Health Feb. 2017

Expands Practice

Hope Fund

Acupuncture

Rheumatologist Dr. Eric Schned is expanding his practice at NUMC.

New NUMC Foundation fund assists breast cancer patients.

Sufferers of chronic pain can find relief with acupuncture treatment.

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THE JOURNAL, New Ulm, MN Monday, February 20, 2017 Page THE RETAILER, New Ulm, MN Tuesday, February 21, 2017

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Local woman has Sudden Cardiac Arrest in just the right company There’s never a good time or place to suffer sudden cardiac arrest (SCA).

But if you do experience SCA, it probably helps to be in the presence of medical professionals and have law enforcement with an Automated External Defibrillator (AED) just minutes away.

In a 2015 report, the American Heart Associated stated that of those who experienced an out-of-hospital SCA and were treated by emergency medical services, just over 10 percent survived. Of those who could be treated effectively with a defibrillator, just over 31 percent survived.

New Ulm resident Jill Hady defied the odds when she experienced SCA while working out at the New Ulm CrossFit on the evening of January 5. Two registered nurses from New Ulm Medical Center (NUMC) – Carrie Haugen and Tracy Berg – happened to be on hand and began CPR immediately. Haugen is an

emergency nurse and Berg is a surgical nurse. They were backed up by law enforcement, who arrived within minutes with an AED, followed by Allina Health Emergency Medical Services team of a paramedic and emergency medical technician.

SCA is often confused with a heart attack. Hady said a physician at Abbott Northwestern Hospital, where she was transferred, explained it to her best: “Your heart has plumbing and it has electrical. A heart attack is when your plumbing is clogged.

Cardiac arrest is when your electrical is disrupted.”

The American Heart Association defines sudden cardiac arrest as “the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs instantly or shortly after symptoms appear.”

Hady discovered, through one of several tests performed on her at Abbott

Jill Hady survived a Sudden Cardiac Arrest in early January thanks, in large part, to the fact that there just happened to be medical personnel on hand and an Automated External Defibrillator arrived within minutes.

Northwestern, that her arteries are clear, so it wasn’t a “plumbing” problem.

Hady had recently joined a CrossFit Boot Camp group at the recommendation of a friend. It was her fifth

session and she was loving the camaraderie and the feeling of getting stronger.

“I remember feeling tired but thought I needed to just push through it,” Hady said.

“I was on my sixteenth squat of twenty, and I felt like maybe if I stretched out I’d feel a little better. Then I felt like I better sit down for a few minutes. I remember resting my head on the black mat. That’s the last thing I remember.”

When Hady came to, six minutes later, she couldn’t understand what all the fuss was about. “I just thought I’d passed out. Big deal!

“I remember thinking, why do I have to go to the hospital, why am I being flown out?” she said.

The severity of her condition began to sink in when she was in the Emergency Department at NUMC, she said.

“I remember the looks of amazement on peoples’ faces in the ER. That I was alert and talking,” she said.

During her stay at Abbott Northwestern Hospital she

Courage Kenny Rehab Institute – New Ulm offers Experia Clinical Device to treat dysphagia in cancer survivors Dysphagia, or difficulty swallowing, can sometimes be the “added insult to injury” of another condition such as a brain injury or cerebral palsy. Certain conditions can weaken your throat muscles, making it difficult to move food from your mouth into your stomach, increasing the risk of aspiration. Additional causes of dysphagia include neurological disorders, neurological damage, or cancer.

A treatment option that may be beneficial for patients struggling with dysphagia is called VitalStim Therapy, which has been available for several years at Courage Kenny Rehabilitation Institute – New Ulm,

Whatʼs Inside Volunteers Dedicated volunteers work to make New Ulm the healthiest it can be.

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located in the lower level of the New Ulm Medical Center (NUMC). Recently, The Institute acquired a tool called the Experia clinical device which is best of practice when treating head and neck cancer survivors who have suffered dysphagia.

VitalStim Therapy is designed to help swallowing through the use of neuromuscular electrical stimulation (NMES).

Electrical stimulation is used to aid muscle strengthening to rehabilitate the swallowing ability. The sensory stimulation that is provided also helps muscle recruitment and swallowing function. Liza Rignell, a speech therapist at Courage Kenny Institute – New Ulm, has worked with many patients over the years to help them overcome dysphagia using VitalStim Therapy.

“I see a variety of diagnoses’ causing dysphagia including head and neck cancer, cerebrovascular accident (CVA), traumatic brain injury (TBI), ALS (more commonly known as Lou Gherig’s Disease), multiple sclerosis (MS), cerebral palsy (CP) and generalized weakness,” Rignell said.

“Unfortunately, dysphagia is more common than expected.”

Patients with cancerous tumors of the oral cavity, pharynx, or larynx will usually be treated for their disease with surgical removal of their tumor, radiotherapy, chemotherapy, or a combination of these procedures.

“Each type of oral head and neck cancer treatment may result in some degree of dysphagia,” Rignell said.

further learned what a close call she’d had. “It seemed like there were no other patients there recovering from the same thing. I didn’t hear that. I heard that there were a couple other cases in the past week where the person didn’t make it.”

Hady says that everything went right for her in her scenario. “I had no loss of oxygen, I was only out for a few minutes,” she said.

For their part, both the nurses jumped into action without a thought.

“Both Carrie and I work in high acuity areas – Carrie in the emergency room and me in operating room and post anesthesia care unit – so quick response is something that is just hard wired into us as nurses,” Berg said. “We are both certified in Advanced Cardiac Life Support which is an advanced form of CPR for licensed health care providers. We immediately recognized that Jill was in need of CPR and we began compressions and attempted

to maintain an airway.”

“I was very thankful that Tracy was there because not everybody can just jump in like that,” Haugen said. “I feel like the two of us worked together really well.

Law enforcement showed up quick, even though it didn’t feel like it at the time.”

Haugen marvels over the fact that she decided, on a whim, to stick around to do some additional exercise after her own CrossFit class had ended earlier.

Haugen and Berg took turns doing the compressions and breaths during CPR so that neither of them would fatigue, not knowing exactly how long it would take for the AED to arrive.

“Tracy and Carrie are godsends who really knew their jobs,” Hady said.

“That, and the AED, are the reasons I’m here.”

The AED came with the Brown County Sheriff’s deputy who arrived on the

Hady Continued on page 2H

Dermatologist Rachel Qualley, MD, seeing patients at NUMC

Speech Therapist Liza Rignell works with patients to help them overcome dysphagia using VitalStim Therapy at Courage Kenny Rehabilitation Institute – New Ulm. The Institute recently acquired a tool called the Experia clinical device (pictured here) which is best of practice when treating head and neck cancer survivors who have suffered dysphagia.

“The type and severity of dysphagia will depend on the size and location of the original tumor, the structures involved, and the treatment modality used for the cure. Up until now, Courage Kenny Rehabilitation Institute – New Ulm did not have the equipment to treat severe dysphagia of the head and neck cancer population.

Speech therapy at Courage Kenny Rehabilitation Institute referred patients with severe dysphagia to the

metro hospitals or Sioux Falls, SD, for advanced need of this specialty equipment.

The only type of NMES used on oral head and neck cancer (OHNC) patient’s uses a high volt waveform delivered from the Experia device. The high volt current with the Experia device is recommended for patients with OHNC because it is more effective

Dysphagia Continued on page 2H

Dermatologist Rachel Qualley, MD, never considered any career besides medicine. Inspired by her mother, who loved her job as a nurse, Dr. Qualley has been practicing dermatology since 2001.

Dr. Qualley began seeing patients at New Ulm Medical Center (NUMC) clinic in early January. In addition to her practice at the Mankato Clinic, she sees patients at NUMC every Monday.

“My mother loved her work, and I wanted to have the same satisfaction,” Dr. Qualley said of her chosen profession. “I have wanted to be a physician since I was a junior in high school. I don’t recall considering another career.”

Dr. Qualley was born in Minot, N.D., and raised in Peoria, Ill. She earned her undergraduate and doctoral degrees and completed her residency at Southern Illinois University in Springfield, Ill. She is board certified in dermatology.

“I try to involve patients in the decision-making process when it comes to therapy, so they take ownership in the treatment,” Dr. Qualley said of her professional approach. “I allow a lot of discussion and questions.”

What she enjoys most about her practice, Dr. Qualley said, is “the variety of patients I get to see, very young to the very old, from all different backgrounds and walks of life, and being able to help them in some way.

Every day is different and exciting.”

Some of the more interesting cases to treat, she said, include psoriasis, because of all the treatment options available today (see accompanying article in today’s Health Edition); skin cancer, because it is such an important condition to treat; and acne, because it is a very

Rachel Qualley, MD

rewarding condition to treat.

Dr. Qualley says that, although she is not from Minnesota, being born and raised in the Midwest she shares similar values as those in the state.

She and her family currently live in North Mankato. Her husband of 21 years, J.D., is pursuing a career in human resources and is currently going back to school to earn his Masters of Business Administration.

His hobbies include cooking and travel. The couple have three children: twin boys, Justin and Tyler, (16) and daughter, Amanda, (10).

Justin plays drums and is into VEX Robotics. He wants to be an engineer. Tyler plays guitar and is in choir and drama at school. Amanda likes to draw and read, participates in gymnastics, and enjoys arts and crafts.

Together, the family likes to travel in their RV in the summer months. Dr. Qualley enjoys reading and collects owls.

“Less is more,” Dr. Qualley says of her approach to life. “I think it’s essential to remove distractions and items of minimal importance to have time to focus on the things that matter: family, friends and nature.”

To make an appointment with Dr. Qualley at NUMC, call 507-217-5011.

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The Journal, New Ulm, MN Monday, February 20, 2017

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Volunteers are hard at work to help New Ulm support health Heart of New Ulm and NUMC Community Engagement and Benefit Committee led by dedicated volunteers The New Year has brought a new look for two volunteer groups working to make New Ulm the healthiest it can be: The Heart of New Ulm Project’s (HONU) Leadership Team and the New Ulm Medical Center’s (NUMC) Community Engagement and Benefit Committee. In late 2016, the two groups worked together to develop an ambitious three-year plan to address healthy lifestyles, mental health and addiction and risky use of substances.

Now, as we begin 2017, the two groups have merged to become a single leadership team with a shared mission.

Cindy Winters, manager for The Heart of New Ulm Project who serves as a staff facilitator for the leadership team, said, “The group is passionate about pursuing its mission, which is to improve the health, well-being and quality of life of all New Ulm-area residents through education, available resources, initiatives and partnerships that empower people of all ages to take responsibility for their own health in a supportive environment.”

The combined group has taken on the name of The Heart of New Ulm (HONU) Leadership Team and is comprised of 12 members.

Two members of the former Community Engagement and Benefit Committee have joined the HONU Leadership Team. New Ulm’s 3rd Ward City Councilor Les Schultz replaced Dan Beranek after Beranek’s term expired, while Joey Schugel from New Ulm Park and Recreation has replaced Dave Schnobrich as an appointed member from the City of New Ulm. Winters said, “We sincerely thank both Dan and Dave for their years of service on the HONU Leadership Team and for

Heart of New Ulm Leadership Team

From top, left to right: Dr. Bryana Andert, New Ulm Medical Center; Jeff Bertrang, Independent School District #88; Carisa Buegler, New Ulm Medical Center; Lydia Drexler, Firmenich Manufacturing; Dr. Daniel Holmberg, New Ulm Medical Center; Jennifer Maurer, New Ulm Medical Center (Facilitator); Karen Moritz, Brown County Public Health; Matt Pearson, Martin Luther College; Laura Schmidt, Hy-Vee; Joey Schugel, New Ulm Parks and Recreation; Les Schultz, Brown County; Audra Shaneman, New Ulm Chamber of Commerce; Virginia Suker Moldan, Turner Hall; Cindy Winters, Heart of New Ulm Project / Minneapolis Heart Institute Foundation (Facilitator).

helping us make significant strides toward health for everyone in our community.”

Along with Winters, Jennifer Maurer, a wellness specialist with NUMC’s Occupational Health and Wellness Services, will co-facilitate the HONU Leadership Team and the action teams as part of her NUMC Community Benefit and Engagement responsibilities.

Eight action teams moving the work forward Hard at work to implement the various

strategies in the HONU Leadership Team’s three-year plan are eight volunteer “action teams.”

Winters said, “HONU started creating action teams in 2014, which are designed to be short-term teams that work on a specific project or initiative. They allow more residents to get involved in areas they may be passionate about.”

Winters explained that as an action team accomplishes a project or initiative, it may disband, while new action teams will sprout up to meet the needs of the community.

She said, “The action teams have been so successful in getting more residents involved and in accomplishing their work that more action teams keep forming.”

Currently, there are eight active action teams: The Coalition for Active, Safe and Healthy Streets; Safe Routes to School; Health Equity; Worksite Wellness; Community Health Challenge; Food Access; Mental Health; and the NU-HOME Study. The action teams meet anywhere from once a month to only a

to purchase AEDs. “The AED was amazing,” Haugen said.

“I’ve never used one in real life (in the hospital setting, manual monitor/ defibrillators are used) and it worked so well. It just goes to show that basic life support is what saves lives.”

There is a history of heart conditions in Hady’s family.

She said she was glad when she made it to the age of 50

last November. “I thought I’d made it,” she joked.

“I think I lived scared for many years, and now I have to flip it and say I just have to live,” she said.

After almost a week at Abbott Northwestern Hospital and many other concerns ruled out, Hady had a defibrillator implanted in her chest, so that if an abnormal rhythm occurs again, the defibrillator will

deliver an electric shock to reestablish a normal heartbeat.

Another testament to the fact that everything went right in Hady’s case was that there was no damage to Hady’s heart from the SCA event. She has only minor restrictions placed on her for a few weeks, which is good, since she says she can’t wait to get back to CrossFit.

duration varies from patient to patient, depending on the severity of their dysphagia, along with the patient’s tolerance. Treatment could be as little as two to three times a week or as much as five times a week. After a thorough evaluation of the patient’s swallowing function by completing a video fluoroscopy video swallow study, the intensity

of treatment is determined.

Patients should talk to their primary care provider about whether or not VitalStim or Experia therapy may be right for them.

For more information on these therapies or about Courage Kenny Rehabilitation Institute – New Ulm, call 507-217-5173.

Hady From page 1H scene within minutes.

“I don’t think a lot of people understand how important the AED is and how important it is to administer it in a timely manner,” Hady said.

The importance of AEDs for this exact kind of incident is what led the NUMC Foundation to donate $15,000 to local law enforcement and other public entities in recent years

few times a year, depending on the project.

A few examples of the work these action teams have been doing include: Community Health Challenge – Action team members from nine different community partners worked to implement the Holiday Trimmings program, which resulted in the highest program participation since 2012.

Worksite Wellness – Action team members from four community partners are planning and conducting quarterly networking and training events that are attracting an average of more than 30 participants

from various local worksites.

Coalition for Active, Safe and Healthy Streets – Action team members from 14 different organizations are working to make it safer for all residents and visitors to walk or bicycle throughout New Ulm. Winters said, “We always have more room for action team members who are passionate about a cause, so we encourage everyone to roll up their sleeves and get involved.”

For more information and to get involved, please contact Cindy Winters at 217-5548.

ʻHealthʼ 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.

Dysphagia From page 1H in reaching the muscles of patients who have had head or neck cancer that may have lymphedema or scarring and fibrotic tissues that make it difficult for the traditional VitalStim Therapy current to reach the target muscles.

NMES can help with head and neck cancer patients by reducing muscle weakness and stiff and immobile tissue due to radiation, restricted range of motion due to radiation, radiation induced fibrosis, deconditioning, and disuse atrophy.

“There are limited options for patients to receive this service. Patients needing NMES for cancer rehabilitation through use of

Experia previously would have to travel to the Twin Cities or Sioux Falls,” Rignell said. “Therapy can be intensive for patients and commuting to the cities three to five times a week can be exhausting for a 60 minute treatment session.”

Now that the new equipment, therapy is available in New Ulm for all head and neck cancer survivors, the patient is referred by their primary care provider to a physical medicine and rehabilitation physician, and then is able to complete all their treatment in New Ulm. The treatment sessions are usually 60 minutes, however the

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Rheumatologist Eric Schned, MD, expands practice at NUMC Eric Schned, MD, rheumatologist, has seen patients at New Ulm Medical Center (NUMC) on an outreach basis for more than 25 years. His primary practice location for 35 years has been Park Nicollet in Minneapolis. As of January 2017, he is seeing patients four times a month at the NUMC clinic, and in summer 2017 he will add another day each month to that schedule.

“I really love coming down here. The doctors are excellent and the nursing staff is terrific,” Dr. Schned said.

In addition to that, Dr. Schned feels drawn to the community of New Ulm. “There’s something unique about small-town Minnesota. The people are gentle and kind,” he said.

“Helping out in a rural area and making it easier for people to get access is something I believe in.”

While he is looking to

cut back his practice at Park Nicollet and eventually retire from that location later this year, he didn’t want to quit all together, he said. He was pleased to be able to reach an agreement with the Physicians Group of New Ulm (the group of physicians who provide services at NUMC clinic) to become a member of the group and increase his clinic days at NUMC. Rheumatology, as a specialty, covers a large variety of diseases that affect the joints, bones, muscles, and soft tissues.

Many of the disorders are autoimmune in nature, i.e. the body’s immune system inappropriately “attacks itself.”

Some of those conditions include rheumatoid arthritis, osteoporosis, lupus, scleroderma, vasculitic conditions, gout and Lyme disease (when it affects joints). Many of these

diseases are chronic (long-lasting) and constant.

Cortisone injection is one of the main procedures that provide patients relief of pain and inflammation in individual joints and tendons.

“However, we work with other team members on additional treatment options, also. Physical therapy is an important partner, as well as chiropractic and acupuncture,” he said.

Rheumatologist Eric Schned, MD, has seen patients at New Ulm Medical Center “Treatment has been (NUMC) on an outreach basis for more than 25 years. At the beginning of 2017, Dr. Schned almost revolutionized in my career,” Dr. Schned said. “I has expanded his clinic practice at NUMC and now sees patients four days a month. tell people I’ve had two medications,” he said. degenerative arthritis) in Dr. Schned also careers. The first half of my “Osteoporosis treatments the first place, Dr. Schned recommends that women at career was the dark ages. have improved markedly in said, there are two very the age of menopause The treatments could not the last several years. They important steps a person should have either an often reverse these kinds of can actually increase bone can take: maintain a healthy adequate amount of dairy or conditions. calcium and vitamin D density and reduce fracture weight and stay active.

“In the last 15 to 20 rates. It has been very “You don’t have to be supplements in their diet, years, there’s a whole host gratifying to see.” extravagant in your activity, and they should have a of treatments that have been To help avoid or but some kind of aerobic bone density scan. successful in putting minimize the consequences movement 3-4 times a To make an appointment patients into remission and of wear-and-tear type week, like walking or with Dr. Schned at the New eventually allowing us to arthritis (called biking, can be very Ulm Medical Center clinic reduce or even discontinue osteoarthritis call 507-217-5011. or beneficial,” he said.

The Jacobsons and Grow Safe Great Lakes: YOU are The Heart of New Ulm When Topher and Mary Jacobson moved back to New Ulm in 2011 and decided to open a new restaurant, they were inspired by how New Ulm’s culture had changed to better support healthy lifestyles as a result of Hearts Beat Back: The Heart of New Ulm Project (HONU). HONU is a collaborative partnership of The Minneapolis Heart Institute Foundation, New Ulm Medical Center and the entire community.

The duo became committed to doing their part in supporting HONU’s work to help reduce heart attacks in New Ulm by helping everyone who lives or works in the community have better access to healthy, fresh food. Today, the Jacobsons not only own The Pantry restaurant in New Ulm (which is a partner in HONU’s restaurant program focused on healthier choices), but also have launched an innovative venture in New Ulm called The Pepperboy Aquaponics Farm and a new nonprofit called Grow Safe Great Lakes.

“We knew that to become our own farmer would indeed be the best way to ensure access to fresh, safe food, and we’re doing that through our local aquaponics farm,” said Topher Jacobson. “Now, through our Grow Safe Great Lakes initiative, our mission is to help other rural communities ‘Take back their dinner table’ as we have been able to do.”

How aquaponics work

The Jacobsons initially started their aquaponics farm located at 1 S. Valley St. as a means to provide fresh produce year round to

their restaurant customers, as well as difficult-to-get fresh yellow perch. The duo is passionate about food and knowing where it comes from, and chose yellow perch due to the shortage of available fresh perch, and the fact that it is a cold-water native fish. In the United States, it’s estimated that there is a 50-million-pound shortage of perch annually.

Aquaponics involves growing fish and vegetable plants, such as different types of basil and peppers, together in a mutually beneficial system — the fish fertilize the plants, while the plants clean the water for the fish. It’s really an example of how what was once old is now new again, as the history of aquaponics can be traced back to the Aztecs and rice cultivation in South China.

Bringing New Ulm’s success to other rural communities

After the Jacobsons discovered how easy it was to build and maintain their own aquaponics system, they began thinking of the many small rural communities across the Great Lakes region that don’t have access to fresh produce year round. What produce is available is only available on a limited basis —and very expensive.

So, just as The Heart of New Ulm Project aims to help other rural communities learn from its

successes and improve their health, the Jacobsons became committed to helping other rural communities benefit from aquaponics and gain access to healthy food options.

With the help of several like-minded individuals, the nonprofit Grow Safe Minnesota was born, which has now evolved into Grow Safe Great Lakes as it has expanded to include all 12 states bordering the Great Lakes.

Topher Jacobson explained that the Grow Safe concept is to work with rural communities with a population between 1,500 and 5,000 to help them build their own aquaponics systems in older buildings that are sitting empty. There are approximately 253 communities this size in Minnesota alone, and Grow Safe can help an interested community build the system, train individuals on how to manage the system, and provide them with their first batch of perch fingerlings (young fish).

Each community will decide what type of produce to grow in order to meet their community’s unique needs and their culture. It is also up to each community to find the building location and assist in building the system.

Grow Safe has met with a few communities in the area to share the idea, which has been received very positively. In fact, the

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idea has proved so popular that they needed to create a steady stream of available fingerlings to populate the soon-to-be-developed aquaponics systems. They recently contracted with a consultant from the University of Wisconsin to provide the fingerlings and train the communities on how to manage and maintain the systems.

The first spawn will occur next month, and 90 days later the fingerlings will be available for distribution so that Grow Safe can begin working

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with the communities that have expressed an interest in creating their own community systems.

Perhaps one of the comments from a group of children from Lafayette Charter School who visited The Pepperboy Aquaponics Farm explains it best. The child wrote, “I thought that this field trip was an amazing learning experience. We were able to learn things that were new while still having fun.

My favorite part was learning about how people are able to make, grow and

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The Journal, New Ulm, MN Monday, February 20, 2017

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Acupuncture offers relief to chronic pain sufferers Anyone who has lived with chronic pain knows that it can affect every facet of one’s life. It makes everyday tasks like maintaining a job and raising a family difficult to almost impossible, depending on the pain level.

The acupuncturists at the Penny George Institute for Health and Healing – New Ulm say that chronic pain is one of the most common conditions they treat and that it can often be treated very successfully, with limited risk. Both acupuncturists at the Penny George Institute – New Ulm – Kayla Sweeney and Megan Paulsen – are licensed acupuncturists and oriental medicine practitioners (L.Ac.). This means that they are certified by the National Commission for the Certification of Acupuncture and Oriental Medicine, as well as being licensed in the state of Minnesota.

The Penny George Institute – New Ulm is located in the lower level of the clinic at the New Ulm Medical Center.

Acupuncture uses fine, sterile needles that are inserted into specific points on the body. The needles, Paulsen said, are as thin as a strand of hair or a cat’s whisker. They are solid (not

hollow as some mistakenly believe), surgical-grade, sterile stainless steel. They are used once and thrown away.

“Many of the chronic pain conditions that we treat include things like headaches or migraines, fibromyalgia, joint pain, menstrual pain, and plantar fasciitis,” Sweeney said.

With most types of pain treated with acupuncture, the patient doesn’t need to be having active pain to be treated for it.

“Our primary goals are to reduce the intensity and frequency of the pain,” Sweeney said. “For most patients, they come in once a week at first, and then we reassess the pain after four to six treatments. The goal is to feel better all the way to the next treatment. Once that is achieved, we can back it off to every other week.”

Patient Amber Coil can attest to the success possible with acupuncture. Due to a painful condition called endometriosis – in which the tissue that normally lines the inside of the uterus grows outside the uterus – Coil suffered years of chronic pain.

Between the endometriosis, the scar tissue resulting from surgeries to remedy the endometriosis, and fertility

Megan Paulsen, L.Ac.

Kayla Sweeney, L.Ac.

surgeries, Coil endured eight surgeries within a few years.

One time she had thoracic surgery because her endometriosis was severe and covered her diaphragm.

“The pain was to the point that they were going to send me to a pain clinic, which would’ve meant weekly trips to the Twin Cities,” Coil said. She had tried acupuncture a few years earlier and hadn’t found much relief but decided to give it another try, which turned out to be a great decision.

“My pain level is the best it’s been in years,” Coil said.

She is combining

acupuncture with chiropractic and massage therapies. She initially began having acupuncture once a week, then went down to every two weeks and now has a treatment every three or four weeks. “I don’t know ultimately how often I’ll have to go to maintain this level, but if it keeps controlling it as well as it is, I’ll go every month for the rest of my life if I have to.”

Coil said that on the pain scale of 1-10, with 10 being the worst pain, she was consistently at a 7 or 8 before starting acupuncture.

“Now I’m consistently at

about a 1 or 2. Some days I’m at a zero.”

Coil, who is a nurse at the Virginia Piper Cancer Institute – New Ulm, was concerned about trying to control her pain in other ways.

“There are not a lot of great alternatives when it comes to pain. The medications can have damaging side effects and can cause addiction issues,” she said. “It was either that or drive to the Cities to the pain clinic. I didn’t want to go down either of those roads.”

This is a familiar refrain to Sweeney and Paulsen.

“Our patients are often looking for something holistic,” Sweeney said.

“We take the time to look at the entire patient, not just their pain or whatever specific condition we are treating. We address other aspects of their health and daily routines. They are all interconnected.”

In fact, the first visit with an acupuncturist at the Penny George Institute will be 60 to 90 minutes long as the practitioner gathers detailed health and lifestyle information from the patient so as to better treat their concerns.

The subsequent visits are usually 30 to 60 minutes.

Once the acupuncture points are placed, the patient rests for about 30 minutes. While the needles are placed, it is common to have some sensation at the point. This can include a slight pinch like a mosquito bite, warmth, or a heavy sensation. Most people describe the process to be very relaxing and even sleep while the points are retained.

It is also within their scope of practice as acupuncturists to incorporate additional techniques such as electrostimulation (a nonpainful electrical pulse sent through the needles), Tui Na (Chinese medical massage), or other forms of care based on the specific needs of each individual patient.

Patients have the option to pay for services out of pocket or through insurance.

If the patient’s insurance covers acupuncture care, in most cases they must have a provider’s referral for acupuncture to be covered by insurance, and Sweeney and Paulsen urge all patients to contact their own insurance company to be sure about their coverage.

To make an appointment with either Kayla Sweeney, L.Ac., or Megan Paulsen, L.Ac., call 507-217-5307.

Psoriasis is more than just a skin condition For those who have never suffered from psoriasis, it’s easy to think of it as just a skin condition, little more bothersome than eczema.

However, psoriasis is a chronic inflammatory skin disease that can be associated with other diseases such as inflammatory bowel disease, heart disease, diabetes, obesity and metabolic syndrome. 7.5 million people in the United States have psoriasis.

Psoriasis can present itself as a red, itchy rash, sometimes with silvery scale, said Dermatologist Rachel Qualley, MD, who sees patients at the New Ulm Medical Center clinic every Monday. Sometimes the rash

Rachel Qualley, MD

will itch, crack or bleed.

Most sufferers have localized psoriasis, which

means they have isolated patches on their scalp, hands, feet, elbows, knees, and so on.

“Unfortunately, some people fall into the category of generalized psoriasis, which means they can have over 80 percent or more of their body surface involved,” Qualley said.

“Sometimes those patients suffer in silence, and they just never leave their homes.”

While the rash itself can be embarrassing because it’s unsightly, the more body surface it covers, the more important it is for a patient to be seen and monitored because of all the other co-morbid conditions that accompany generalized

psoriasis.

The good news is that treatment options for psoriasis are better than ever.

“We used to have just phototherapy and pills that had some undesirable side effects,” she said. Now we have injectable medicines that have greater effectiveness, far fewer side effects, and less need for blood test monitoring than previous medications, she said.

For localized psoriasis, creams will often help clear a flare-up. Once a person has psoriasis, they will always have it, Qualley said, although there is no cure, the medications and creams can help manage the condition.

Treating generalized

psoriasis can be more challenging, however, there’s good news there, also.

“The new treatments for generalized psoriasis are being shown to clear up about 70 percent of the troubled area within a 6- to 8-week time period,” she said. “Some of the studies are showing up to 90 percent clearing, which is really promising.

The new injectable medications are far more effective than what we’ve had available before, with less toxicity.”

Another common condition associated with psoriasis is arthritis, or psoriatic arthritis, which can cause pain or stiffness in and around the joints. Even those

with localized psoriasis can suffer from psoriatic arthritis. 40 percent of patients with psoriasis can have associated psoriatic arthritis.

There is no known cause of psoriasis, but there are certain triggers that can cause flare-ups once a person has the condition.

Triggers such as stress, recent infection (especially strep throat), cold weather, or anything that affects the body’s immune system.

“Smoking is a big trigger,” Qualley said, “especially for pustular psoriasis on the hands and feet.”

Psoriasis Continued on page 5H

Best ways to use MyChart’s popular functions Since New Ulm Medical Center (NUMC), part of Allina Health, implemented MyChart more than ten years ago, the online medical record tool has grown and improved, offering more features every year. In fact, MyChart is now part of the larger, more comprehensive My Account.

Some of the more popular features are the ability to schedule or cancel appointments at any time of the day or night; send a medical message to your provider; view test results, immunizations and more; refill prescriptions at an Allina Health Pharmacy; and view and pay bills online.

With all those available features, however, there can be confusion about do’s and don’ts, as well as the most effective way to use some of the functions.

“One of the biggest changes we’ve seen recently is that, due to an upgrade in the software, some of the more common lab test results are released automatically to patients at 6 a.m. and 6 p.m.

every day, whether the provider has had a chance to review them or not,” said Clinical Systems Educator Lori Burkhart, RN. “That can sometimes mean that a patient is looking at results without any clarifying comments from his or her provider. Rest assured, your provider will review your results and get back to you.”

Not all results are auto-released, however.

Radiology and pathology tests are not auto-released as well as sensitive test results like those for sexually transmitted diseases, Hepatitis, HIV, and cancer. More than 100 of the most common lab tests are auto-released.

Another commonly misunderstood function is Medical Messaging, Burkhart said. This feature can be tremendously useful for communication between a patient and provider for things like follow-up questions following an office visit; a request for a referral; sending results of home monitoring, and questions about

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Medical Messaging should not be used as if it is an e-mail account, however. All the messages sent through Medical Messaging are saved in the patient’s medical record.

Often, patients will send medication refill requests through Medical Messaging, which is also not appropriate.

There is a medication refill

function within the “Medications” tab in MyChart that allows patients a quick and easy way to request refills if they fill their medications at the Allina Health Pharmacy on the NUMC campus.

If a patient refills their medications at any other pharmacy in the area, all they need to do is call the pharmacy directly to ask for a

refill and the pharmacy will contact the patient’s provider.

Another common misunderstanding, Burkhart said, is that a parent sending a Medical Message for their child must sign in to their child’s account through “proxy” access.

Additionally, patients should understand that Medical Messages do not go directly to the provider, but

rather through a nurse pool at NUMC. “If the provider is out of the office, the nurse is then able to move that message along to the provider on call so that there is no gap in service for the patient,” Burkhart said.

The communications features of MyChart are

MyChart Continued on page 5H

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The Journal, New Ulm, MN Monday, February 20, 2017 5H

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The benefits of practicing gratitude

Allina Health Assessment and Referral is a hospital-based menatal health service that responds to patients who experience a crisis related to mental health. If an Emergency Department (ED) physician determines that the Assessment and Referral process should be implemented, the patient will then have a face-to-face meeting with a masterʼs degree level mental health professional through the EDʼs telehealth service (pictured here).

Assessment From page 6H hours to make calls to up to 20 facilities looking for a bed,” Halvorson said. “This removes that additional work from our ED staff so they can focus on other patients who are in the department.”

Similarly, in the past, nurses from the inpatient mental health unit would go to the ED to assess the patient and provide a recommendation for the ED

provider on the patient’s disposition.

Since the addition of Assessment and Referral services, the mental health nurses do not have to go the ED to meet with the patient, taking time away from patients in their department.

Once the assessment is done, a plan will be made by the ED health care team to help the patient receive the right level of care. The

possibilities may include any of the following: • Admission to the hospital • Transfer to another hospital • Return home with a crisis plan in place • Referral to a mental health provider at an outpatient clinic • Referral to a day treatment or partial hospital program

• Giving information about additional resources The length of time that it takes for the assessment and referral process will vary for each patient. Assessment and Referral staff are based in the Twin Cities and, at any one time, are helping find mental health beds for multiple patients from around the state.

Hope Fund available for breast cancer patients Dealing with breast cancer can be challenging enough without the additional financial burden that can result from cancer treatment.

New Ulm Medical Center Foundation (NUMCF) is pleased to offer a new fund to assist people who are actively receiving care for breast cancer. The Hope Fund is financed through the support of the Minnesota Affiliate of Susan G. Komen for the Cure and is available only for patients with breast cancer, not other kinds of cancer.

Active treatments for breast cancer include chemotherapy, radiation, bone marrow transplant, surgery, lymphedema therapy, cording therapy (treatment of scar tissue in the armpit), hospice, and palliative care. “The New Ulm Medical Center Foundation is happy to be partnering with other Allina Health facilities, including Buffalo Hospital, Cambridge Medical Center and Owatonna Hospital, to make these funds available to breast cancer patients in need,” NUMCF Director Missy Dreckman said.

“Between the four facilities, we have funds available through a grant from the Susan G. Komen for the Cure fund.”

The Hope Fund offers emergency financial

New Ulm Medical Center Foundation Director Missy Dreckman

assistance to help with basic living expenses such as mortgage, rent, car payments, heat, electricity, other utilities, food, and gas.

The Hope Fund began in 2011 when the Susan G. Komen Minnesota Affiliate worked with the Cambridge Medical Center Foundation.

It was expanded shortly thereafter to include communities served by Buffalo and Owatonna Hospitals. In 2017, it has expanded again to include the New Ulm Medical Center service area.

The 17 counties that make up the primary service areas of these four facilities are all rural Minnesota

counties that tend to have higher than average poverty rates.

“Many patients diagnosed with breast cancer in these counties are uninsured, under-insured, self-employed, or heads of single parent households,” Dreckman stated.

“We want to help patients with a breast cancer diagnosis understand they have a local resource when this devastating diagnosis prevails,” Dreckman said.

It can take up to a few weeks for each application to be processed. The check will be issued and mailed directly to the creditor. A check cannot be made out to an individual.

“We are so excited to be able to offer this to our patients,” Dreckman said. “It is similar to the Patient Assistance Fund that we’ve had available for years. Any patient with qualifying financial strain can apply to receive funds, and we’ve seen firsthand what a tremendous impact it has had on patients and their families.”

The application for the Hope Fund can be picked up at the New Ulm Medical Center in the Virginia Piper Cancer Institute – New Ulm, or online at allinahealth.org/newulm (Foundation tab).

Psoriasis From page 4H Psoriasis is hard to manage on one’s own, Qualley said. Because of associated conditions, when it comes to psoriasis, a doctor’s visit tends to be quite long, as the physician will ensure that other concerns are monitored.

“Sometimes patients with generalized psoriasis (large surface area) will be frustrated because their insurance will require them to try other kinds of treatments before allowing them to try the newer injectable medications,” Qualley said. “But in the

long run, if those other medications do not work, the insurance companies will generally cover them, and they work quite well.”

Patients who have had cancer, tuberculosis, multiple sclerosis, or viral hepatitis may not qualify for certain medications. Patients will be tested for some of these conditions before starting on those medications.

To make an appointment with Dr. Qualley at New Ulm Medical Center, call 507-217-5011.

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

It was written by Melissa Kennedy, PA-C, a certified physician assistant practicing family medicine in Buffalo, MN. Have you ever asked yourself, “What am I truly grateful for in my life?” If so, you may already be practicing gratitude. If this isn’t a common practice of yours, this may be a good time to start. Gratitude helps us realize what we have.

Being aware of what we’re grateful for can decrease our tendency to want more all the time. Plus, gratitude helps us see our situation in a way that opens up our thinking to new solutions.

Research has proven the positive benefits of practicing gratitude. Daily gratitude sessions can improve your alertness, enthusiasm, determination, optimism and energy levels. You may also experience: • less depressed thoughts • less stress, worry, anxiety • progress toward personal goals • a willingness to help others • a desire to exercise more regularly Practicing gratitude can become a positive habit, but only with continued practice.

Here are a few tips to help you make it a part of your daily routine.

Start small: Write in a gratitude journal for as little as five minutes a day, three times a week. This practice will help you to be thankful for what you have. The more you learn to appreciate all that you already have, the more fulfilled you

will become.

Keep your journal close by: Buy a small journal to keep at your bedside or find apps for your mobile device. I like Gratitude 365 or Gratitude to Bliss. This will make it easy to jot down a few thoughts whenever it’s convenient.

Practice, practice, practice: Take a few minutes each day to write three positive thoughts about your day or what you are thankful for. This practice has the potential to change your life!

Express gratitude toward others: You may even want to go beyond writing in a gratitude journal and express your gratitude toward others. This can be done by writing a gratitude letter and mailing it, or even more powerful, calling someone to share why he or she makes you feel grateful. You not only will make the recipient joyful, but this act will significantly increase your own happiness.

Share with children: Sharing this practice with children is extremely impactful.

Research indicates children who are shown how to have an attitude of gratitude actually achieve greater life success.

They get better grades, are more pro-social and get more involved in their communities.

Ultimately, the research tells us they lead happier, healthier lives. You may even want to encourage older children to have their own gratitude journals or engage younger children in this practice by talking about it over dinner or bedtime routines. Children learn by example, so if they see you doing this, they are more likely to incorporate this practice themselves.

MyChart From page 4H definitely one of the more powerful functions of the system. Which is why, if a patient has signed up for MyChart, that is the sole method that their provider will use to communicate with them, unless it’s something urgent or critical. It’s crucial that patients check their e-mail inbox if they have signed up for MyChart and they are expecting a test result or an appointment reminder. It’s also important that the patient keeps their e-mail address up-to-date in “My Settings” within their MyChart account so that those messages can reach them.

Other MyChart benefits

and helpful tips that Burkhart recommended include: A toll-free number is available Monday through Friday, 8 a.m. to 8 p.m. for technical assistance: 866-301-6698.

The MyChart mobile app for Apple and Android devices makes it easy to take all these features on the go with you.

A person can gain proxy access to an elderly parent’s MyChart information if they are involved in that parent’s care.

For more information or to sign up for My Account and MyChart, go to Account.Allinahealth.org.

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The Journal, New Ulm, MN Monday, February 20, 2017

www.nujournal.com

Video answers questions about joint replacement The decision to move ahead with a total joint replacement is not an easy one. Many patients may have a fear of the unknown. What will the process be like? How long will it take? Who will support me in my recovery period? New Ulm Medical Center (NUMC) recently created a four-minute video to answer all these questions and more. The video follows patient Katie Senske (pictured at right) from pre-op visits with the orthopedic surgeon through the day of surgery and the hospital stay, and all the way through rehabilitation with the Courage Kenny Rehabilitation Institute – New Ulm. Go to www.allinahealth. org/newulmorthopedics to view the video.

Diabetes classes help patients manage their health Being diagnosed with a chronic condition comes with a set of challenges. One of the most widespread and life-changing chronic conditions is diabetes.

The American Diabetes Association states that approximately 1.4 million Americans are diagnosed with diabetes every year.

That is a large group of people who have to learn to eat differently, track their blood glucose levels, regulate new medications, exercise more and just plain treat their bodies differently than ever before.

The diabetes classes at New Ulm Medical Center are designed to help those who are diagnosed with diabetes to become successful at managing their health with this challenging condition. Participants may have been newly diagnosed or may have lived with diabetes for several years.

The class is run by Registered Nurse Sarah Pugh and Pharmacy Resident Leah Eckstein.

“The goal is for them to leave here with the knowledge of how to make the best choices,” Pugh said.

“It all sounds easy on paper until you get out in the real world.”

The course includes three 90-minute classes, spread out over six weeks.

“We provide an overview of diabetes and different approaches to managing it.

We look at real-life situations, like menus from local restaurants,” Pugh said.

“The class is a small group, so questions can be answered, and the patients can bounce ideas off each other.”

Patients are also encouraged to bring along a significant other, such as a spouse or a caregiver. The classes are usually covered by insurance, though patients are encouraged to check with

Eckstein said. “Everyone is welcome.”

Patients should be referred to the class by their primary care physician, Pugh said. Often, health insurance will cover the cost of the classes, but patients are

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Registered Nurse Sarah Pugh (left) and Pharmacy Resident Leah Eckstein lead the diabetes classes at New Ulm Medical Center. The classes are designed to help those who are diagnosed with diabetes to become successful at managing their health with this challenging condition.

their insurance carrier to confirm.

“My biggest goal is that the patients are able to manage their blood sugar outside of the clinic so that we’re not just being reactive to high blood sugar a couple times per year at clinic visits,” Pugh said. The better diabetic patients can manage their blood sugar, the better their health will be in the long term. Unchecked high blood sugar over a long time can lead to damaged blood vessels, which can lead to loss of feeling in legs and feet, diminished eyesight and reduced kidney function.

“We try to tailor the classes to the group’s needs,” Eckstein said. “Each group has a different set of p e r s o n a l i t i e s , responsibilities, jobs, family needs and so on.”

Food and medications seem to be the biggest topics,

Allina Health Assessment and Referral assists patients experiencing mental health crisis The Emergency Department (ED) at New Ulm Medical Center (NUMC), part of Allina Health, has a new process for getting some of their most vulnerable patients the assistance they need. Allina Health Assessment and Referral is a hospital-based mental health service that responds to patients experiencing a crisis related to mental health. These services are provided in the ED 24 hours a day, seven days a week.

When a patient arrives at the ED with a mental health issue, he or she will be evaluated by a nurse and physician to determine if the Assessment and Referral process will be implemented.

If so, the patient will then have a face-to-face meeting with a master’s degree level mental health professional through the ED’s telehealth service.

“The biggest benefit for patients with this new system is the face-to-face assessment. The patient sees and talks to an expert in the mental health field,” said ED Manager Julie Halvorson.

encouraged to check with their own insurance company.

To find out more about the diabetes classes at NUMC, either talk to your primary care provider or call Sarah Pugh at 507-217-5773.

“Not only does it benefit the patient, but providers across the system like it because they receive a very clear, concise assessment from the clinicians,” said NUMC inpatient Mental Health Manager Mary Shupe.

When the initial assessment is done, the evaluator may contact additional people in the patient’s life (spouse, parent, teacher, counselor, etc.) to round out the assessment.

The evaluator will then make a recommendation to the ED physician.

“If the patient needs to be admitted, Allina Assessment and Referral will work on placement,” Halvorson said.

They will start by trying to find an open bed in a nearby hospital. If a bed is not available locally, they will then connect with other Allina Health facilities and, after those options are exhausted, reach out to facilities outside the system.

“In the past, it could take ED staff or our social worker

Assessment Continued on page 5H

Pugh and Eckstein agreed.

“In terms of food, we can look at real-life situations, like reviewing menus from local restaurants and what might be the best choices for a diabetic patient,” Pugh said. “It can be surprising because you may think if you pick this salad, it’ll be a good choice, but it may turn out to have more carbs than you think.”

The class becomes almost like a support group, too, in which participants can trade recipes that they’ve found or share strategies that have worked for them.

“Medications is a popular topic, also,” Eckstein said.

“We talk about things like dosing, timing, or why something isn’t working the way we thought it would.”

The class participants come from a wide range of personal experience when it comes to their common

diagnosis.

“We’ve had people that are on no medications to those who’ve been on insulin for ten or more years,”

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