pharmacy offers conveniences and value to patients of New Ulm Medical Center Though the Allina Health Pharmacy at New Ulm Medical Center has been open for almost five years, it’s a benefit patients are still getting used to, along with comprehending the advantages of a full-service pharmacy located feet away from their physician’s office.

“We first opened with a core staff of four and we were open six days a week,” said Pharmacy Manager Jenifer Kalis, PharmD. “We knew demand would grow as patients became familiar with our services and that’s just what happened.”

The pharmacy has added many staff members, increased hours as well as being open seven days a week.

Having a pharmacy located just short hallway from the clinic has been incredibly beneficial for patients, Kalis said. “If you’re sick or are caring for a sick child or dependent adult, it just adds to the difficulty if you have to drive to a pharmacy to fill prescriptions. We find that, often, by the time a patient has walked from the exam room to the pharmacy, on their way out to the parking lot, we have their prescription ready.”

The efficiency and speed with which they can fill prescriptions is, in part, thanks to the pharmacy’s access to the shared electronic medical record.

“Our pharmacists and technicians are able to see the documentation from the New Ulm Medical Center provider in the medical record,” Kalis said. “That not only improves the efficiency with which we can fill a prescription but it is also a major safety feature.”

Allina Health New Ulm Pharmacy staff are available to help you understand your medications and answer any questions you may have. Pictured (l-r) are: pharmacy Manager Jenifer Kalis and technicians Amber Faerber and Luann Marti.

For refills or filling a prescription from another facility, the drive-through window or free mail delivery are popular options.

Other features include: • The ability to refill a prescription online, via phone or in person

• One-on-one counseling to understand prescribed medications • Help transferring prescriptions • Nearly all insurance plans accepted • Competitive pricing, price matching

• Help with prescription coverage issues • C o m p r e h e n s i v e Medication Review with Resident pharmacist Additionally, the pharmacy offers delivery options to certain patients, such as those who live at an

Holiday Trimmings program is back for 10th year The holidays are fast approaching, and the Heart of New Ulm Project (HONU) is once again launching its annual “Holiday Trimmings,” an eight-week program designed to help people achieve better health and a stronger sense of well-being.

Online registration opens Nov. 1 for the free program, which starts Nov. 19, 2018, and runs through Jan. 11, 2019.

This year the focus of the program is to help people achieve better health and a strong sense of well-being. By helping people make small improvements during the hectic holiday season, they will also be in a better position to avoid gaining extra weight.

Through the program, participants will learn about and explore fun and interesting ways to maintain or improve well-being during the busy

holiday season; receive weekly tips via email to help them embrace a healthier lifestyle; and stay motivated with the help of fun local activities, inspiring social media posts and delicious, easy recipes.

This year’s Holiday Trimmings program is being coordinated by the HONU Worksite Wellness and Community Health Challenge Action Team and offered by a collaboration of community partners, including Brown County Public Health, Dittrich Specialties, Firmenich,

KNUJ Radio, Minneapolis Heart Institute Foundation, New Ulm Area Chamber of Commerce, the New Ulm Journal and New Ulm Medical Center.

Holiday Trimmings is also designed to encourage building a social support network that can help people stay motivated. The program encourages people each week to use their own networks and tools such as Facebook to share their goals and their progress using the hashtag #HT2018. People are encouraged to invite friends and family to get involved; share tips,

assisted living facility or group home, immobile elderly patients, and hospice and home care patients.

The pharmacy is open Monday through Friday, 8 a.m. to 7 p.m.; Saturday and Sunday 8 a.m. to 2 p.m.

To find out more about

the pharmacy at New Ulm Medical Center, go to allinahealth.org/pharmacy, call 507-217-5808, or stop by the pharmacy attached to the north end of the clinic.

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resources and successful strategies; and help motivate each other.

Online registration for the program is available from Nov. 1 to 21, 2018, by visiting w w w. h e a r t o f n e w ulm.com and choosing “Get Involved.” Anyone who registers, participates and then completes the final program evaluation will have their name entered into a drawing for $50 in Chamber Bucks to be used at any Chamber member organization.

Joint Replacement From page 6H and support needed prior to the surgery.

When the surgery is complete, the patient stays in the hospital 2-3 nights and begins physical therapy right away. Pain reduction methods continue to improve, Dr. Honstad said, and most patients are surprised at how well their pain is controlled following surgery.

“After the patient is discharged, they will continue physical therapy for several weeks,” Dr. Honstad said. “This is a very important component to a successful recovery following any joint replacement surgery.

Regularly performing the exercises from the therapist goes a long way toward helping them to regain

motion and function.

They’ll find their balance and strength is much better.

Overall, they will be able to get back to their activities more quickly.”

For more information about joint replacement, call for a consultative appointment with Dr. Honstad or Dr. Desouza at 507-217-5011.

Ankle Sprain From page 6H resonance imaging) may have to be conducted to rule out ankle fractures, and to determine what is inflamed or torn or if there are any loose bones that may have detached off from the injury.

“Depending on how severe the ankle damage is, there are several different methods and/or injections we can try. These methods can regenerate some of the ligaments or tendons to help promote healing. It can be done in the office setting, without any formal surgical procedures,” Dr.

Ouyang said. “There are also surgical options if the ankle is bad enough. An ankle arthroscopy can be performed to better visualize the ankle joint, so any synovitis and frayed tissue that is causing impingement with ankle movement can be addressed. That can be really helpful and fix their problem.”

Dr. Ouyang has a special interest in sports medicine and will also see conditions such as Achilles tendonitis, heel pain, foot sprains, foot fractures, and

more.

To make an appointment with Dr. Ouyang, call 507-217-5011. No referral is needed.

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Osteopathic physicians use their hands to detect, resolve issues While people may be more familiar with the initials “MD” behind a physician’s name, it’s important to know that a “DO” can provide the exact same services as an MD, but will perhaps be literally more “hands on” when it comes to treating patients.

Obehi Okojie, DO

A DO is an osteopathic physician, which means that their training is the same as an MD (Medical Doctor), they can prescribe medications, practice specialty medicine and perform surgeries. But, in addition to traditional medical training, osteopathic physicians also zero in on a mind-body-spirit approach.

At New Ulm Medical Center (NUMC) pediatrician Obehi Okojie, DO, recently joined the facility’s other two osteopathic physicians: Bryana Andert, DO, and

Jared Colvert, DO. “A DO has an additional skill set,” Dr. Okojie explained. “We use anatomy and physiology to know how things are supposed to feel and move, so when things aren’t functioning like they should, we can manipulate the body with our hands to make sure they are moving like they should.”

Dr. Okojie said she pursued osteopathic medicine because she loved the idea of being able to help people feel better just through the power of her own hands. “I thought that was so cool. It was like magic,” she said.

Sometimes people will confuse an osteopathic physician with a chiropractor, Dr. Okojie said, because the two disciplines did have their start from the same founder, Dr. A. T. Still. However, a chiropractor focuses on the spine and a DO treats the entire body.

“You can go to a DO for any of the things you see a chiropractor for,” she said.

As a pediatrician, there are many conditions or concerns that osteopathic manipulation can be used to help children, Dr. Okojie said. For instance, head shape issues, colicky babies, sucking or eating issues, and “even behavioral issues, believe it or not.”

A lot of chronic pain – such as headaches or abdominal pain – can be treated very well with

Pediatrician Obehi Okojie, DO, is an osteopathic physician, which means she uses her hands to help heal patients.

manipulation, also, she said.

“In addition to children and babies, I’ll see pregnant women to help them with pain they may be feeling as their body goes through changes,” she said. Pregnant women are the only adults Dr. Okojie sees in her practice and she sees them for manipulation only.

Because Dr. Okojie takes a whole-person approach to her practice, she will often encourage patients to work with her to get to the bottom of an issue or symptom.

“Eczema’s an easy example. If you have eczema, the common treatment is a steroid cream and if you’re having a

flare-up, then that’s what you need and that’s what I’ll prescribe,” she said. “But you aren’t have eczema because there’s a shortage of steroids running through your body. If a person is interested in finding the root cause of the eczema, rather than just continuing to treat it with medication, that is a

journey I’m willing to take with you.”

Dr. Okojie also integrates a special interest in nutrition into her practice and will be incorporating acupuncture, for which she has been trained, in the future.

To make an appointment with Dr. Okojie, call 507-217-5011.

Joint replacement is sometimes the best option When a knee, hip or shoulder joint has given its all and a person is in so much pain that they can’t enjoy the activities they used to enjoy, joint replacement surgery might be the next step.

“There are many things we can do to help a patient feel more comfortable when they are experiencing joint pain,” said Orthopedic Surgeon Angela Honstad, MD. “However, when the pain becomes unmanageable and when it is interfering in daily life, it may be time to consider a joint replacement surgery.”

Dr. Honstad has joined Mario Desouza, MD, and

Angela Honstad, MD

Jean Eelma, MD, in the Orthopedics and Sports

Medicine Department at New Ulm Medical Center (NUMC). Dr. Eelma is retiring at the end of 2018.

Non-surgical treatment options to treat joint pain include: • Activity modification (low-impact activities such as biking or swimming) • Weight loss or maintaining a healthy weight • Anti-inflammatory medications (over the counter or prescription) • Braces (specifically for knee pain) • Injections (there are several different types) • Physical therapy, which helps to restore joint

mechanics and strengthen surrounding muscles to take stress off of the joint, as well as maintaining your joint flexibility “When those options have been exhausted and the pain is keeping you up at night or preventing you from doing the things you love, it’s time to explore joint replacement,” Dr. Honstad said.

The surgeon will work with each individual patient to make a recommendation as to whether they are a good candidate for surgery or not.

“Artificial joints last longer than they used to, but we still don’t want a

patient to have surgery at too young an age,” Dr. Honstad said. “We want the patient to get as much use out of the joint as possible and not have to have a second surgery.”

In general, most joint replacement patients fall into the 55-80 year old category, though there are exceptions to that grouping. Patients who are at or as close to a healthy weight as possible are at lower risk for complications from anesthesia and surgery. The surgeon will discuss individual risks with each patient prior to the surgery and try to modify any risk

factors possible to make surgery safer for the patient.

Once a patient decides they are ready for a joint replacement surgery, it can generally be scheduled within a few weeks. Before the surgery, the patient will need to have a history and physical exam with their primary provider, which generally includes labs, a chest xray, and EKG. The patient will also meet with an orthopedic nurse, physical therapist, and social worker to ensure they have all the supplies

Joint Replacement Continued on page 5H

Have an ankle sprain? Don’t ignore it Ankle sprains can affect anyone. Most people might think it affects mostly marathoners or amateur runners, but it can happen when you’re just dropping the kids off at school or carrying your groceries into the house. You might think the pain or swelling can go away only by resting, but ankle sprains should not be minimized or ignored.

Ankle sprain happens when the ligaments that support the ankle are injured or damaged in some way.

“Many people with

ankle pain or frequent ankle sprains may have been told to believe that they are clumsy and may feel that this is something they just have to live with,” said New Ulm Medical Center’s Podiatric Medicine and Surgery Specialist Grace Ouyang, DPM. “That’s not the case at all. There are a lot of things we can do to help identify the problem and to reduce ankle pain and recurring ankle sprains.”

Lateral ankle sprains are more common than medial ankle sprains because of the anatomy of having 3

Grace Ouyang, DPM

ligaments on the outside of the ankle vs. the inside of the ankle which has 4 ligaments. To understand what kind of a sprain you have and how to treat it, it’s important to consult a specialist for proper treatment before the symptoms increase. “The first treatment towards an ankle pain or a sprain is to identify the problem and to treat it conservatively with rest, ice and elevation to calm down the swelling and or bruising,” says Dr. Ouyang. “Ankle bracing can be helpful during this initial injury phase to help

stabilize the ankle.

However, over time, it is important to transition out of the ankle brace to not lose proprioception of the ankle.”

If this isn’t your first sprain on the same ankle, consider the additional care that may be needed.

“It is important to address the mechanical instability.

Multiple sprains may lead to ankle arthritis, and it can actually change your foot and ankle position,” Dr. Ouyang said. “When that happens, you may start to notice a change in shoe wear. One part of your sole

may wear down faster than the other. You may be leaning in a certain direction to compensate.

That can lead to knee, hip and spine problems.”

The first thing Dr. Ouyang — who began seeing patients at New Ulm Medical Center in August — would do for a patient with frequent ankle sprains during an office exam would be to first perform a physical exam on the ankle and foot.

X-rays and MRI (magnetic

Ankle Sprain Continued on page 5H

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